JANA L. WRIGHT, Employee, Claimant,
v.
STATE OF ALASKA, Self-Insured Employer, Defendants.
AWCB Decision No. 19-0020
AWCB No. 201604175
Alaska Workers’ Compensation Board
February 20, 2019
FINAL DECISION AND ORDER
Kathryn Setzer, Designated Chair
Jana L.
Wright’s (Employee) September 12, 2016 claim was heard
on January 22, 2019 in Juneau, Alaska, a date selected on
November 27, 2018. A June 20, 2018 affidavit of readiness for
hearing gave rise to this hearing. Employee appeared
telephonically, represented herself and testified. Attorney
Adam Franklin appeared and represented State of Alaska
(Employer). Witnesses included Brian Baehr and Kitty
Angerman, who testified telephonically for Employee. Employee
sought an order keeping the record open to submit additional
medical records. An oral order sustained Employer’s
objection to this request. The record closed at the
hearing’s conclusion on January 22, 2019. This decision
examines the oral order and addresses Employee’s claim
on its merits.
ISSUES
Employee
requested the hearing record be left open so she could submit
additional medical evidence. Employee contended she continued
to seek medical care for her work injury before and after the
date the hearing evidence record closed. Employee contended
Employer failed to file the medical evidence and the Alaska
Workers’ Compensation Division (division) failed to
obtain the medical evidence.
Employer
opposed admission of additional medical evidence. Employer
contended Employee was informed about the hearing evidence
deadline and the process for submitting medical records.
Employer contends acceptance of additional medical evidence
would be prejudicial to Employer. Employer contends Employee
failed to provide good cause for her failure to file
additional medical evidence. At hearing, an oral order issued
denying Employee’s request to leave the record open.
1)
Was the oral order denying Employee’s request to leave
the hearing record open to file additional medical records
correct?
As a
preliminary issue, the parties stipulated the issue for
hearing is whether Employee’s work for Employer is the
substantial cause of her disability and need for medical
treatment. Employee contends she developed reactive airway
disease after exposure to chemicals while working for
Employer. She contends her work for Employer is the
substantial cause of her disability and need for medical
treatment. Employee seeks an award of permanent total
disability (PTD) and medical benefits.
Employer
contends Employee’s work with Employer is not the
substantial cause of her disability and need for medical
treatment. Employer contends the weight of the evidence does
not support finding Employee’s work for Employer was
the substantial cause of her reactive airway disease.
Employer contends Employee’s non-work related
preexisting asthma is the substantial cause of her disability
and need for medical treatment. Employer requests an order
denying Employee any additional benefits.
2)
Is Employee’s work for Employer the substantial cause
of her disability and need for medical treatment?
FINDINGS
OF FACT
A
preponderance of the evidences establishes the following
facts and factual conclusions:
1) On
August 17, 2015, Employee reported coughing, wheezing and
malaise for the prior three days. An examination revealed a
prolonged respiratory phase with faint wheeze. Employee was
diagnosed with tobacco abuse disorder and asthmatic
bronchitis. She was encouraged to stop smoking and prescribed
a Z-pack and albuterol inhaler. (Paul Weinberg, MD, Medical
Report, August 17, 2015).
2) On
November 30, 2015, Employee complained of a moderate
productive cough lasting four weeks and gradually worsening.
She is a smoker and has a sick family member. Lying down and
exertion aggravated her symptoms, which included dyspnea,
post-nasal drainage, rhinorrhea, sinus pressure, sore throat
and wheezing. A physical examination revealed mild wheezing.
Employee was diagnosed with acute bronchitis and was
prescribed Zithromax, prednisone and albuterol. (Denise
McPherson, ARNP, Medical Report, November 30, 2015).
3) On
December 8, 2015, Employee described a nonproductive cough
for one month and reported dyspnea. Employee completed
antibiotics and felt better but still had a lingering cough.
She used the albuterol inhaler when she went for a walk and
it helped. A physical exam revealed mild wheezing. After an
albuterol nebulizer treatment, her wheeze cleared. Employee
was prescribed Flovent. (Denise McPherson, ARNP, Medical
Report, December 8, 2015).
4) On
February 5, 2016, Employee described a productive cough
lasting five days and reported chills, cough, dyspnea,
fatigue, fever, nasal congestion, night sweats, rhinorrhea,
sinus pressure, sore throat and wheezing. An examination of
her respiratory system revealed cough and mild wheezing.
Employee was diagnosed with acute bronchitis and prescribed
Augmentin. She was excused from work on February 5 and 6,
2015. (Denise McPherson, ARNP, Medical Report, February 5,
2016).
5) On
March 14, 2016, Employee reported trouble breathing and a
non-productive cough aggravated by chemicals while working
for Employer on the M/V Kennecott as a cashier. (Employee
First Report of Occupational Injury or Illness, March 14,
2016).
6) On
March 14, 2016, Employee visited the emergency room at
Ketchikan General Hospital for a dry cough starting three
days ago. Employee reported trouble breathing. She was
diagnosed with a viral infection and instructed, “No
strenuous activity. Rest. Return to work when better. ([W]ear
a mask at work).” Employee was prescribed an albuterol
inhaler, Robitussin AC, and Tessalon perles. (Emergency Room
Medical Report, March 14, 2016).
7) On
March 16, 2016, Employee followed up with Donna Paul, ARNP,
for ongoing chest congestion and cough. Employee reported
mild intermittent episodes of shortness of breath worse at
night and a persistent cough beginning three months ago. ARNP
Paul assessed asthma exacerbation, cough and smoking history
greater than 30 pack years. ARNP Paul noted:
Unfortunately patient presents with an extended history of
cough. 11/30 she was seen by acute care and treated for
bronchitis with prednisone and Z-Pak. She was instructed to
return to the clinic in 10 days if not improved. She did
return to the clinic at that time for persistent cough but
again saw the acute care provider and not her PCP. She was
given an inhaled steroid and was told to follow up with her
PCP in 2 weeks if she was still having an issue. Patient
reports that she will use the albuterol but that she is not
using the inhaled steroid because it is “scary”
– chest x-ray at that time was negative. Patient had
thought that she had improved but was seen again in acute
care 2/5/2016 with a flare of her bronchitis and a secondary
ear infection which was treated with albuterol and Augmentin.
She returned to work on the ferry and found herself becoming
more and more [short of breath] - especially at night. She
had a roommate with a humidifier and it got a lot worse when
she moved to another room. She left the boat that morning on
3/14/2016 and was seen in the ER in [Ketchikan]. Normal EKG
and chest x-ray -she was instructed to follow through with
her PCP and was given 2 forms of cough suppressant. She needs
a work excuse today. . . . The good news is that patient has
stopped smoking about 1 week ago because of this cough.
Employee’s
physical examination revealed wheezing. She was treated with
nebulized albuterol. Employee was prescribed prednisone and
albuterol. (Paul Chart Note, March 16, 2016).
8) On
March 21, 2016, Employee followed up with Lynn E. Prysunka,
MD, for respiratory issues. Employee reported ongoing cough,
wheezing, shortness of breath and right ear pain. Dr.
Prysunka diagnosed mild intermittent asthma beginning months
ago, aggravated by airborne chemicals and respiratory
infections and noted Employee’s family history of
brittle severe asthma. She stated Employee “did not
really have symptoms of this until a viral infection last
fall. Recently Employee’s job on the ferry exposed her
to fumes while cleaning. Her symptoms have improved now but
she continues to feel short of breath and wheezy with
moderate activity.” Employee used both nebulized and
metered doses of albuterol. Employee’s examination was
fairly normal. Dr. Prysunka took Employee off work for
another week and scheduled reevaluation on March 28, 2016.
(Prysunka Chart Note, March 21, 2016).
9) On
March 28, 2016, Dr. Prysunka...
