BRIDGET FINLEY v. DBM TECHNOLOGIES; HON. DONNA H. TERRY, ADMINISTRATIVE LAW JUDGE; AND WORKERS' COMPENSATION BOARD
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RENDERED:
JANUARY 26, 2007; 10:00 A.M.
TO BE PUBLISHED
Commonwealth Of Kentucky
Court of Appeals
NO. 2006-CA-001132-WC
BRIDGET FINLEY
APPELLANT
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS’ COMPENSATION BOARD
ACTION NO. WC-02-96021
v.
DBM TECHNOLOGIES; HON. DONNA H. TERRY,
ADMINISTRATIVE LAW JUDGE; AND WORKERS'
COMPENSATION BOARD
APPELLEES
OPINION
VACATING AND REMANDING
** ** ** ** **
BEFORE:
DIXON AND TAYLOR, JUDGES; KNOPF,1 SENIOR JUDGE.
TAYLOR, JUDGE:
Bridget Finley petitions this Court to review an
opinion of the Workers’ Compensation Board (Board) entered April
28, 2006, affirming a decision of the Administrative Law Judge
(ALJ) to deny Finley’s claim for income and medical benefits
related to the arousal of her congenital scoliosis but awarding
income and medical benefits related solely to her work-related
back injury.
1
For the reasons stated, we vacate and remand.
Senior Judge William L. Knopf sitting as Special Judge by assignment of the
Chief Justice pursuant to Section 110(5)(b) of the Kentucky Constitution and
Kentucky Revised Statutes 21.580.
Finley was hired as a machine operator at DBM
Technologies (DBM) in August 2001.
On January 30, 2002, Finley
lifted a box weighing approximately thirteen pounds and squatted
down to place it on the floor.
Finley was immediately unable to
stand upright due to pain in her lower back.
The record indicates Finley unsuccessfully attempted
to return to work.
Finley experienced back pain, right hip
pain, and numbness and tingling in her right leg and foot.
On
February 14, 2002, the severity of Finley’s leg numbness
allegedly caused her to fall at work.
According to the uncontradicted medical evidence,
Finley also suffered from a congenital deformity of the spine
known as scoliosis.
Additionally, as pointed out by the Board,
it was “undisputed that Finley’s scoliosis was a dormant
abnormality at the time of her work-related injury.”
Before the
injury on January 30, 2002, Finley’s congenital scoliosis was
both asymptomatic and required no treatment.
It was also
undisputed that the work injury aroused the scoliosis into a
disabling reality.
To remedy her back injury and scoliosis, Finley
underwent two surgical procedures.
On January 2, 2003, Dr.
George Raque performed right L5-6 and L6-S1 laminotomies upon
Finley.
And, on October 30, 2003, Dr. Steven Glassman performed
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a complicated L4-S1 fusion upon Finley.
After these surgeries,
Finley still reported back and leg pain.
Eventually, Finley filed a claim for workers’
compensation benefits.
Therein, Finley claimed to be totally
disabled as a result of the work injury and sought both income
and medical benefits.
By opinion entered December 20, 2005, the ALJ
concluded:
Based upon the above medical history and the
opinions of Dr. [Robert B.] Nickerson and
Dr. [Robert] Clendenin, the Administrative
Law Judge finds that the scoliosis was a
pre-existing condition which was exacerbated
by the January 30, 2002 work injury.
However, the Administrative Law Judge
further finds that the(sic) Dr. Clendenin
has provided the most accurate and
authoritive view of the relationship of the
pre-existing scoliosis, the work injury, and
the two subsequent surgeries. Dr. Clendenin
opined that the work injury exacerbated the
pre-existing congenital deformity, causing
an L5-S1 disc protrusion to the right and
resulting in radicular pain and requiring
the January 2, 2003 L5-S1 diskectomy and
decompression surgery.
Dr. Glassman, the treating orthopedic
surgeon, reported that the subsequent fusion
surgery was performed to correct the
congenital malalignment of Ms. Finley’s
lumbosacral spine. Based upon the expert
opinion of Dr. Clendenin, it is found that
Ms. Finley’s January 2, 2003 surgery was the
result of the work-related injury, but that
the lumbar fusion and all subsequent medical
treatment was for treatment and revision of
the pre-existing congenital deformity,
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rather than for the cure and relief of the
work injury.
Similarly, the reasonableness and
necessity of the medical treatment afforded
Ms. Finley should be apportioned in like
manner. The January 2, 2003 surgery was
reasonable and necessary for treatment of
the work injury, but the subsequent fusion
surgery was not reasonable or necessary
treatment for that injury. Therefore, DBM
shall be liable for payment of all medical
expenses arising from the January 2, 2003
injury and for treatment prior to the fusion
surgery. The lumbar fusion surgery changed
some of her symptomatology, and it cannot be
found that the surgery, post-surgical
treatment, or other medical expenses for
treatment of either the effects of the
fusion surgery or the treatment of scoliosis
are the responsibility of DBM.
. . . .
In this case, the Administrative Law Judge
adopts Dr. Clendenin’s expert opinion that
the work injury resulted in a 10% permanent
impairment under the most recent edition of
the AMA Guides, and that the remainder of
her impairment rating is nonworkrelated. . . .
The ALJ specifically found that the scoliosis was a
“pre-existing condition.”
The ALJ also found that the
laminotomies were reasonable and necessary for the treatment of
the work-related injury.
However, the ALJ found that the fusion
surgery was solely for the treatment of the pre-existing
congenital scoliosis “rather than for the cure and relief of the
work injury.”
Ultimately, the ALJ held that Finley was not
entitled to recover medical expenses related to the fusion
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surgery.
In particular, the ALJ held that “DBM shall be liable
for payment of all medical expenses arising from the January 2,
2003, injury and for treatment prior to the fusion surgery.”
Upon the extent of Finley’s work-related impairment,
the ALJ assessed a ten percent permanent impairment rating and
viewed the remainder of her impairment as nonwork-related.
In
reaching this conclusion, the ALJ specifically relied upon the
expert opinion of Dr. Clendenin, who performed an independent
medical examination of Finley.
Although not referenced in the ALJ’s opinion, Dr.
Clendenin believed that Finley actually qualified for a twentythree percent permanent impairment rating.
Dr. Clendenin
apportioned ten percent as caused directly by the work-related
injury and thirteen percent as caused by the congenital
scoliosis.
Being unsatisfied with the award, Finley sought review
with the Board.
By opinion entered April 28, 2006, the Board
affirmed the ALJ’s award.
Finley contends that the permanent impairment and
medical expenses directly attributable to her congenital
scoliosis are compensable.
Finley asserts her congenital
scoliosis constitutes a pre-existing dormant condition that was
permanently aroused into a disabling reality by the work-related
injury; thus, any permanent impairment or medical expense
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incurred as a result of such arousal is compensable.
Finley
stresses that her congenital scoliosis was both asymptomatic and
non-disabling prior to the work-related injury.
It was only
after the work injury that the dormant condition became active
and required treatment.
Finley argues the evidence compels a
finding that the congenital scoliosis was permanently aroused by
the work-related injury.
On appellate review, the ALJ’s findings of fact are
entitled to considerable deference and will not be set aside
unless the evidence compels a contrary finding.
Peabody Coal Co., 882 S.W.2d 676 (Ky. 1994).
Bullock v.
However, the ALJ’s
and the Board’s application of the law are reviewed de novo.
Combs v. Gaffney, 282 S.W.2d 817 (Ky. 1955); Hardy Burlingham
Min. Co. v. Hart, 238 Ky. 589, 38 S.W.2d 460 (1931); Sears
Roebuck & Co. v. Dennis, 131 S.W.3d 351 (Ky.App. 2004).
It is well-established that the work-related arousal
of a pre-existing dormant condition into disabling reality is
compensable.
McNutt Constr./First Gen. Servs. v. Scott, 40
S.W.3d 854 (Ky. 2001).
In its opinion, the Board correctly and
succinctly set forth the law upon compensability of a preexisting dormant condition:
What then is necessary to sustain a
determination that a pre-existing condition
is dormant or active, or that the arousal of
an underlying pre-existing disease or
condition is temporary or permanent? To be
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characterized as active, an underlying preexisting condition must be symptomatic and
impairment ratable pursuant to the AMA
Guidelines immediately prior to the
occurrence of the work-related injury.
Moreover, the burden of proving the
existence of a pre-existing condition falls
upon the employer. Wolf Creek Colleries v.
Crum, 673 S.W.2d 735, 736 (Ky.App. 1984).
Alternatively, where the underlying
pre-existing disease or condition is shown
to have been asymptomatic immediately prior
to the work-related traumatic event and all
of the employee’s permanent impairment is
medically determined to have arisen after
that event – due either to the effects of
the trauma directly or secondary to medical
treatment necessary to address previously
nonexistent symptoms attributable to an
underlying condition exacerbated by the
event – then as a matter of law the
underlying condition must be viewed as
previously dormant and aroused into
disabling reality by the injury. Under such
circumstances, the injured employee must be
compensated not just for the immediate
physical harm acutely produced by the workrelated trauma, but also for all proximate
chronic effects corresponding to any
contributing pre-existing condition,
including any previously dormant problem
strictly attributable solely to congenital
or natural aging processes, as it relates to
the whole of her functional impairment and
subsequent disability rating, including
medical care that is reasonable and
necessary pursuant to KRS 342.020.
The arousal of a pre-existing dormant
condition into disabling reality may be
considered temporary when, upon attaining
maximum medical improvement, the employee
post injury fully recovers and reverts to
her pre-injury state of health. However,
where the trauma or the underlying preexisting defect exacerbated by the trauma
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results in a permanent impairment rating
post injury, even though secondary to
surgery or other medical treatment, the
totality of the effects of the employee’s
condition must be judged compensable as a
matter of law.
To summarize, a pre-existing condition that is both
asymptomatic and produces no impairment prior to the workrelated injury constitutes a pre-existing dormant condition.
When a pre-existing dormant condition is aroused into disabling
reality by a work-related injury, any impairment or medical
expense related solely to the pre-existing condition is
compensable.
A pre-existing condition may be either temporarily
or permanently aroused.
If the pre-existing condition
completely reverts to its pre-injury dormant state, the arousal
is considered temporary.
If the pre-existing condition does not
completely revert to its pre-injury dormant state, the arousal
is considered permanent, rather than temporary.
With these
legal principals in mind, we shall undertake a review of the
ALJ’s award.
The ALJ specifically found that “the scoliosis was a
pre-existing condition which was exacerbated by the January 30,
2002, work injury.”
The ALJ, however, failed to make specific
findings of fact upon whether the congenital scoliosis was a
dormant condition and whether the scoliosis was temporarily or
permanently aroused by the work-related injury.
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Given that the
medical evidence was undisputed, we believe the ALJ was
compelled to find that the scoliosis constituted a pre-existing
dormant condition.
See Powell v. Winchester Garment Co., 312
Ky. 38, 226 S.W.2d 341 (1950); Melcher v. Drummond Mfg. Co., 312
Ky. 588, 229 S.W.2d 52 (1950).
As to whether the scoliosis was temporarily or
permanently aroused, a review of the record reveals that the
medical evidence overwhelmingly demonstrated that Finley’s
scoliosis was permanently aroused and resulted in permanent
impairment.
However, one medical expert, Dr. Michael Best,
opined that Finley’s scoliosis was only temporarily aroused but
then inexplicably assigned a five percent permanent impairment
rating due to the scoliosis.
In any event, we conclude that the ALJ erroneously
failed to make an essential finding of fact upon whether
Finley’s pre-existing dormant scoliosis was temporarily or
permanently aroused by the work-related back injury.
As a
reviewing body, neither we nor the Board should attempt to
supplant such a finding of fact.
See Bright v. American
Greetings Corp., 62 S.W.3d 381 (Ky. 2001); Aden Min. Co. v.
Hall, 252 Ky. 168, 66 S.W.2d 41 (1934); Rudd v. Ky. Mfg. Co.,
574 S.W.2d 928 (Ky.App. 1978).
We would also caution the ALJ
that the scoliosis must have completely reverted to a dormant
state to support a finding of temporary arousal.
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Upon remand, the ALJ should reconsider the evidence as
a whole and make a finding of fact upon whether Finley’s preexisting scoliosis was temporarily or permanently aroused by the
work-related back injury.
If the ALJ finds that the scoliosis
was permanently aroused, Finley would be entitled to recover
benefits for any medical treatment and for any permanent
impairment directly attributed to the arousal of the scoliosis.
On the other hand, if the ALJ finds that the scoliosis was
merely temporarily aroused, Finley would be entitled to only
recover benefits for medical treatment of the scoliosis while
temporarily aroused but would not be entitled to recover
benefits for medical treatment thereafter.
Under the later
scenario, Finley would not recover benefits for permanent
impairment attributed to the scoliosis because no such
impairment would exist.
For the foregoing reasons, the opinion of the Workers’
Compensation Board is vacated and this cause remanded for
proceedings consistent with this opinion.
ALL CONCUR.
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BRIEF FOR APPELLANT:
BRIEF FOR APPELLEE:
Russ Wilkey
Owensboro, Kentucky
Michael W. Alvey
Owensboro, Kentucky
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