KENTUCKY RETIREMENT SYSTEMS VS. ROBB (LINDA)
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RENDERED: NOVEMBER 25, 2009; 10:00 A.M.
TO BE PUBLISHED
Commonwealth of Kentucky
Court of Appeals
NO. 2009-CA-000437-MR
KENTUCKY RETIREMENT SYSTEMS
APPELLANT
APPEAL FROM FRANKLIN CIRCUIT COURT
HONORABLE PHILLIP J. SHEPHERD, JUDGE
ACTION NO. 07-CI-00557
v.
LINDA ROBB
APPELLEE
OPINION
AFFIRMING
** ** ** ** **
BEFORE: CLAYTON, DIXON, AND THOMPSON, JUDGES.
DIXON, JUDGE: Kentucky Retirement Systems (“KERS”) appeals a decision of
the Franklin Circuit Court reversing KERS’s Board of Trustees’ (“the Board”)
final order denying Linda Robb’s application for disability retirement benefits. We
affirm.
Robb, who was employed as a preschool bus driver for the Kenton
County Board of Education, applied for disability retirement benefits in July 2005,
when she was 62 years old. In her application, Robb stated she suffered from
lumbar disc disease and bilateral osteoarthritis of the knees. Robb opined that she
had decreased mobility, and she experienced chronic pain exacerbated by
prolonged sitting, standing, or walking.
On September 15, 2005, KERS notified Robb that two of the three
KERS medical review physicians recommended denial of her application.1 A short
time later, Robb requested a second review and submitted additional medical
records to support her claims. On March 18, 2006, KERS again notified Robb that
two of the three physicians had denied her application. Thereafter, Robb requested
a formal administrative hearing.
An evidentiary hearing was held August 4, 2006, where Robb was the
only witness. Robb testified that she was required to have a Commercial Driver’s
License (CDL) to drive the school bus, and she was responsible for assisting
preschool students on the bus. Robb stated she began having knee pain in 1995 or
1996, which was treated with cortisone injections for several years. In 2005, Robb
experienced increasing pain in her knees, and in July 2005, she was unable to
renew her CDL because of her mobility issues. On cross-examination, Robb stated
that, although her doctor recommended a total knee replacement, she would have
to lose weight before she could have the procedure. Robb also acknowledged that
1
Pursuant to KRS 61.665(2)(d), three licensed physicians evaluate a claimant’s medical records
and recommend whether to approve or deny disability benefits.
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she had experienced arthritis in her hands in the late 1980s while working at a
bakery, and in 1991, she had swelling in her left lower leg.
The medical evidence submitted by Robb included: 1) more than 400
pages of medical records chronicling her medical care since 1989; and 2) an
independent medical examination report from Dr. Roger Meyer, an orthopedic
surgeon. The record also included the medical reports of the KERS medical
review physicians, Drs. Strunk, Kimball, and McElwain. KERS also tendered,
without objection, three articles from the internet regarding osteoarthritis.
On December 5, 2006, the hearing officer rendered a report and
recommended order denying Robb’s request for disability benefits. The hearing
officer concluded that the objective medical evidence did not support a finding that
Robb was disabled due to her lumbar disc disease.2 The officer further concluded
that Robb’s arthritis was a pre-existing condition, which precluded disability
retirement benefits. Both Robb and KERS tendered exceptions to the hearing
officer’s report. On March 16, 2007, the Board adopted the recommended order,
in part, and substituted its own finding of fact on the issue of Robb’s osteoarthritis
claim:
The medical records reflect that the Claimant was being
treated for arthritis and degenerative joint disease as early
as 1989, prior to her membership. Notations from May
1991 indicate the Claimant had swelling in her left lower
extremity, had been treated for a blood clot and was
suffering from venous insufficiency. Clearly the
Claimant was having difficulty with her lower
2
This finding is not contested on appeal.
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extremities prior to her membership. Further, the records
indicate the Claimant weighed approximately 250 pounds
as of her membership date. At 5’3” tall, the Claimant
would be classified as morbidly obese. It is well
established that excess weight causes stress and wearing
of the joints, especially in the knee. In fact, Claimant’s
physicians have repeatedly advised her to lose weight in
order to reduce the pain and swelling in her knees. The
objective medical evidence confirms that the Claimant’s
knee problems are directly or indirectly related to
preexisting conditions.
Robb then appealed the Board’s decision to Franklin Circuit Court.
On February 11, 2009, the circuit court reversed the Board, concluding that the
medical evidence compelled a finding that Robb did not have a pre-existing
condition that precluded an award of retirement disability benefits. This appeal
followed.
“‘In its role as a finder of fact, an administrative agency is afforded
great latitude in its evaluation of the evidence heard and the credibility of
witnesses, including its findings and conclusions of fact.’” McManus v. Ky. Ret.
Sys., 124 S.W.3d 454, 458 (Ky. App. 2003), quoting Aubrey v. Office of Attorney
Gen., 994 S.W.2d 516, 519 (Ky. App. 1998). As Robb was unsuccessful before
the Board, she is entitled to prevail on appeal only if the evidence in her favor was
“so compelling that no reasonable person could have failed to be persuaded by it.”
Id.
Kentucky Revised Statutes (KRS) 61.600 sets forth the criteria for
disability retirement. The statute requires a determination, based on objective
medical evidence, as to whether “[t]he person, since his last day of paid
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employment, has been permanently mentally or physically incapacitated to
perform the job, or jobs of like duties, from which he received his last paid
employment.” KRS 61.600(3)(a)-(c). However, the claimant’s physical incapacity
cannot “result directly or indirectly from bodily injury, mental illness, disease, or
condition which pre-existed membership in the system . . . [.]” KRS 61.600(3)(d).
KERS contends the circuit court impermissibly re-weighed the
evidence and substituted its judgment for that of the fact-finder. KERS specifically
points out the circuit court addressed issues not raised by either party, including the
admissibility of hearsay evidence. The court disregarded the medical review
physician reports and the internet articles as inadmissible hearsay and relied on a
non-final opinion3 of this Court in its decision.
KERS’s procedural complaints are well-taken, since, “[i]n an appeal
of an administrative action by an agency, the circuit courts are to provide review,
not reinterpretation.” Johnson v. Galen Health Care, Inc., 39 S.W.3d 828, 833
(Ky. App. 2001). Nevertheless, under the circumstances presented here, although
the court may have exceeded the scope of its review, we agree that the evidence
compelled a decision in Robb’s favor.
In its specific findings, the Board asserted that Robb had been
“treated” for arthritis and degenerative joint disease in 1989, prior to her
membership. The full medical record indicates, though, that Robb’s complaint of
3
Kentucky Retirement Systems v. Sizemore, 2007-CA-002591-MR (Nov. 7, 2008), discretionary
review granted March 11, 2009.
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arthritis in 1989 was an isolated event, and there is no correlation between her
complaint of arthritis in 1989 and the subsequent onset of bilateral osteoarthritis of
the knees more than eight years later. Although the medical records from her 1989
office visit lacked specificity as to her arthritic symptoms, Robb testified that,
during that time, she experienced arthritis in her hands due to her employment as a
cake decorator.
Furthermore, the Board noted that Robb sought treatment for a venous
insufficiency in May 1991, and the Board believed that indicated Robb had
suffered “difficulty with her lower extremities prior to her membership.” The
Board is clearly mistaken in this instance, as Robb’s date of membership was
January 1, 1991, and there is no other indication of lower extremity “difficulty”
prior to that date.
Finally, the Board specifically concluded that Robb was morbidly
obese at the time her membership began, which contributed to her subsequent
“knee problems.” Despite the Board’s conclusion that Robb’s obesity constituted a
pre-existing “condition” within the meaning of KRS 61.600(3)(d), there was no
objective medical evidence to support that conclusion. KRS 61.510(33) defines
“objective medical evidence” as:
reports of examinations or treatments; medical signs
which are anatomical, physiological, or psychological
abnormalities that can be observed; psychiatric signs
which are medically demonstrable phenomena indicating
specific abnormalities of behavior, affect, thought,
memory, orientation, or contact with reality; or
laboratory findings which are anatomical, physiological,
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or psychological phenomena that can be shown by
medically acceptable laboratory diagnostic techniques,
including but not limited to chemical tests,
electrocardiograms, electroencephalograms, X-rays, and
psychological tests[.]
At the hearing, Robb acknowledged that she gained weight while
taking anti-depressants and beta-blockers, and she conceded that her treating
physicians encouraged her to lose weight. The record indicates that two of the
three medical review physicians opined that obesity was the causative factor for
Robb’s osteoarthritis, with Dr. Strunk noting Robb’s problems were “almost
certainly due to her severe morbid obesity . . . [.]” However, the record also
indicates that several factors exist in the development of osteoarthritis including
gender, age, weight, heredity, and activity level. Although two of the medical
review physicians inferred that Robb’s weight contributed to the development of
osteoarthritis, we are not persuaded that Robb’s obesity constituted a pre-existing
condition that resulted in her eventual physical incapacity from work pursuant to
KRS 61.600(3)(d).
The record shows that Robb had no complaints of knee pain until
1996, and she began cortisone injections for knee pain in December 1999.
Ultimately, in November 2004, she was diagnosed with end-stage degenerative
arthritis in her right knee and moderate-severe arthritis in her left knee. In
Kentucky Convalescent Home v. Henry, 463 S.W.2d 328 (Ky. 1971), a workers’
compensation decision, the Court addressed whether obesity constituted a preexisting “disease” for the purpose of apportioning liability to an employer.
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Although workers’ compensation and Kentucky employees’ disability retirement
benefits are governed by two distinct statutory schemes, we nevertheless find the
logic of the Henry Court illuminating:
Common human experience demonstrates that [obesity]
can and does accentuate the consequences of injury in
given situations, but the same experience also establishes
that the same accentuation of ordinarily expectable
consequences of injury may be caused by general bone
structure or body frame or statu[re].
Id. at 330.
We conclude that, because osteoarthritis may be caused by several
different factors, obesity cannot constitute a pre-existing condition to preclude
retirement disability benefits where there is no objective evidence that Robb
suffered osteoarthritis of the knees prior to her employment in January 1991.
Accordingly, the circuit court properly reversed the Board’s decision, as the
evidence compelled a finding that Robb did not suffer a pre-existing condition, and
she was physically incapacitated from performing her job or a job of like duties.
For the reasons stated herein, we affirm the decision of the Franklin
Circuit Court.
ALL CONCUR.
BRIEFS FOR APPELLANT:
BRIEF FOR APPELLEE:
Leigh A. Jordan
Frankfort, Kentucky
Christopher S. Nordloh
Covington, Kentucky
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