TRIM MASTERS, INC. V. SHAWN CLARK; HON . W. BRUCE COWDEN, JR., ADMINISTRATIVE LAW JUDGE; and WORKERS' COMPENSATION BOARD
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IMPORTANTNO 77CE
NOT TO BE PUBLIS_HED OPINION
THIS OPINION IS DESIGNA TED "NOT TO BE
PUBLISHED. " PURSUANT TO THE RULES OF
CITAIL PROCEDURE PR OMUL GA TED B Y THE
SUPREME COURT, CR 76.28 (4) (c), THIS OPINION
IS NOT TO BE PUBLISHED AND SHALL NOT BE
CITED OR USED AS A UTHORITYIN ANY OTHER
CASE INANY CO URT OF THIS STA TE.
RENDERED : SEPTEMBER 23, 2004
NOT TO BE PUBLISHED
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2003-SC-0664-WC
TRIM MASTERS, INC .
V.
APPELLANT
APPEAL FROM COURT OF APPEALS
2003-CA-56-WC
WORKERS' COMPENSATION BOARD NO. 00-WC-78291
SHAWN CLARK;
HON . W. BRUCE COWDEN, JR.,
ADMINISTRATIVE LAW JUDGE ; and
WORKERS' COMPENSATION BOARD
APPELLEES
MEMORANDUM OPINION OF THE COURT
AFFIRMING
This appeal is from a decision of the Court of Appeals which affirmed the opinion
of the Workers' Compensation Board, which in turn, had upheld the opinion and award
of the Administrative Law Judge of temporary total disability benefits to Clark and the
payment of medical bills.
The questions presented are whether temporary total disability benefits can be
awarded to an individual who was already off work for a nonwork-related cause;
whether the award by the ALJ of medical bills to Dr. O'Neill is erroneous and whether
there is substantial evidence to support an impairment of 13%.
Clark was employed by Trim Masters in May 1999, and in March 2000, she
began suffering from the symptoms of carpal tunnel syndrome. At the time of her injury
she was working as an assembly-line welder . She testified that her job as a welder
required repetitive pushing and pulling of up to 30 lbs. with repetitive wrist
flexion/extension, and the occasional use of vibratory tools . She stated that her job
also involved frequent lifting, pushing and pulling, as well as lifting the finished product
which had an average weight of 15 to 20 lbs . In March 2000, Dr. Rice placed her on
restrictions of lifting no more than 10 lbs. and referred her to a specialist, Dr. Ronald
Burgess, who performed bilateral carpel tunnel release surgery on her right hand in
May 2000 and on her left hand in June 2000. She returned to work, but the symptoms
reoccurred . In December 2001, she was taken off work for a nonwork-related
condition . She has not worked since that time .
The ALJ found her to have a 13% functional impairment rating which translated
into a 16 .25% occupational disability . He awarded her benefits for an additional period
of temporary total disability from February 26, 2001 through July 16, 2001 and
determined the medical bills of Dr. O'Neill should be the responsibility of the employer.
The Board affirmed the decision of the ALJ stating that there was substantial evidence
to support the award . A unanimous panel of the Court of Appeals affirmed the Board .
This appeal followed .
The claimant testified that she had surgery on her right hand in May 2000 and on
her left hand in June 2000. She stated that upon her return to work, she continued to
have problems with her hands . Clark testified that she saw Dr. Sajadi at the request of
an insurance adjuster for the employer in order to obtain a second opinion . In
December, she sought medical advice from Dr. O'Neill, but had to postpone any further
treatment because she was hospitalized for two weeks for surgery not related to the
employment .
Trim Masters introduced the deposition of Michelle Corey, an insurance claims
specialist who testified that she received a form 113 from Clark in March 2000
indicating that Dr. Burgess was the treating physician. Corey stated that Clark indicated
a desire to seek a second opinion. Corey advised Clark that the physician she chose
for the second opinion would be the last doctor authorized. Corey testified that she did
not authorize any payment to Dr. O'Neill because Clark selected Dr. Sajadi as her
second treating physician .
Dr. O'Neill's office never contacted Corey concerning authorization and a form
113 was never completed for payment of his bills. Corey indicated that she received a
call from Trim Masters on July 23, 2001, stating that Clark had told them that she had
been under the treatment of Dr. O'Neill for the past few months and had submitted
those bills under her group health insurance. Further, she asked that the bills of Dr.
O'Neill be paid . Corey told Trim Masters that Dr. Sajadi was the second and last
choice of physicians and no payment would be made to Dr. O'Neill .
Medical testimony was submitted by both parties. Clark introduced a medical
report of Dr. Emily Rayes, a physical medicine and rehabilitation specialist employed by
the University of Kentucky who performed an independent evaluation on the claimant.
Dr. Rayes was of the opinion that a 13% impairment should be assessed and that Clark
did not have the physical capacity to return to the type of work that she performed at
the time of her injury . Dr. Rayes testified by deposition
On vigorous cross-examination, Dr. Rayes only agreed that if her job could exist
with severe restrictions, Clark could return to such a hypothetical job . For four pages of
the deposition, Dr. Rayes answered rigorous questioning by Trim Masters' counsel. Dr.
Rayes was making the point that she did not believe that the welding job could be
performed under Clark's restrictions . Counsel demanded a direct yes or no response
as to whether, if the welding job could hypothetically be performed under the
restrictions, would Dr. Rayes believe Clark could work it. Dr. Rayes did not believe the
welding job would follow the restrictions, but conceded that if it could, Clark could
return. Trim Masters' brief says, "She would be able to return to the same
employment." This statement relies on a dependent conditional clause in the brief
immediately preceding it that adds, "If Clark's job position would allow her to follow
restrictions, such as no lifting over 15 pounds, no repetitive flexion or extension of her
wrists ." Therefore, Dr. Rayes agreed that Clark could return to work only under severe
restrictions . Such a statement was obviously not a general release back to Clark's
previous work, nor does it conflict with Dr. Rayes' assignment of a 13% functional
impairment to Clark.
Clark presented the deposition of Dr . William O'Neill, a specialist in
reconstructive and plastic surgery, who began treating Clark in February 2001 . He also
referred Clark to Dr. Robert Taylor for a repeat of the nerve test because of possible
recurrent carpal tunnel syndrome. Dr. O'Neill testified that he did not believe Clark
needed additional surgery and thus he treated her conservatively . Dr. O'Neill stated
that if Clark returned to repetitive work, it would possibly worsen her symptoms .
Trim Masters introduced the deposition and medical reports of Dr. Joseph Zerga
who performed an independent evaluation of Clark on January 14, 2002. He believed
that Clark's condition was work related, but that she would be able to return to the
welding job. Trim Masters introduced a deposition and medical report of Dr. Daniel
Primm . He agreed with the report of Dr. Burgess finding no objective medical basis to
substantiate the subjective complaints. He was of the opinion that Clark could return to
her previous work .
Trim Masters also introduced the medical reports of Dr. Burgess, who first
treated Clark in 2000 on a referral from her family doctor . He had performed carpal
tunnel syndrome release on both the left and right wrists and directed restrictions
following the surgery . Dr. Burgess denied Clark's request to be taken off work because
he could not find any objective evidence to substantiate the complaints . Clark indicated
that she would seek another medical opinion .
The ALJ found the impairment rating of 13% assessed by Dr. Rayes to be the
most accurate . He indicated that he relied on the testimony of Dr. O'Neill as well as the
latest EMG and NCV studies from Dr. Taylor which reflected that Clark had experienced
a worsening on the right side and now suffered from moderate to severe motor median
neuropathy at the wrist. Based on the recommendations of Dr. O'Neill and Dr . Rayes,
the ALJ determined that Clark could not return to repetitive work and did not have the
physical capacity to return to the type of work performed at the time of injury .
I . Temporary Total Disability Benefits
The award of the administrative law judge of additional temporary total disability
benefits from February 26, 2001 to July 16, 2001 is supported by substantial evidence .
The ALJ relied on the testimony of Dr. O'Neill who treated Clark during that period of
time and stated that she was not at maximum medical improvement until July 16, 2001
and that he would have placed her on restricted duty not to do repetitive work with her
hands during that time . There was also evidence from Dr. Rayes who assessed an
impairment rating of 13% and indicated that Clark could not return to the type of work
performed at the time of injury. We are not convinced that the argument of the
employer that the concurrent disability that the claimant experienced during this period
of time as a result of her Crohn's disease has merit. The ALJ, the Board and the Court
of Appeals were not persuaded either. The ALJ, the Board and the Court all relied on
Daugherty v. Watts, Ky., 419 S .W.2d
137 (1969),
for the proposition that when there
are two causes of temporary disability, a worker will not be denied compensation
merely because
of
the existence of an independent, concurring cause of disability.
II . Medical Bills of Dr. O'Neill
There was conflicting testimony as to who actually chose Dr. Sajadi that Clark
sought for a second opinion. The insurance investigator testified that it was Clark who
requested to see Dr. Sajadi . However, Clark changed her mind and did not see Dr.
Sajadi, but rather sought a second opinion from Dr. O'Neill . As often noted, it is the
responsibility of the AU to select from conflicting evidence and make a determination
based on his evaluation of such conflicting evidence . See Paramount Foods, Inc. v.
Burkhardt ,
(1977) .
Ky ., 695
S .W .2d
418 (1985) ;
Pruitt v. Bugg Bros . ,
Ky., 547
S .W .2d
123
Clearly the AU did not accept the arguments of the employer.
III . Permanent Partial Benefit Award
There was substantial evidence to support the award of permanent partial
disability benefits based on the 13% impairment rating of Dr. Rayes . The report of Dr.
Taylor indicated that the most recent EMG/NCV study demonstrated that the employee
suffered from moderate to severe medium neuropathy of the right wrist.
A careful review of the record indicates that the ALJ considered all the lay and
medical testimony. It is well settled that the ALJ as the finder of fact, has the sole
authority to determine the weight, credibility, substance and inference to be drawn from
the evidence . Paramount Foods. Inc., supra . Where the evidence is conflicting, the
ALJ may choose whom and what to believe. Additionally, the ALJ may choose to
believe part of the evidence and disbelieve other parts. Pruitt, supra . This is clearly a
question relating to findings of fact. The testimony presented by Dr. O'Neill and Dr .
Rayes was sufficient substantial evidence upon which the ALJ could rely. There is
nothing incredible about their testimony . Special Fund v. Francis , Ky., 708 S.W .2d 641 .
A review of the evidence does not compel a finding otherwise . Paramount Foods; See
also Western Baptist Hosp. v. Kelly, Ky., 827 S .W.2d 685 (1992).
The opinion of the Court of Appeals is affirmed .
All concur.
COUNSEL FOR APPELLANT :
H. Douglas Jones
Kenneth J . Dietz
JONES, DIETZ & SCHRAND PLLC
P.O. Box 0095
Florence, KY 41022-0095
COUNSEL FOR APPELLEES :
Thomas G . Polites
WILSON, SOWARDS, POLITES &
MCQUEEN
444 East Main Street, Suite 201
Lexington, KY 40507
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