SHELBY MOTOR COMPANY, INC. V. CARL Q. QUIRE, ET AL.
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RENDERED : November 1, 2007
TO BE PUBLISHED
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2006-SC-000884-WC
SHELBY MOTOR COMPANY, INC.
V
APPELLANT
APPEAL FROM COURT OF APPEALS
2006-CA-000862-WC
WORKERS' COMPENSATION NO. 93-91805
CARL Q . QUIRE ; HON . J . LANDON
OVERFIELD, ADMINISTRATIVE LAW JUDGE ;
AND WORKERS' COMPENSATION BOARD
.APPELLEES
OPINION OF THE COURT
REVERSING
The claimant sustained back injuries in two work-related accidents . Based on
findings that the second accident temporarily exacerbated the previous back injury and
that the statute of limitations barred a claim for the first injury, the ALJ awarded a period
of medical and temporary total disability (TTD) benefits for the second injury and
dismissed the claim for the first injury . The Workers' Compensation Board (Board)
affirmed, stating that it found no clear error in the decision and that the claimant failed
to preserve in his brief to the ALJ an argument that the payment of TTD after the
second injury tolled the statute of limitations for the first injury .
A two-to-one majority of the Court of Appeals determined that the Board erred
because it affirmed the ALJ's decision to dismiss the 2002 claim under Calloway
County Fiscal Court v. Winchester, 557 S .W .2d 216 (Ky. App. 1977), and, therefore,
that the question of limitations was preserved for its review. The majority held
ultimately that TTD benefits paid when subsequent trauma exacerbates an injury will toll
the period of limitations for the injury if it has not expired . Thus, the court reversed and
remanded for the entry of an award.
We reverse because neither the AU nor the Board erred. The claimant raised
the tolling argument at the hearing but abandoned it in his brief to the ALJ . Thus, the
AU did not err in failing to consider the argument and it was not preserved for appeal .
Calloway County Fiscal Court v. Winchester , supra , is authority on these facts for the
principle that work-related trauma may aggravate or exacerbate a previous injury but
cause no compensable disability . It does not conflict with Robertson v. United Parcel
Service, 64 S .W.3d 284 (Ky. 2001), which states that if work-related trauma aggravates
or exacerbates a pre-existing condition, causing it to require medical treatment but
result in no permanent impairment rating, the worker has sustained a compensable
injury and is entitled to what medical and TTD benefits the evidence permits .
The claimant was born in 1964 and has a high school education with a GED . He
also has specialized training as an auto technician and is ASE and GIVI certified . He
testified that he had injured his low back at work previously, in 1998 or 1999, but he had
missed no work and did not file a claim . The problem had resolved after eight to ten
weeks of chiropractic treatment. This appeal concerns incidents of work-related back
trauma that occurred in October 2002 and on February 26, 2003.
The claimant testified that he injured his back while working in October 2002. He
sought medical treatment and received two weeks of physical therapy . He testified that
he missed only one day of work and returned to his regular duties without restrictions.
Asked if he had back problems between the injury and February 2003, he stated that
his back got a little sore after heavy work but that he was fine otherwise .
On February 26, 2003, the claimant slipped in a puddle of oil while helping to
carry a transmission . He fell, hitting his head and shoulders, and the transmission fell
on his thighs and lower legs. Medical records indicated that he sought treatment later
that day at Jewish Hospital-Shelbyville for complaints of head, left shoulder, neck, and
lower back pain . He gave a history of falling and hitting the back of his head and of
being dazed but not unconscious. X-rays of the lumbar spine were normal, and Dr.
Shields diagnosed only a head contusion and concussion without loss of
consciousness . The claimant was given head injury instructions, taken off work for two
days, and advised to follow up with his family physician . His neck pain increased, so he
went to Norton Hospital's emergency room three days later.
On March 5, 2003, the claimant's family physician, Dr. Wallace, noted that the
claimant complained of persistent pain and stiffness in the neck but denied back or
lower extremity pain. Dr. Wallace diagnosed a probable neck sprain, ordered physical
therapy, and kept the claimant off work until March 31, 2003. A cervical MRI showed
no significant degenerative changes or nerve root compression .
On April 3, 2003, Dr. Wallace's physician's assistant noted that the claimant
complained of severe low back pain . He indicated that he had experienced no recent
trauma but had injured his back in October 2002, which resulted in several weeks of
back pain. He stated that he had noticed a fleeting back pain about once a week for
the past three to four weeks, but it had become very severe since his return to work.
Noting that a lumbar spine x-ray showed a decreased disc space at L5-S1, Dr. Wallace
ordered an MRI . A lumbar MRI performed on April 11, 2003, revealed degenerative
disc disease and various other degenerative changes, including diffusely bulging discs
from L3-4 through L5-S1 and significant abnormalities at L5-S1 . On April 16, 2003, Dr.
Wallace noted continued complaints of back pain in the lower lumbar area, which came
on suddenly and dramatically about two weeks after the neck injury. He diagnosed low
back pain, degenerative disc disease, and degenerative arthritis, and he referred the
claimant to Dr. Myers, an orthopedic surgeon .
On April 24, 2003, Dr. Myers noted that the claimant gave a three- or four-year
history of episodic, mild back pain; of severe pain that resolved about three weeks after
the October 2002 incident ; of recurrent pain "everywhere" after the February 2003 fall;
and of constant, dull lumbosacral pain since then . Dr. Myers noted that MRI revealed
severe degeneration at L5-S1, which appeared to be chronic . He concluded that the
symptoms were consistent with the disc degeneration and recommended continuing
physical therapy . On June 12, 2003, he stated that the claimant was at maximum
medical improvement (MMI) and had no permanent impairment rating.
Dr. Stewart, a specialist in physical medicine and rehabilitation, evaluated the
claimant in August 2003. He received a history of two work-related accidents, the first
on October 9, 2002, and the second on February 26, 2003. He noted from medical
records that the claimant complained of low back pain after the first accident and
underwent six physical therapy sessions between October 16 and 28, 2002. The
claimant reported that his pain resolved and that he returned to work and felt well until
he was injured again on February 26, 2003. After summarizing the subsequent medical
evidence, Dr. Stewart noted that a decompression of the lumbosacral spine had been
considered but that the claimant had chosen not to have the procedure . Dr. Stewart
limited lifting to no more than 50 pounds to the waist and 40 pounds overhead and
limited carrying to no more than 40 pounds for distances of 20 feet or less .
He
assigned a 13% permanent impairment rating under DIRE lumbar category II and stated
that the claimant probably injured his back in 2002 and re-injured it in 2003, but he did
not allocate the permanent impairment rating to either or both injuries .
The claimant's application for benefits alleged that he injured his back, neck,
lower body, and right shoulder on February 26, 2003 . He filed it on March 16, 2005,
which was within two years after the last TTD payment for the injury . Although the
employer admitted that the claimant sustained a compensable injury that occurred or
became disabling on that date, it contested the amount of compensation he was owed .
Dr. Best evaluated the claimant for the employer on June 9, 2005, and
performed a functional capacity evaluation. He concluded that the claimant reached
MMI in June 2003 and presently was able to perform heavy-duty work. Although he
assigned no cervical spine impairment, he placed the claimant in DIRE lumbar category
II due to the disc space narrowing at L5-S1 but characterized it as a pre-existing
condition . Noting that the claimant had a chronic, active low back condition dating to
2002, Dr. Best found no objective evidence that the 2003 injury made the condition
worse or resulted in permanent impairment .
The claimant testified that the employer paid TTD benefits through March 30,
2003, and accommodated his subsequent physical restrictions. Yet, he was able to
work only 40 to 60 hours bi-weekly rather than the 80 to 120 hours that he had worked
before the accident . He stated that the employer had helped him further by placing him
on salary, which reduced but did not eliminate the loss of income.
Like the claimant's application for benefits, the Benefit Review Conference
Memorandum does not mention the 2002 accident or injury . It indicates that the
employer continued to accept the claim for the 2003 injury as being compensable but
contested the extent and duration of disability . The AU noted at the hearing, however,
that the evidence referred to two accidents and asked the parties whether the claim
involved one or two back injuries. In the discussion that followed, the employer
asserted that the statute of limitations barred a claim for the 2002 injury; whereas, the
claimant asserted that TTD paid after the 2003 injury tolled the period of limitations for
both injuries. The AL permitted the claimant to amend his claim to include the 2002
injury ; permitted the employer to assert that KRS 342.185's two-year statute of
limitations barred compensation for the 2002 injury; and directed the parties to present
arguments on the matter in their briefs.
The claimant's brief argued only that any injuries before February 26, 2003, were
minor and resulted in no work restrictions ; that "the claimed injury either occurred or
became disabling on February 26, 2003;" and that the employer admitted that the
claimed injury either occurred or became disabling on February 26, 2003. The brief did
not raise an alternative argument that voluntary TTD benefits paid after the 2003
accident tolled the period of limitations for the effects of both accidents . Nor did it
assert that the employer's alleged failure to notify the Office of Workers' Claims when it
terminated TTD benefits after the 2003 injury precluded the employer from asserting a
limitations defense regarding the 2002 injury. Addressing the argument that was made,
the employer asserted that the 2003 accident caused no permanent impairment rating.
The AU determined that the back injury causing the permanent impairment
rating that Dr. Stewart assigned occurred in 2002 ; however, the statute of limitations
barred a claim for the 2002 injury. Citing Calloway County Fiscal Court v. Winchester,
supra, and finding that the 2003 injury exacerbated the pre-existing back condition, the
AU determined that the claimant was not entitled to permanent income or medical
benefits for the injury but was entitled to TTD and medical benefits through March 30,
2003.
The claimant argued in his petition for reconsideration that if the 2003 accident
exacerbated the injury that occurred in 2002, then the payment of TTD benefits in 2003
tolled the period of limitations for both accidents until March 30, 2005. Thus, his claim
was timely . Among other things, he also alleged that the employer failed to notify the
Office of Workers' Claims when it terminated TTD and, therefore, was barred from
raising the question of limitations for either injury . H. E. Neumann Co. v. Lee, 975
S.W.2d 917 (Ky. 1998) . The AU denied the petition on the ground that it raised no
patent error in the opinion and award .
Although the claimant raised the tolling argument on appeal, the Board noted
that the AU permitted him to amend his claim belatedly to allege the 2002 injury,
permitted the employer to assert that the claim was barred by a straightforward
application of the two-year limitations period, and directed the claimant to address the
question of limitations in his brief. Yet he failed to do so. Thus, the Board concluded
that the AU did not err in applying the two-year limitations period . Nor did the AU err
in awarding a period of medical and TTD benefits for the exacerbation that occurred in
2003 because, under Robertson v. United Parcel Service , supra , the 2003 accident
technically caused an injury, albeit a temporary one.
Calloway County Fiscal Court v. Winchester , supra , concerned a 1974 claim
that was decided under definitions of "injury" and "disability" that were different from
those enacted in 1996. At that time, the Board was the fact-finder. A, Board-appointed
physician stated that the second of two work-related incidents was of "no consequence"
and that the worker's disability was solely attributable to the first incident. The Board
stated that the worker injured his back, had a period of TTD, returned to work with a
different employer, and later "aggravated his injury when he mopped a floor." He never
returned to work. Thus, the Board placed all liability for temporary and permanent
income benefits on the employer that was responsible for the first incident, and the
court determined that substantial evidence supported the decision .
KRS 342 .0011(1) defines the term "injury" as a work-related traumatic event that
is "the proximate cause producing" a harmful change in the human organism . The
court determined in Robertson v. United Parcel Service, supra , that the definition
requires a work-related traumatic event that exacerbates a pre-existing condition and
causes it to be symptomatic to be viewed as being an "injury." The court also
determined that a harmful change that is temporary may warrant only limited medical
and TTD benefits . FEI Installation . Inc. v. Williams , 214 S.W.3d 313 (Ky. 2007),
explained subsequently that the 1996 Act does not define "disability" generally but
equates it with "impairment," i .e. , "a loss, loss of use, or derangement of any body part,
organ system, or organ function," which may or may not be permanent or rise to the
level that warrants a permanent impairment rating. An injury must result in a permanent
impairment rating to warrant permanent income benefits under the Act.
Callowav County Fiscal Court v. Winchester, supra , did not involve a period of
TTD after the second incident, and the decision did not mention medical benefits . It
stands for the principle that work-related trauma may aggravate or exacerbate a
previous injury but cause no compensable disability . That principle does not conflict
with Robertson v. United Parcel Service, supra, which states that if work-related trauma
aggravates or exacerbates a pre-existing condition, causing it to require medical
treatment but result in no permanent impairment rating, the worker has sustained an
injury and is entitled to what medical and TTD benefits the evidence permits .
The claimant's application was amended to allege two work-related injuries, one
in 2002 and one in 2003. Although he argued at the hearing that TTD benefits paid
after the 2003 injury tolled the periods of limitations for both injuries and although the
AU directed him to address that argument in his brief, he abandoned it and asserted
that the 2003 incident caused his disability . The AU found that the 2002 incident
caused his permanent impairment rating, that KRS 342.185 barred a claim for the 2002
injury, and that the 2003 incident caused a temporary exacerbation of the 2002 injury,
which resulted in a period of TTD and necessitated a period of medical treatment.
Substantial evidence supported the findings of fact, and the conclusions of law and
award were consistent with Chapter 342 as well as with Callowav County Fiscal Court v.
Winchester, supra , and Robertson v. United Parcel Service , supra. Because the
claimant abandoned the tolling argument, the AU did not err in failing to consider it or
denying his petition for reconsideration. Nor did the Board err in concluding that it was
not a proper basis for appeal.
The decision of the Court of Appeals is reversed .
All sitting . All concur.
COUNSEL FOR APPELLANT,
SHELBY MOTOR COMPANY, INC . :
PHILLIP J . REVERMAN
BOEHL, STOPHER & GRAVES, LLP
AEGON CENTER, SUITE 2300
400 WEST MARKET STREET
LOUISVILLE, KY 40202
COUNSEL FOR APPELLEE,
CARL Q. QUIRE :
UDELL B. LEVY
CLAY, KENEALY, WAGNER & ADAMS
1730 MEIDINGER TOWER
462 S . FOURTH AVENUE
LOUISVILLE, KY 40202
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