I find that Claimant, Virginia Neves, was born May 28, 1963, is married with four children, and has a tenth-grade education. I find that Claimant worked for Employer for three or four years prior to the alleged work-related injury. Employer is a nursing home. Claimant worked in the laundry for the first year of her employment, and then worked as a certified nursing assistant ("CNA") thereafter. Claimant would usually work the 10:00 P.M. to 6:00 A.M. shift, and usually worked less than 40 hours each week. Claimant was responsible for approximately 36 of the nursing home residents during her shift. A significant portion of Claimant's duties consisted of "turning" residents in their beds, for comfort and to prevent bed sores. Approximately 30 of the patients would need to be turned; usually a patient was turned every two hours. A sheet was used to turn the patients; some of the patients could assist Claimant in this task, others could not. Another part of Claimant's duties consisted of getting residents out of bed in the morning, dressing them, brushing their teeth, and otherwise attending to their hygiene. Claimant testified that she would, thus, assist approximately six residents each morning.
Claimant testified that a significant portion of her duties consisted of lifting the residents. Claimant testified that, at least once or twice a night, a resident would lose his or her balance and "they would fall on me".
There was no evidence adduced that indicated that Claimant suffered from any back or neck problems prior to her employment at Lewis County Nursing Home.
The claim for compensation filed in this case (Injury No. 02-045936) on May 10, 2002, alleges that Claimant injured "neck, spine, and back", and a description of how the injury occurred alleges "Claimant was injured while lifting patients repetitively", "on or about April 19, 2002".
Claimant testified that in February 2002, an incident occurred when Claimant was working in a resident's room with her back to the door, and a nurse came to the door to talk to Claimant. Claimant testified that as she turned her head to listen, she felt immediate pain in her neck. On April 4, 2002, Claimant filed with Employer a REPORT BY INJURED EMPLOYEE concerning this incident. On May 13, 2002, Employer filed a first report of injury with the Division of Workers' Compensation, and Injury No. 02-044039 was assigned.
According to the REPORT BY INJURED EMPLOYEE filed by Claimant, Claimant was seen by Dr. Dysktra for her neck as well as for her back in March 2002, although there are no such medical records in evidence. The first medical records in evidence are a CERTIFICATE OF PHYSICAL EXAMINATION from a nurse practitioner at Quincy Medical Group, stating that Claimant should not work until seen by Dr. Gilchrist, and a WORK ABILITY REPORT from Dr. Gilchrist at Quincy Medical Group dated April 16, 2002, stating that Claimant could return to work with no lifting over 25 pounds, and scheduling Claimant for physical therapy beginning April 17, 2002. Claimant testified that Employer did provide her with light duty from this time forward until her last day of work on September 12, 2002.
The first history noted in the medical records is on the physical therapist's INITIAL EVALUATION dated April 23, 2002. This noted an onset date of "February 2002" and states: "Patient recalls no specific injury. She noticed pain in her back beginning in February. Patient states that her work is also a difficulty (sic) type job and this could have been gradually building up reportedly from her work."
A lumbar MRI was done on April 19, 2002, which showed a posterior disc bulge at L4-5 and at L5-S1, with significant dessication in the L5-S1 disc, without compromise of the nerve roots.
On May 6, 2002, Claimant was seen by Dr. Linda Johnson. The history recorded by Dr. Johnson is as follows:
She has a 4 -year history of working as a CNA. Through the last two of those, she has had increasing amounts of back pain. It has been especially severe for two or three months with pain in the right buttocks going into the back of the thigh, which was stabbing. She tried to go back to work about $21 / 2$ weeks ago, but the lifting and weight seemed to worsen the pain and it has become a cramping pain rather than a stabbing pain that more often travels into the lateral thigh and sometimes down into the leg. ... She does not remember a specific injury, although there is some neck pain and she remembers that in February she was working and turned her head to answer a question and felt the neck pop. Since then, pain problems have been somewhat worse, especially in the neck.
On May 15, 2002, Claimant was seen by a pain clinic specialist, Dr. M. Azad Tayyab, who performed an epidural steroid injection. The history given to Dr. Tayyab was similar to that given to Dr. Johnson, with the addition of the following: " She is married, with four children, who currently keep her very active, busy, and may be the cause of her pain."
On May 16, 2002, Employer-Insurer sent Claimant to see Dr. Christopher Bieniek, an orthopedic surgeon. Dr. Bieniek's PROGRESS REPORT of that date was admitted into evidence over the objection of Employer-Insurer. Employer-Insurer argues that Dr. Bieniek's PROGRESS REPORT is not a record of medical treatment, but is rather an evaluation fo