The issues in this case are as follows:
- whether the Claimant sustained injury by accident arising out of and in the course of her employment on October 11, 2002;
- the nature and extent of any permanent disability resulting from that accident;
- liability for temporary total disability benefits from November 17, 2003 through today's date with the exception of the period of March 22, 2005 through April 11, 2005, when the Claimant was working and receiving salary; and
- liability for future medical aid.
The evidence in this case also consisted of the Claimant's testimony, the independent evaluation of Dr. Swaim and various medical records admitted at the hearing.
On March 13, 2002, I find the Claimant sustained injury by accident arising out of and in the course of her employment at Ford Motor Company. I make this finding based on the Claimant's testimony and medical records, which indicate she did sustain some type of injury to her right knee when she fell from a platform on a truck she was working on and injured her right knee. She was evaluated by the company physician and had some physical therapy. No temporary total disability benefits were paid at this time as the Claimant missed only a day or two of work.
She testified at the hearing that her knee did continue to crack, pop and click, but that these symptoms did not prevent her from continuing to work. On October 11, 2002, I also find the Claimant sustained injury arising out of and in the course of her employment with Ford Motor Company and that such injury was, again, to her right knee. She apparently slipped and fell while going downstairs and twisted her right knee. She testified that all of her symptoms got worse, and that she received additional treatment, as well as more physical therapy. She testified that the treatment and therapy did not help.
On November 18, 2002, Ms. Stockman had an MRI evaluation of her right knee at Medical Imaging, Inc. The radiology report noted that she had right knee pain since October of 2002 rather than March of 2002. The MRI study revealed evidence of an oblique tear of the posterior horn of the medial meniscus with a tear extending to the inferior articular margin of the meniscus; chondromalacia of the medial facet of the patella was seen with an erosion of the cortical bone in this region and subchondral sclerotic changes; a bone bruise was seen involving the medial margin of the medial tibial plateau and there appeared to be a small region involving the weight-bearing portion of the medial femoral condyle suggesting possible avascular necrosis. While the medial collateral ligament was intact, there appeared to be minor fluid adjacent to the ligament.
The Claimant was referred to Dr. Paul, an orthopedic surgeon for a right knee arthroscopy, which he performed in January of 2003. When Dr. Paul saw the Claimant in December of 2002 he did note that the Claimant had fallen on March 13, 2002, as well as twisting her knee on October 11, 2002. Dr. Paul's impression was as follows: mild degenerative joint disease of the right knee with osteochondral lesion of the medial femoral condyle, possible posterior horn medial meniscus tear and chondromalacia. Dr. Paul performed surgery to the Claimant's right knee on January 8, 2003 at North Kansas City Hospital. He performed arthroscopic surgery of her right knee with posterior medial meniscectomy, chondroplasty of the medial femoral condyle and patella. The arthroscopic evaluation revealed chondromalacia involving a large portion of the weight-bearing surface of the medial femoral condyle. Postoperatively Dr. Paul referred the Claimant to physical therapy and kept her off work. The Claimant was paid temporary total disability benefits through February 10, 2003. She was returned to work on February 11, 2003 with restrictions.
On May 5, 2003, Dr. Paul indicated that the Claimant would eventually need a total knee replacement. On that day he injected the Claimant's knee with a steroid and local anesthetic. She remained on work with restrictions. On June 9, 2003, Claimant received the first injection to the right knee and on June $16^{\text {th }} the second injection, and on June 23^{\text {rd }}$ the third injection. She was also given a prescription for Celebrex at that time. Claimant continued to work through July 23, 2003. Claimant apparently quit working on July 24, 2003 as she received temporary total disability benefits from that date through November 16, 2003. On August 25, 2003, Claimant continued to have pain and swelling to her right knee. In that evaluation, Dr. Paul noted that most of her pain was coming from the degenerative joint disease to the knee including the medial femoral condyle and patellofemoral joint. Dr. Paul again noted that the Claimant would eventually need a total knee replacement. On October $6^{\text {th }}$ Dr. Paul determined that a subsequent MRI was in order and on October 13, 2003 when he reviewed that MRI, he noted that her degenerative joint disease was exacerbated by the meniscal tear. The new MRI showed marked abnormality to the posterior torn to the medial meniscus, which was where h