Claimant is a 49-year-old male who was working for Employer as a critical care nurse. Claimant is right hand dominant. Claimant was a nurse for 19 years. He began working for Employer in April 2002. The incident that is the subject of this case happened on October 16, 2002. Claimant testified that on that date, he treating the burns of a large Downs Syndrome patient. The patient was in 4-point restraints, and when Claimant had removed one of the leg restraints to treat the area under the restraint, the patient kicked him in the shoulder, causing Claimant to strike his back against the wall. Claimant's testimony was that he was struck with such force that his feet came up off the floor, and that after striking the wall, he then slumped to the floor.
Claimant returned to work to complete that shift after about an hour break. Claimant saw a doctor within 24 hours. He testified that at the time of the incident he had pain in the back of his head, his left elbow and shoulder, and his buttocks. Claimant's initial treatment was with an occupational doctor at St. John's Hospital.
Claimant testified that Dr. Doerr was the first treating physician. Dr. Doerr took x-rays and performed other diagnostic tests. Claimant stated that Dr. Doerr told him that he could not do much for Claimant and referred him to Dr. Schoedinger. Dr. Schoedinger ordered mylogram and discogram tests on Claimant. Claimant's impression was that these tests revealed protrusions and bulges at the L3, L4, and L5 vertebrae and that Dr. Schoedinger wanted to perform surgery, but the insurance company denied coverage for the procedure, hence there was no operation performed.
Dr. Schmidt then treated Claimant. Claimant's understanding of Dr. Schmidt's diagnosis was that he had Reflex Sympathetic Dystrophy (RSD), Myofascial Pain Syndrome, and Cauda Equina. Claimant testified that he had previously had RSD in conjunction with Carpal Tunnel Syndrome (CTS) in 2000 or 2001, but that it had not bothered him since the surgery to repair the CTS, approximately two years prior to this incident.
Subsequent to Dr. Schmidt, Dr. Strege treated Claimant. Dr. Strege treated Claimant with therapy and pain injections. It is Claimant's understanding that Dr. Strege rated him at 25 % disability in the shoulder and 30 % disability for the RSD. According to Dr. Strege, Claimant was at Maximum Medical Improvement (MMI). Since Dr. Schmidt could not give him any more pain injections, he then went to his personal physician, Dr. Abbott. Dr. Abbott took over his pain control and treatment.
Claimant was admitted to St. Mary's Hospital in August 2003 for pain and subsequently ended up in a "narcotic coma." He has visited the emergency on other occasions for pain. Claimant testified pain is a daily problem, that he takes medication for the pain, and that he did not have to take pain medication for at least one year prior to this incident.
Claimant testified that he had been treating with the above referenced physicians for about two years when he began seeing Dr. Irvin for depression. He had not worked during those two years. Before treating with Dr. Irvin, he had never been treated by a psychiatrist. Dr. Irvin suggested Claimant get a job. Claimant testified that he did in fact try teaching, but there was too much "running around," and that the pain in his back was a "problem." Claimant also testified that he was still taking narcotics for pain, and this also affected his ability to teach. Dr. Irvin also referred Claimant to Dr. Schwabo for behavior modification.
Claimant testified that he was prescribed the drug Seroquil as part of his treatment. He testified that the use of Seroquil resulted in his breasts enlarging. The swelling was painful and therefore he underwent a "bilateral mastectomy." As a result of this operation, his chest is disfigured from the scars, he can't take his shirt off in public, and that this has all made his depression worse.
Claimant testified that he had treated for back pain one time prior to this injury. His treatment was not on a regular basis and he took over the counter medications.
Claimant testified that his current problems are: Pain in his lower back, RSD, Capsulitis in shoulder, Major Depression, Post-Traumatic Stress Disorder, and bowel and bladder dysfunction that requires him to wear a diaper when in public. Claimant walks with a cane and has a wheelchair, but doesn't use the wheelchair often. One time he tried not to use the cane, but "paid for it" the next day.
He testified that his day-to-day activities include playing with his dog and sometimes attending local medical seminars that are sponsored by his attorney, Mr. Tarlow. Claimant feels he needs continued treatment for pain with Dr. Abbott and for Depression with Dr. Irvin. He further testified he also currently suffers from Radiculopathy and Sciatica.
During cross-examination, Claimant testified he does not recall a Worker's Compensation settlement from 1997 in which he received a PPD settlement of 5 % for the Lumbar Spine and 7.5 % for the left elbow. (Employer's Exhibit 3). He
does remember a Workers' Compensation claim form Nebraska in 2001 for Carpal Tunnel Syndrome (CTS), in which he received a PPD settlement of 20\% of the left upper extremity. (Employers Exhibit 4). Claimant also concedes that he did not tell Dr. Abbott or Dr. Cohen that he had RSD prior to this accident.
He further testified that he has had two injuries since the work injury of October 16, 2002. An August 2003 occurrence at St. Mary's Hospital, which resulted in Claimant being in a narcotic coma. Claimant testified that his injuries were "all mental," but have physical manifestations. He was initially more depressed, but he has returned to his normal level. He testified that he first began psychiatric treatment after this incident.
Claimant testified that he was an automobile accident in 2004. He went to the hospital 1 hour after accident and received a pain shot. He testified that his back problems increased after this accident, but his back condition has returned to where it was prior to this accident.
Geraldine Breite testified on behalf of Claimant. Breite is a Life Care Planner and a Legal Nurse Consultant. Breite testified that as a Nurse Life Care Planner she evaluates long-term medical issues in response to injury or illness and addresses the medical needs of the patient. Breite prepared a voluminous report of her findings marked as Claimant's Exhibit S. Counsel for Claimant initially moved for the admission of Exhibit S, however, Counsel for Employer objected. Claimant then withdrew his request at that time, and never renewed his request that Exhibit