Sheila Dickson v. Roadway Express, Inc.

1. Are any benefits awarded herein? YES
2. Was the injury or occupational disease compensable under Chapter 287? YES
3. Was there an accident or incident of occupational disease under the Law? YES
4. Date of accident or onset of occupational disease: July 31, 2004
5. State location where accident occurred or occupational disease was contracted: JASPER COUNTY, MO
6. Was above employee in employ of above employer at time of alleged accident or occupational disease? YES
7. Did employer receive proper notice? YES
8. Did accident or occupational disease arise out of and in the course of the employment? YES
9. Was claim for compensation filed within time required by Law? YES
10. Was employer insured by above insurer? YES
11. Describe work employee was doing and how accident occurred or occupational disease contracted: CLERICAL DUTIES
12. Did accident or occupational disease cause death? NO
13. Part(s) of body injured by accident or occupational disease: BILATERAL UPPER EXTREMITY, CERVICAL SPINE AND BODY AS A WHOLE
14. Nature and extent of any permanent disability: 17.5 PERCENT
15. Compensation paid to-date for temporary disability: -0 -
16. Value necessary medical aid paid to date by employer/insurer? -0 -
17. Value necessary medical aid not furnished by employer/insurer? $\ 6,844.00
18. Employee's average weekly wages: UNKNOWN
19. Weekly compensation rate: $\ 354.05
20. Method wages computation: STATUTORY MAXIMUM

1. Amount of compensation payable:

Unpaid medical expenses: $\ 6,844.00 -0- weeks of temporary total disability (or temporary partial disability) 70 weeks of permanent partial disability from Employer $\ 24,783.50 -0-weeks of disfigurement from Employer

1. Second Injury Fund liability: N/A

TOTAL: $\ 31,627.50

1. Future requirements awarded: SEE AWARD

Said payments to begin IMMEDIATELY and to be payable and be subject to modification and review as provided by law.

The compensation awarded to the claimant shall be subject to a lien in the amount of 25 PERCENT of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant:

TOM CARLTON

A hearing Was held in the above case on December 5, 2006, before Administrative Law Judge, Karen Fisher. The employee appeared in person and with attorney, Tom Carlton. The employer/insurer appeared by attorney, Rex Henoch. The parties stipulated that the workers' compensation rate in this case is $\ 354.05. They additionally agreed that no temporary total disability had been paid and that none was being claimed. There have been no medical benefits paid to date in the case as the employer/insurer claims that treatment was not authorized.

The issues which are to be decided are as follows:

1. Whether the employer/insurer is liable for past medical benefits of $\ 6,844.00.

1. The nature and extent of any permanent partial disability.

The employee presented the following evidence as well as testifying on her own behalf.

Sheila Dixon is a 39-year old, right-handed female who began working for Roadway Express in 1993 as customer service representative in the Iola, Kansas office. In 1997 she moved to Joplin to become the city dispatcher for Roadway Express. She continued that position until 2004. This position required extensive telephone use, computer keyboard use, calculator use, and writing. She worked ten hours a day and took her lunch break while working. In 2002 she did on-site analysis of her position. On one particular day she averaged 170 phone calls in a 10 -hour shift. The phone calls would come in on an average of every $31 / 2$ minutes. The calls lasted anywhere from 20 seconds to 20 minutes.

Ms. Dixon indicate that in June of 2002 she developed numbness and tingling in both her elbows and hands more so on the right than the left. She continued to work thinking her symptoms would improve. When they did not she sought medical attention. On August 14, 2002, Ms. Dixon was examined by her family physician, Dr. Sprenkle. He prescribed Vioxx and a cock-up splint for possible right carpal tunnel syndrome. She also complained of headaches that she felt were triggered by using her neck and head as a cradle to answer the phone. In January of 2003 Ms. Dixon saw Dr. Sprenkle again complaining of sharp pains in her forearms and elbows most of the time. She indicated that they felt bruised. The right side was affected more than the left. Dr. Sprenkle diagnosed bilateral radial tendonitis and migraine headaches. He prescribed a Depo-Medrol dose pack, left and right elbow splints and anti-inflammatories.

In May of 2003 Ms. Dixon saw a chiropractor, Dr. Logan, who examined her for complaints of bilateral elbow pain. He provided physical therapy on three occasions within a week.

In May of 2004, Dr. Sprenkle saw Ms. Dixon for epicondylitis, right carpal tunnel syndrome, and multiple arthralgias. He recommended a cock-up splint and EMG testing. He repeated an arthritis profile and it came back negative.

In June of 2004, Dr. Karges, a physiatrist, examined the employee for continued complaints of pain in her right extensor forearm, migraine headaches that started in the neck and ended behind the eyes, decreased strength in both hands and her left hand falling asleep at night. Dr. Karges performed an EMG study that showed acute denervation in the distal and proximal C6, C7 muscles supporting the diagnosis of early mild acute right C6, C7 radiculopathy. He recommended a myelogram and CT scan. Ms. Dixon testified that she told Fred Pitts at her employer the cause of her pain was due to having too many phone calls. She indicated she did not request treatment due to the fact that she was afraid of losing her job.

A CT scan was performed in July of 2004 and was normal. An MRI also performed of the cervical spine was read as normal. In September of 2004 Dr. Karges reexamined Ms. Dixon. He diagnosed her as having cervical and upper trapezius myofascial strain with myofascial pain and mild cervical disk disease with straightening of the normal cervical lordosis and minimal desiccation on the MRI scan. He recommended physical therapy. In October 0f 2004 Dr. Karges maintained the same diagnosis and added right upper extremity pain with probable forearm tendonitis and possible pronator teres syndrome. He recommended the patient be referred to Bruce Silverberg, a neurosurgeon.

Ms. Dixon indicated that in May of 2003 she asked the employer to provide treatment.

Ms. Dixon was examined by Dr. Silverberg in September of 2005. At that time she was also complaining of a tremor resulting in trembling and weakness whenever she would try to write or grab objects. Dr. Silverberg diagnosed residual weakness and trembling in the right arm following repetitive motive labor activities. He did not feel she had a surgically correctable problem and recommended an neurologist.

Ms. Dixon testified that currently she experiences tingling in both hands. She has a tremor in the right hand. She experiences pain in between her shoulders up into the neck and has headaches. Her hands tingle when he claps or applauds and she has pain in the hands when gripping. She indicated that the tremor is embarrassing and she finds it difficult to eat with it. She has problems with driving especially for longer periods and she finds personal grooming difficult.

On cross-examination Ms. Dixon indicated that she in November of 2004 had worked as a clerk at her husband's auction business. She also testified that she worked three auctions since she left her employment at Roadway Express. The last auction she worked was in May of 2005 and of the three she had worked since she left Roadway Express one was a twohour auction, one was a half-day auction, and one was all day during which she suffered from a migraine. She currently

works as a real estate agent. She also admitted that on a couple of occasions she had indicated she had no further problems with the left arm.

After performing an independent medical examination Dr. Robert Paul indicates in his opinion that the patient's employment at Roadway Express is the substantial factor in the employee developing stress-related headaches, bilateral epicondylitis, and right wrist tendonitis with overuse syndrome resulting in chronic weakness. He is of the further opinion that the chronic weakness has resulted in an intention tremor. He also indicated that she had been diagnosed as having an acute irritation of the right C7 nerve root. He felt that she had reached maximum medical improvement with the possible exception of a neurological workup. He did give an opinion as to her permanent partial disability and rated her at 5 percent of the body as a whole due to residual cephalgia; 5 percent of the body as a whole due to residual complaints of pain in the upper thoracic, upper and mid back; 20 percent of the right wrist at the 175 -week level due to tenderness, numbness, and weakness with an intention tremor; and 15 percent of the left wrist at the 175 -week level due to residual weakness and numbness. These ratings combined would come to a total of 101.25 weeks.

The employer/insurer offered the Notice of Intent of Dr. Lennard's report which was admitted into evidence.

Dr. Ted Lennard, a physical medicine doctor, performed an independent medical examination on behalf of employer. Dr. Lennard indicates in his August 25, 2006, report that "Ms. Dixon's complaints of neck and right upper extremity pain appear to correlate with her work while employed for Roadway Express." He assigns a 5 percent to the body as a whole for her residual neck and right upper extremity complaints. He indicated that the left upper extremity complaints had resolved and indicated that he was unable to state within a reasonable degree of medical certainty that the complaints of headaches could be attributed at her work at Roadway Express.

After considering all of the evidence and testimony submitted in this case, I find claimant's testimony to be credible. Absent any evidence to the contrary I believe claimant's testimony that she had, in fact, notified Roadway Express regarding her problems and had requested treatment for her symptoms. Therefore, employer/insurer is obligated to pay the claimant's medical expenses as these were necessary and reasonable costs associated with her medical treatment to cure and relieve her symptoms of the occupational disease to which she was exposed at Roadway Express. I order the employer/insurer to pay $\ 6,844.00 for medical bills.

Additionally, I find based upon the ratings and other medical evidence submitted in this case that the claimant has suffered a $171 / 2$ percent to the body as a whole permanent partial disability as a result of her occupational disease at Roadway Express. This would entitle the claimant to 70 weeks of compensation at a rate of $\ 354.05 perweek for a permanent partial disability benefit of $\ 24,783.50. I hereby order employer/insurer to pay said benefit to the claimant subject to an attorney fee of 25 percent of this benefit to attorney, Tom Carlton as well as any expenses incurred.

A true copy: Attest:

$\qquad$ /s/ Patricia "Pat" Secrest $\qquad$

Patricia "Pat" Secrest

Director

Division of Workers' Compensation