Geneva Sellers v. A. G. Edwards & Sons, Inc.

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 03-060302

Employee: Geneva Sellers

Employer: A. G. Edwards \& Sons, Inc.

Insurer: Sentry Insurance Company

Additional Party: Treasurer of Missouri as Custodian of Second Injury Fund (Open)

Date of Accident: May 19, 2003

Place and County of Accident: St. Louis City, Missouri

The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by section 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commission finds that the award of the administrative law judge is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Act. Pursuant to section 286.090 RSMo, the Commission affirms the award and decision of the administrative law judge dated July 16, 2007. The award and decision of Administrative Law Judge Linda J. Wenman, issued July 16, 2007, is attached and incorporated by this reference.

The Commission further approves and affirms the administrative law judge's allowance of attorney's fee herein as being fair and reasonable.

Any past due compensation shall bear interest as provided by law.

Given at Jefferson City, State of Missouri, this 6th day of March 2008.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

Alice A. Bartlett, Member

John J. Hickey, Member

Attest:

Secretary

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: May 19, 2003
5. State location where accident occurred or occupational disease was contracted: St. Louis City, 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: While performing her job duties, Employee developed left cubital and carpal tunnel syndrome, and right carpal tunnel syndrome.
12. Did accident or occupational disease cause death? No
13. Part(s) of body injured by accident or occupational disease: Left elbow and wrist, and right wrist.
14. Nature and extent of any permanent disability: 15 % PPD referable to the right wrist, 27.5 % PPD at the elbow referable to the left wrist and elbow, 15 % multiplicity, and 7 weeks disfigurement.
15. Compensation paid to-date for temporary disability: None
16. Value necessary medical aid paid to date by employer/insurer? None

Employee: Geneva Sellers

Injury No.: 03-060302

Sentry Insurance Company, and represented by Attorney Ben Shelledy. Pursuant to agreement by the parties Second Injury Fund (SIF) will remain open.

Prior to the start of the hearing the remaining parties identified the issues for disposition in this case: arising out of and in the course/scope of employment; occupational disease; medical causation; medical expenses in the amount of $\ 18,150.80; temporary total disability (TTD), future medical care; and the liability of Employer for permanent partial disability (PPD) benefits and disfigurement. Hearing venue is correct, and jurisdiction properly lies with the Missouri Division of Workers' Compensation.

Claimant offered Exhibits A-E, and Employer offered Exhibits 1-2. All exhibits were admitted into the record without objection. Any markings contained within any exhibit were present when received, and the markings did not influence the evidentiary weight given the exhibit. Any objections not expressly ruled on in this award are overruled.

All evidence presented has been reviewed. Only testimony necessary to support this award will be reviewed and summarized.

1. Claimant is forty-two years old, began working for Employer as a wire operator in December 1999, and left Employer's employment in September 2003. Claimant's job duties included data entry, typing, and filing. 90 % of Claimant's work day was spent in data entry. Claimant utilized a keyboard that was located an arms length from her body, rested her arms on her desk, used her left arm to flip the tickets she was entering, and used her right hand to enter the data.
2. Claimant has a medical history of undergoing a breast reduction during 2002 due to pain in her upper back, shoulders, and neck, took thyroid medication for approximately two years during 2003-2005, and is a smoker. Claimant is 5'3" and weighs 187 pounds.
3. During April or May 2003, Claimant developed numbness in her left ring and small fingers, and pain in her left forearm and right hand. Claimant told her supervisor about the numbness, but no medical care was offered. During June 2003, Claimant sought medical care with her private physician, and a nerve conduction velocity (NCV) was ordered that was reported as within normal limits. Claimant next sought care with Dr. Glogovac, a hand surgeon. Dr. Glogovac diagnosed left cubital and carpal tunnel syndrome. Dr. Glogovac took Claimant off work from June 24, 2003 until July 8, 2003.
4. Claimant again approached Employer about her condition, and Claimant was sent for a medical evaluation with Dr. Crandall, a hand surgeon. Dr. Crandall examined Claimant on June 30, 2003. Upon examination, Dr. Crandall noted an equivocal left brachial plexus provocative test, an equivocal left ulnar and median Tinel's sign, numbness of her left ring and small fingers during Phalen's testing, numbness in all left fingers during left arm raise testing, and pain in her left ring and small fingers with provocative testing. Dr. Crandall suggested a keystroke analysis be performed, and a possible repeat NVC. Dr. Crandall did not find a relationship between cubital tunnel syndrome and her typing. On October 20, 2003, Dr. Crandall further opined it is not uncommon for patients who have undergone breast reduction to experience pain in the ulnar nerve distribution. Additionally, Dr. Crandall opined "women who have large breasts wear very tight bras and it cuts across their shoulders and pinches the nerves before they enter the clavicle and then they have pains all the way down their arm." Dr. Crandall also found Claimant typed between 44,000 - 47,000 keystrokes per day, and OSHA does not relate development of carpal tunnel syndrome to typing unless the worker types four hours of continuous typing a day or 60,000 keystrokes.
5. Claimant left her employment with Employer at the end of September 2003. Claimant went to work for Wal-Mart as a cashier on October 7, 2003. On January 14, 2004, Dr. Glogovac performed a left cubital tunnel decompression, and provided off-work slips for Claimant from January 12, 2004 until February 17, 2004. On August 4, 2004, Dr. Glogovac performed a right carpal tunnel decompression, and provided off-work slips for Claimant from July 30, 2004 until November 1, 2004. On December 21, 2005, Dr. Glogovac performed a left carpal tunnel decompression. The total cost for Claimant's medical care was $\ 18,150.80.

1. Dr. Schlafly examined Claimant on two occasions, October 21, 2005 and December 1, 2006. Upon Dr. Schlafly's last examination, Dr. Schlafly noted a positive Tinel's and Phalen's sign over Claimant's median nerve at her left wrist, and indicated Claimant had difficulty with two point discrimination testing involving her left ring and small fingertips. Dr. Schlafly diagnosed Claimant with bilateral carpal tunnel syndrome, and left cubital tunnel syndrome, and found her work to be a substantial factor in her development of the syndromes. Dr. Schlafly rated Claimant's disability as 25 % PPD of her right wrist, 27.5 % PPD of her left wrist, 35 % PPD of her left elbow, and opined Claimant should receive extra compensation due to multiplicity. Dr. Schlafly testified OSHA has never established a minimum number of keystrokes needed to produce carpal tunnel syndrome, and cubital tunnel syndrome starts with repetitive motion of the fingers in association with muscle movement along with flexed elbow position. Further, Dr. Schlafly testified nothing in his review of Claimant's medical records indicated she underwent breast reduction surgery for median or ulnar nerve problems.
2. Dr. Ollinger examined Claimant on January 16, 2006. Dr. Ollinger indicated the abnormal finding upon physical examination included numbness and tingling of Claimant's left ring and small fingers. Dr. Ollinger did not find any positive responses to Claimant's cervical brachial area or findings of radiculopathy. Dr. Ollinger did not believe Claimant's work duties were a substantial factor in causing Claimant's upper extremity disorder. Dr. Ollinger opined there was a "possibility" of a connection between mammary hyperplasia and Claimant's upper extremity disorder, Claimant's obesity is a risk to development of carpal tunnel syndrome, and Claimant's thyroid condition was also an additional risk. Dr. Ollinger noted Claimant still has symptoms despite receiving treatment. Dr. Ollinger rated Claimant's disability at 2 % PPD to her left elbow, and 2 % PPD to her right wrist.
3. As of hearing, Claimant continues to experience aching and decreased strength. Her hands go numb if she raises her hands over her head, and her left ring and small fingers remain numb. Regarding