Based upon the competent and substantial evidence, I find:
- Claimant is a 57 year-old married female who has worked for Employer as a Nurse for 30 years. She continues to work for Employer part-time as a Staff Nurse working eight hour shifts, three times a week.
- Claimant cares for a group of patients on each shift. She administers medications and treatments, and she oversees the patient care technicians and nurses' aids.
- On May 20, 2004, Claimant was going into a patient's room. The floor was wet, and she fell onto her knees hitting her right knee harder than her left. Claimant had no prior injury, medical treatment or pain in her right knee. She reported her injury to the Charge Nurse, but deferred treatment expecting her knees to improve. After a few weeks, her right knee pain increased and she was not able to climb steps.
- Claimant sought treatment through workers' compensation and was sent to Concentra. After a few months of conservative treatment, she had an MRI which revealed a torn meniscus. Employer then sent Claimant to Dr. Ritchie.
- Claimant first saw Dr. Ritchie September 22, 2004. He reviewed her recent x-rays and MRI and noted they showed no appreciable arthritis.
- Dr. Ritchie performed surgery October 14, 2004, to repair Claimant's medial and lateral meniscus tears. He also noted some degenerative findings at the time of surgery, and characterized these as "not horrible". He noted she was not down to "bare bone". Following surgery, he ordered physical therapy and prescribed medications.
- Claimant returned to work November 1, 2004. She worked limited duty sitting at a desk for two weeks and returned to full duty November 20, 2004.
- She continued to have pain, limited movement, and difficulty walking. Due to Claimant's ongoing problems, she had cortisone injections in December 2004. These alleviated her symptoms for a few days. In January 2005, Dr. Ritchie released Claimant from treatment. She testified she still had problems in her knee at this point, but she felt they were improved.
- Over the next few months, Claimant continued to have knee pain and was not able to walk on her treadmill. She had difficulty walking up and down stairs and wore a brace for support.
- By April 2005, Claimant still had stiffness and significant pain with activities. She sought additional treatment and saw Dr. Ritchie April 25, 2005. He thought she could be treated for her degenerative wear which he opined was not work related.
- A few months later, Claimant had cardiac bypass surgery, and walked on her treadmill during rehab. She testified her knee symptoms increased at this time.
- When Claimant returned to work following her bypass, she still had complaints with her knee. She had difficulty getting in and out of her car. She was not able to kneel or squat on the floor to play with her grandchildren. She had spasms and excruciating pain which was worse at night.
- On October 7, 2005, Claimant went to Dr. Markenson since additional care through Employer had been denied. She complained of stiffness, swelling and soreness in her knee. She was starting to have discomfort in her hip and with walking. She told Dr. Markenson she felt she had not done well following her 2004 surgery. Dr. Markenson ordered x-rays which showed she was now down to bone on bone on the medial side of her right knee. He noted the MRI from before her 2004 surgery showed early signs of arthritis. Dr. Markenson treated Claimant with injections, and advised Claimant she was going to need a knee replacement once she was stable from her heart condition.
- By January 2006 Claimant's symptoms persisted, and Dr. Markenson recommended additional surgery. He performed a total knee replacement on February 9, 2006. When Claimant returned to work April 17, 2006, she still had knee complaints, but they were improved. She continued to take Advil, avoided steps and avoided long periods of sitting. Claimant was released from treatment in June 2006.
- Claimant continues to have a locking feeling in her knee when she uses stairs. She can not bend her
knee back completely. She still has pain, but it is bearable. She has difficulty getting up after a fall. She continues to take over-the-counter anti-inflammatories. She continues to work as a nurse, but she needs help with heavy patients and with lifting things off the ground.
- Claimant did not have complaints or difficulties with her knee before her work injury. She had arthroscopic surgery to her left knee in 1995, but has had no recommendation for left total knee replacement.
- In August 2001, Claimant was diagnosed with fibromyalgia. She has continued to treat with Dr. Kirschner for her complaints of muscle weakness and fatigue related to this condition.
- Claimant is credible.