The claimant worked for Webco Manor as a nurse's aid and housekeeper since November 1984. Her duties included general cleaning, linens, laundry, and patient care such as giving meals and baths. She is currently 70 years old.
On May 6, 2006, she had finished cleaning and was putting things away. There was a mop bucket in the floor. It was a 5 gallon bucket, approximately $1 / 2 to 2 / 3$ full of water. She used the outside of her left foot to move it out of the way, approximately 2-3 feet. She had to strain to push the bucket. She did not feel pain as she moved the bucket but did feel pain 5-10 seconds later as she turned and walked out of the apartment and down the hall. She felt acute and severe pain down in the left lower back and the back of her left leg from the waist to the ankle.
Claimant told the medical aid, Diana Clift, that her leg was hurting. Claimant then went to her car where she had pain medication for a previous rotator cuff surgery. She used some of this medication.
This incident occurred about 3:30 p.m. Claimant worked until the end of her shift at 8:30 p.m. She continued to have pain. It worsened after she got home. The next day she sought medical treatment at St. John's emergency room.
St. John's records show that she was seen on May 7, 2006. She gave a history that her leg hurt and the pain had started the previous day. The nurse's notes state "no recent injury." The claimant testified that she was in such extreme pain that she does not remember anything that she told the staff in the emergency room, she just wanted to get relief from her pain.
Claimant went to Dr. Mestin, a chiropractor, the next day, May 8, 2006. Thehistory given in Dr. Mestin's notes is "Pain started two days ago. Patient was walking at work and pain came on all of a sudden." This history was filled out by the nurse not by the claimant. Claimant testified that the history was accurate as her pain began as she began walking down the hall within a few seconds of moving the bucket.
Claimant testified that she discussed her injury with her supervisor on May 11, 2006. A report of injury was filled out on that date. Claimant said that when she notified her supervisor, Debby Ginetti, she told her that she felt her back and leg pain was related to her employment, and when asked what incident caused it she said she discussed moving a chair in the apartment she was cleaning and moving the bucket with her left foot. Claimant testified that she had no pain or problems doing her job before May 6, 2006. Claimant was sent to Dr. Dennis Robinson on May 11, 2006.
Dr. Robinson's notes show a follow-up from the emergency room. His notes state she "hurt her back last week." She received an injection to the left sacroiliac joint. She was also prescribed medications.
Claimant was referred to Dr. Scarrow, a neurosurgeon. On May 18, 2006, she had an MRI of the lower back
which showed multilevel degenerative changes; a central disc protrusion at L4-5 with moderate to sever degenerative disc disease; and small left foraminal disc protrusion at L2-3 without nerve root compression. Claimant continued to treat with Dr. Robinson and received treatment at the pain clinic through the summer of 2006. Dr. Scarrow performed three epidural steroid injections. She said these would help for 2-3 days. She also had physical therapy. The physical therapy initially helped, and Dr. Robinson returned her to work on August 28, 2006. Her duties were the same as before. She continued to work until June 2007.
Dr. Shane Bennoch examined the claimant on October 30, 2006. Dr.Bennoch testified by deposition. He diagnosed her with "acute onset of low back pain with radiculopathy, most likely nerve impingement secondary to disc disease; and onset of left calf pain and muscle spasm, persistent, uncertain etiology, possibly related to an S1 radiculopathy." Dr. Bennoch testified that within a reasonable degree of medical certainty, the incident of May 6, 2006, when claimant pushed the mop bucket with her foot, was the prevailing factor in causing the injuries. He further testified that when he used the term "uncertain etiology" he did not mean that he was uncertain that the May 6, 2006, incident was the prevailing factor; rather, he was referring to the uncertainty whether the pain was coming from a torn muscle in the calf or radiating from the back. Dr. Bennoch testified that she had not reached maximum medical improvement in the area of the calf since she is still having persistent pain, but found the overall severity of the pain in her back had improved. Dr. Bennoch recommended a repeat MRI of the lumbar spine. If this did not disclose a reason for the calf pain then would find an MRI of the calf muscles helpful to see if it is something like a torn muscle.
Dr. Bennoch testified that pushing the bucket with her foot was an appropriate mechanism of injury. He also said that it was not unusual for an individual to have a delayed onset of acute pain shortly after such an incident. Dr. Bennoch also testified that the S1 radiculopathy was distinct from the degenerative changes shown on the MRI taken May 18, 2006.
Claimant testified that although physical therapy helped, she currently experiences severe pain in the back and down the left leg; this causes problems for her walking or sitting more than 30 minutes and squatting. She also has problems with daily activities such as vacuuming and reaching. She still has problems with the left leg as it hurts in the morning. This pain was in the back of the leg, and it was worse in the calf. She cannotdo things that require bending and reaching, such as into a cabinet. She stopped working because of the daily pain. She felt she could not continue without pain medication.