Mr. Conrad testified on his own behalf and presented the following exhibits, all of which were admitted into evidence without objection:
Exhibit A - Rating Report of Lowry Jones, MD dated September 13, 2004.
Exhibit B - Rating Report of Lowry Jones, MD dated July 25, 2005.
Exhibit C - Rating Report of Lowry Jones, MD dated August 16, 2005.
Exhibit D - Operative Report of Lowry Jones, MD dated June 28, 2004.
Although the employer did not call any witnesses, it did present the following exhibits, all of which were admitted into evidence without objection:
Exhibit 1 - Medical Records, Lowry Jones, MD
Exhibit 2 - Medical Records, St. Mary's Hospital
Exhibit 3 - Claim for Compensation
I note that, although marked separately, all the medical records and opinions came only from the Employer-authorized treating physician, Lowry Jones, Jr., M.D.
Based on the above exhibits and the testimony of Mr. Conrad, I make the following findings. Mr. Conrad is a 51-year old male, who lives in Lone Jack, Missouri. Mr. Conrad worked for JCT for over 31 years until he retired in June 2007 after a successful career with the Employer.
On April 30, 2004, Mr. Conrad was working for JCT in his position as a truck hostler. Part of Mr. Conrad's duties was to move trucks - that had been parked by the road drivers the night before - up to fuel pumps in the service area in the JCT Wyandotte County Kansas truck yard, and to fuel and service the trucks in preparation for the day. Once a truck was serviced, Mr. Conrad would move that truck from the pumps, walk back in line and retrieve the next truck to bring it to the pumps to be serviced. During this process, Mr. Conrad was exiting a truck and turned to walk back to the next truck. As he turned, Mr. Conrad twisted his left knee and experienced immediate pain. Mr. Conrad immediately reported the incident to his supervisor. Mr. Conrad continued to work for a few days to allow the left knee to improve on its own. After no improvement in the swelling and pain in his left knee, Mr. Conrad was referred by JCT to the Wyandotte Occupational Health clinic on May 6, 2004. An MRI was ordered to rule out a meniscus tear.
Mr. Conrad suffered a prior non-work related injury to his left knee that resulted in arthroscopic surgery for a meniscal tear at St. Mary's hospital in 1993, as well as a previous work related injury to his right knee in 2001 that was treated by Dr. Lowry Jones. The 2001 injury to Mr. Conrad's right knee settled with 15\% disability to his right knee. Mr. Conrad's prior 1993 left knee injury did not result in a disabling condition. The medical records of St. Mary's Hospital for prior treatment to his left knee were submitted as Employer's Exhibit 2. Medical records of Dr. Lowry Jones, submitted as Employer's Exhibit 1, indicate that Dr. Jones was fully aware of Mr. Conrad's prior injuries.
An MRI of Mr. Conrad's left knee was performed on May 10, 2004 which revealed a medial meniscal tear. On May 12, 2004, Mr. Conrad was referred by JCT to Dr. Lowry Jones for treatment of his meniscal tear.
On June 28, 2004, Mr. Conrad underwent arthroscopic surgery to his left knee by Dr. Jones. The preoperative diagnosis was "Medial meniscus tear with chondromalacia patella." See, Employer's Exhibit 1 at 32. The Operative report documents a postoperative diagnosis of:
Grade 3 chondral flap tear of the medial femoral condyle, grade 2 lesion of the lateral femoral condyle, grade 2 to grade 3 fragmentation of the trochlear groove, patellar chondromalacia grade 1, as well as a complex tear of the medial meniscus.
Id.
The "Description of Procedure" section of the report further describes that:
The patellofemoral joint showed some mild chondral wearing of the patella, grade 1, without much fragmentation. He had a fragmented trochlear groove inflection at about 30 degrees of flexion down to about 90 degrees of flexion" and noted the discovery of a "large chondral flap tear of a large portion of the weightbearing surface of the medial femoral condyle.
Id.
Mr. Conrad's left knee was further found to have "excellent thickness of the articular surface in the medial condyle except for the flap tear . . ." The medial meniscus was found to have "a complex horizontal tear that extended from the posterior horn to the mid body." After debridement and repair of the tears, Mr. Conrad's left knee is reported as "fairly normal." Id.
After a period of recovery, Mr. Conrad was returned to work on August 17, 2004. On September 13, 2004, Dr. Jones opined that Mr. Conrad sustained "15-percent permanent partial impairment at the level of the knee." Id. at 34. Mr. Conrad returned to work at full duty as directed by the Employer's physician; however, Mr. Conrad continued to experience discomfort in his left knee. Mr. Conrad returned to Dr. Jones on April 18, 2005 and the treatment note revealed that:
He has been having some persistent pain in the knee, swelling mostly along the medial joint line.
We placed him on a combination of two Aleve twice a day and some glucosamine sulfate/chondroitin sulfate complex.
Id. at 26 .
On July 25, 2005, Dr. Jones issued an additional "Disability Rating" which stated that Mr. Conrad had "tenpercent (10\%) permanent partial impairment at the level of the knee." Id. at 19.
To clarify the two previous reports, Dr. Jones issued a "Disability Rating Addendum" dated August 16, 2005. Dr. Jones stated that Mr. Conrad had:
. . . presented to my office with continued medial joint line pain and patellofemoral pain. This represen