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Shelly Martin v. Mark Twain Caring Center

Decision date: January 19, 201030 pages

Summary

The Commission reversed the administrative law judge's award and found that employee Shelly Martin suffered work-related back injuries on June 11, 2002, and January 14, 2003, while employed at Mark Twain Caring Center. The Commission determined that employer failed to provide necessary medical treatment and must furnish additional medical care under the direction of Dr. Gornet.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge)
Injury Nos.: 02-055584 & 03-008884
Employee:Shelly Martin
Employer:Mark Twain Caring Center
Insurer:Missouri Nursing Home Insurance Trust
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund (Open)
This cause has been submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. We have reviewed the evidence and briefs, heard the parties’ oral arguments and we have considered the whole record. Pursuant to § 286.090 RSMo, the Commission reverses the award and decision of the administrative law judge dated July 1, 2009.
PreliminariesThe administrative law judge heard this matter to consider: 1) whether employee suffered accidents that arose out of and in the course of her employment on June 11, 2002, and January 14, 2003; and 2) whether the alleged accidents were the medical cause of employee’s back pain complaints and alleged need for further medical aid.The administrative law judge found that employee suffered injuries that arose out of and in the course of her employment on both June 11, 2002, and January 14, 2003. The administrative law judge further found that employee’s back pain complaints had their structural onset from the two work-related accidents. The administrative law judge went on to find that employee is in need of additional medical treatment to cure and relieve her from the effects of her work related injuries. Lastly, the administrative law judge found that employer failed or neglected to provide necessary medical aid to employee and, therefore, waived its right to select the treating physician. As such, employer was ordered to furnish additional medical treatment under the direction and control of Dr. Gornet.
The award was issued as a temporary or partial award and subject to further order, and the proceedings were continued and the case kept open until a final award could be made.Employer appealed to the Commission alleging the administrative law judge erred in failing to designate the June 11, 2002, accident as a final award in that the administrative law judge found employee’s condition was “not disabling” and that employer is not liable for medical treatment as a result of that accident. Employer also alleged that the administrative law judge erred in finding employee’s medical condition and need for treatment to be medically causally related to the January 14, 2003, accident because employee’s testimony regarding the accident is inconsistent and lacks corroborating evidentiary support. In addition, employee’s proof on the issue of medical causation lacks a sufficient probative foundation. Lastly, employer alleged that the administrative

Iaw judge exceeded his statutory authority by mandating employer provide medical treatment "under the direction and control of Dr. Gornet" without a finding that employee's health and recovery is endangered.

Employee filed a motion to dismiss employer's Application for Review under 8 CSR 203.040. Employee claims that employer's Application for Review must be dismissed because employer has failed to allege it is not liable for the payment of any compensation, as required by 8 CSR 20-3.040 to appeal a temporary or partial award.

Therefore, the primary issues currently before the Commission include whether employer's Application for Review must be dismissed under 8 CSR 20-3.040, whether employee suffered injuries that arose out of and in the course of her employment on June 11, 2002, and January 14, 2003, whether employee's current back pain complaints and alleged need for further medical treatment are medically causally related to the aforementioned injuries, and if so, whether employer failed or neglected to provide employee with said necessary medical treatment, consequently waiving its right to select the employee's treating physician.

In addition, employer also requested an award for permanent partial disability if we ruled in favor of employer on the issue of additional medical. Therefore, in the event of said finding, the nature and extent of permanent partial disability for both the aforementioned injuries shall also be included as a primary issue before the Commission.

Findings of Fact

The stipulations of the parties were recounted in the award of the administrative law judge and are hereby adopted and incorporated in this award by the Commission.

Employee began working for employer in May 2002. As part of employee's job, she helped take care of the residents, including showering and bathing, helping with food and drink, reporting any physical or mental changes, answering their call lights, and making beds.

Employee testified that on June 11, 2002, around 7:15 a.m., she was in a room working with a resident named Charley. She dressed him and put a gait belt on to transfer him from his bed to a Geri-chair when, while trying to pivot, she twisted the lower half of her back and felt "pressure" to the right lower back which "wasn't real intense." Employee reported the injury to her supervisor, Crystal, who arranged an appointment with Dr. Smith that day. Crystal told employee to go home and that they would call her with information regarding a doctor's appointment.

Later that same day employee saw Dr. Smith and his note indicates that she had complaints of low back pain related to the transfer of a resident from a bed to a chair that morning. The exam showed mild tenderness was present in the SI joint with palpable muscle spasms in the upper buttock. Dr. Smith diagnosed employee with a lumbar back strain and prescribed her pain medication. Employee was released to work with no lifting over 20 pounds and no repetitive bending.

On June 24, 2002, employee returned to Dr. Smith for a follow-up. Dr. Smith noted mild tenderness above the right sacroiliac joint, but no muscle spasms were present. Dr. Smith discontinued employee's pain medication. Dr. Smith increased her lifting restrictions to no lifting over 30 pounds.

On July 10, 2002, employee returned to Dr. Smith for another follow-up. Dr. Smith noted the spine was "non tender with a full range of motion." Dr. Smith discharged employee from care and released her to work without restrictions.

Employee testified that when she returned to working without restrictions she still had pressure, but that the pain had lessened. She stated that the pain was localized to the right side of her low back and she had no radiating pain down her right leg. Employee did not seek medical treatment for any continuing complaints of low back pain leading up to the January 14, 2003, accident claim. ${ }^{1}$

Between September 10, 2002, and January 3, 2003, employee visited Dr. Schisler on four separate office visits and did not mention any continued back problems. Employee testified she was working mandatory twelve hour work shifts, some 36-48 hours per week, due to work schedule changes made by employer in late 2002.

On January 14, 2003, employee testified she was using a gait belt to transfer a female resident, Ada, from her bed to a Geri-chair. During the transfer, Ada started "twitching" and employee lost her balance. While lifting Ada back up into bed, employee felt sharp pain in her low back followed by a grinding noise, heard popping, and she dropped to her knees. Employee testified that the pain was totally different in intensity than her June 11, 2002, injury. She stated that it felt like someone took a knife and stabbed her. She grabbed the handrail and pulled herself up and used the rail all the way to the nurse's station where she mentioned her injury to some LPNs and a med tech. They told her to fill out an injury report and to return to work. Employee filled out the injury report and returned to work. Employee could not recall if she had requested medical treatment at that time.

Employee's injury report was undated, but was signed by employee and states: "I reinjured my low back on Ada Shalk" during the "p.m." on January 14, 2003. The Form 1/Report of Injury prepared and signed by Chris Taylor on January 23, 2003 shows that the injury was not reported until January 23, 2003. The report shows employee "was allegedly transferring a resident from shower chair to wheelchair." It also indicates employee was sent to Dr. Smith on January 23, 2003. Lastly, it indicates employee returned to work without disability on January 23, 2003.

Dr. Schisler's January 17, 2003, office note does not contain any history of an injury occurring on January 14, 2003, nor does it contain any complaints of low back pain.

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[^0]: ${ }^{1}$ Employee originally listed the date of accident on this claim as January 23, 2003, but filed an amended claim on the day of the hearing, which changed the date of the alleged 2003 accident to January 14, 2003.

On January 23, 2003, employee saw Dr. Smith and complained of low back pain that had come on in the past two weeks, but she reported no recent injury. Dr. Smith's exam showed mild low back tenderness and decreased range of motion without any neurological deficits. Dr. Smith diagnosed employee with a low back strain and put employee on restrictions of no lifting over 30 pounds and no repeated stooping.

Employee testified that her problems progressed to her right leg within a couple of months after the injury. Employee last worked for employer on February 7, 2003. She was discharged because there were not any light duty jobs and they could not find any job that she could do.

On February 13, 2003, employee returned to Dr. Smith. Dr. Smith identified tenderness in the right SI joint with the ability to bend 80 degrees from a vertical position. Dr. Smith continued employee's pain medication and ordered physical therapy, two times per week for three weeks.

On February 14, 2003, employee saw Dr. Schisler for increasing right lower back pain and spasms, which she claimed had been coming on gradually. Dr. Schisler's note indicated that employee hurt her back at work on the left side a couple of weeks ago and then she was carrying some water at work and began having incremental pain in her right side. Employee also noticed a lump in the PSIS area. Dr. Schisler's exam identified palpable muscle spasms in the PSIS area of the right hip, for which pain medication was prescribed.

Employee testified that she told Dr. Schisler about hurting her back at work, but did not remember telling Dr. Schisler that she hurt her back at work carrying water or that the right low back pain came on gradually.

On March 7, 2003, employee attended her physical therapy evaluation and muscle spasms along the right paraspinal in the right thoracic region were identified. The evaluation also showed a complaint of sharp pain that shoots at times down the right leg to the middle of the hamstring. Employee had four physical therapy visits between March 7, 2003, and March 25, 2003, for a right back strain.

On March 31, 2003, employee saw Dr. Smith. Employee informed Dr. Smith that she had quit working for employer and was working for a home health agency. She indicated the work was less strenuous and her back was feeling better. Employee had no tenderness over the SI joint. Dr. Smith assessed employee with a low back strain that had resolved and released her from care with no restrictions.

Dr. Schisler's records show three office visits by employee between March 31, 2003, and July 21, 2003, which contain no evidence of any continuing low back pain problems.

Employee does not know exactly when she began having constant shooting pain down the low back into the right leg. When confronted with the first diagnosis of "sciatica" referred to in the medical records, employee acknowledged "it could be" that her

Employee: Shelly Martin

complaints of constant shooting pain down her right leg had not

Full decision text continues in the plain-text archive copy.

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