therapy. Employee was taken off work and paid temporary total disability benefits for the period from June 29, 1999 to December 14, 1999. During this period, employee received medical treatment, as selected by employer, from HealthSouth, Dr. Jones, Dr. Samudrala, Dr. Sosnoff, and Dr. Weis.
On August 6, 1999, Dr. Samudrala diagnosed employee with chronic muscle strain in the mid-thoracic area and gave employee her first trigger point injection into the left paraspinal muscles in the mid-thoracic area. Employee was then referred to Dr. Sosnoff who administered additional trigger point injections.
Employee returned to work in mid-December 1999. Employee testified that she continued to experience pain and had significant symptoms of tightness and pressure in her mid-back and torso area. Employee returned to employer's medical clinic with continued complaints, and requested additional treatment. Employer's medical department did not place employee off work, but sent her to Dr. Randolph, who performed an independent medical evaluation on March 28, 2000. Dr. Randolph diagnosed employee with nonspecific mid-back pain with a component of myofascial pain being present and opined that employee was at maximum medical improvement. Dr. Randolph limited employee to lifting 30 pounds occasionally. Lastly, Dr. Randolph opined that employee sustained no more than 3% permanent partial disability of the body as a whole as a result of the June 16, 1999, injury. No further medical benefits related to employee's thoracic spine were provided by employer after Dr. Randolph's March 28, 2000, examination report.
On April 10, 2000, employee returned to employer's medical clinic with complaints of pain and discomfort. Employee testified that upon asking employer for additional treatment for her back injuries, she was told that she was on her own. Employee then sought additional medical treatment from several different medical providers. These treatments included chiropractic manipulations, massage therapy, trigger point injections, and other invasive pain management treatments.
Employee offered into evidence medical bills incurred after March 28, 2000, in the stipulated amount of $163,422.61.
Dr. Musich was retained by employee to provide an independent medical evaluation. Dr. Musich reviewed employee's medical records and performed physical examinations of employee on October 7, 2004 and October 13, 2008. In Dr. Musich's October 7, 2004, report, he opined that employee sustained 25% permanent partial disability of the body as a whole as a result of the June 16, 1999, injury. However, in Dr. Musich's October 13, 2008, report, he opined that employee sustained 50% permanent partial disability of the body as a whole as a result of the same injury.
Dr. Musich opined that all of the treatment that employee received for her back and neck injuries, including treatments after March 28, 2000, were causally related to the work injury in June 1999. Dr. Musich also opined that employee will continue needing pain medication indefinitely into the future.
Dr. Wilkey provided testimony regarding an independent medical evaluation he performed on July 14, 2009. Dr. Wilkey reviewed employee's medical records and performed a physical examination of employee. Dr. Wilkey testified that employee demonstrated about five of seven non-physiologic findings that indicated there was some non-physiologic overlay in her presentation. However, Dr. Wilkey opined that the treatment up to his examination was reasonable and causally related to the work injury on June 16, 1999. Dr. Wilkey testified that employee sustained 6% permanent partial disability due to chronic low back pain associated with the June 1999 injury. Lastly, Dr. Wilkey opined that employee may need pain medications for the rest of her life.
Employee testified that she still has lifting restrictions due to her cervico-thoracic back pain. She is unable to kneel, squat, or stoop without pain.
**Conclusions of Law**
**Permanent Partial Disability**
Although neither employee nor employer raised the issue of the nature and extent of employee's permanent partial disability on appeal, we find it necessary to address this issue in light of the ALJ's inconsistent findings. As mentioned above, the ALJ stated in the body of the award that employee sustained 15% permanent partial disability of the body as a whole referable to the June 16, 1999, injury, but later stated in the conclusion that employee sustained 17.5% permanent partial disability of the body as a whole.
The experts' ratings range from no more than 3% to 50% permanent partial disability of the body as a whole.
We find that the 50% permanent partial disability rating by Dr. Musich is the most unreliable. This opinion was given more than nine years after the injury (October 2008). It in no way reflects employee's history of being able to return to work in December 1999 or the other experts' opinions and records. In addition, this 50% rating is inconsistent with Dr. Musich's own prior rating of 25% permanent partial disability, given in October 2004. We find that Dr. Musich's 50% permanent partial disability rating far exceeds employee's actual permanent disability sustained as a result of the June 1999 injury.
While we find that Dr. Musich's 50% permanent partial disability rating far exceeds employee's actual permanent disability sustained as a result of the June 1999 injury, we also find that Dr. Randolph's rating of "no more than 3% permanent partial disability" and Dr. Wilkey's rating of 6% permanent partial disability do not adequately account for employee's ongoing complaints and restrictions.
We find that in light of the medical records, medical reports, medical testimony, employee's testimony, and the record as a whole that the ALJ's initial finding of 15% permanent partial disability of the body as a whole is fully supported by the competent and substantial evidence. Therefore, we find that at the time of the November 22, 2002, accident, employee suffered from 15% permanent partial disability of the body as a whole.