Claimant is a 51 year old woman who was hired by Employer in 1983. She worked at their plant in Huntsville Alabama, which manufactured electronic panels for their vehicles. There is no evidence the work Claimant did for Employer in Huntsville, Alabama involved heavy lifting or excessive use of her back. In February 2005, Claimant moved to St. Louis to work for Employer, and began working at their assembly plant in Fenton on February 21, 2005, and worked there until she left on October 19, 2006. Claimant retired from Employer in May 2008.
After Claimant transferred to the Fenton plant, she was classified as a Tech III. The first department she was assigned to was the Body Shop, where they assembled all of the metal pieces of the mini vans which were then welded together by a robot. Her title in the Body Shop was Floater, which meant she filled in as needed in the body shop department. She worked in the body shop from February to October, 2005. Her first job was putting rear quarter panels on a rack. There were 19 panels weighing 23 pounds on a rack, and she had to step up onto a rack that was one foot off the ground and pick up a panel, back out of the rack, and then set it down. She had to load about 25-50 panels an hour. There was a big metal box on a platform on the floor, and she had to tilt it towards her and pull large pieces of metal which weighed 2 to 5 pounds apiece out of a box. She picked up as many at a time as she could. This required her to bend at the waist. She worked eight to nine hours a day, with twelve minute breaks in the morning and afternoon, and 30 minutes for lunch.
Shortly after Claimant began working at that job, she began to have pain in her low back which radiated into her right buttocks and down her right leg. Claimant saw her primary care physician, Dr. Allen, on April 28, 2005, complaining of low back pain. Claimant told Dr. Allen she had been lifting a lot at work, and had a stiff back from the birth of her daughter. Dr. Allen prescribed physical therapy. She gave Claimant a work restriction of no lifting over ten pounds, and then released her to full duty after one week. Claimant called Employer and told them she would be off work on medical leave for one week. When she returned to work, Employer required a medical release from Dr. Allen. Claimant testified she told the plant medical department she had done a job on Friday and hurt her back and that was why she was off for one week. Claimant testified Employer did not offer her any medical treatment. She testified she reported the incident to her supervisor, and told him the job she was on hurt her back, and he said he would take care of it. According to Claimant, she never heard from him again.
The plant medical records indicate Claimant reported to the medical department on May 5, 2005. The records indicate she was absent since April 25, 2005, and was released by Dr. Allen. The diagnosis was lateral epicondylitis, back pain, and anxiety. The records state Claimant was there to reinstate and she gave a long history of back pain, ever since her daughter was born in 1992. Claimant indicated her pregnancy caused lower back pain, and that her last MRI had been done two years before.
After working in the body shop, Claimant transferred to the inspection department as a floater. Claimant worked in the inspection department from October 15 until she left in 2005. Claimant testified her back flared up when she was doing a job called "lock and latch".
Claimant has a long history of low back problems. In 2002 Claimant had an MRI of her lumbar spine. The clinical history she gave at that time was low back pain radiating to both lower extremities. The MRI was performed to evaluate for herniated disc. The MRI was essentially unremarkable.
On September 27, 2006, Claimant saw Dr. Petkovich for an orthopedic consultation. Claimant's chief complaint was of pain in her low back and right lower extremity. She denied any specific history of injury. She indicated it had been bothering her for the past several months. Claimant denied any prior problems with her lower back. Dr. Petkovich diagnosed muscular and ligamentous lumbosacral strain with prior vascular disease and possible lumbar
discogenic component. He recommended an MRI and physical therapy. An MRI was performed on October 5, 2006. The clinical history given was of back pain and bilateral lower extremity discomfort and bilateral lower extremity weakness. Claimant reported having had low back pain for the previous 14 years, with no specific injury. The MRI revealed degenerative disc disease at L4-5 with desiccation and signal loss with a large central protrusion, which prolapsed slightly below the level of the interspace. There was no significant interspace narrowing at that location.
When Claimant saw Dr. Backer on December 19, 2006, she have a history of low back complaints on and off for 14 years, more severe at times than others. Dr. Backer examined Claimant, and did not find signs of radiculopathy. He noted her MRI showed a bulging disk at L4-5 with a small central and inferior herniation. He discussed with Claimant the uncertainties of outcome with back surgery for just degenerative disk disease. He discussed the possibility of a lumbar diskogram with the knowledge that if she went on to have a back surgery based on the results of the diskogram that the success rate is somewhere between 60 to 70 % with a 30 to 40 % failure rate.
On January 5, 2007, Claimant saw Dr. Bailey, a pain management specialist. Her chief complaint was low back pain. She gave a 14 year history of back pain that began with the gradual onset of pain that starts in the low back and radiates into the legs. She characterized the pain as constant, and severe and indicated that compared to prior episodes, the pain was getting worse. Dr. Bailey's impression was lumbar degenerative disk disease. Dr. Bailey scheduled a discogram with post discogram CT scan. A discogram was performed on February 6, 2007, and the impression was lumbar degenerative disc disease. The CT of the lumbar spine performed on February 6, 2007 showed an L4-5 annular tear.
On April 25, 2007, Claimant underwent a posterior spinal decompression and interbody fusion utilizing Concord cage, autologous bone from same incision and pedicle screw fixation. The post operative diagnoses were degenerative disk, L4-5; with chronic disabling low back pain. After her surgery, Claimant was seen by Dr. Backer for a follow up visit, and reported that she had not received any significant improvement in her symptoms following her surgery. In another follow up visit in June, 2007, Claimant had not improved. Dr. Backer recommended an epidural steroid injection.
Claimant's low back surgery was not successful. Claimant was never able to return to work after her back surgery. She was able to obtain early retirement disability benefits. Claimant currently takes pain medication prescribed by her doctor. Claimant has constant pain in her low back, right leg, and occasionally in her left leg. She has shooting pains into her right knee. She has pain all day, every day, and is never pain free. Lying down or reclining gives her some relief. She has difficulty sleeping, and takes Flexeril for sleep. She is only able to sleep for a couple of hours before she is awakened by pain. She never sleeps a full night. Claimant does minimal household chores. She is able to do some light laundry, sweeping, dishes, and some dusting. She cannot make beds. She is unable to do her lawn work, and is no longer able to walk for exercise. She can walk about $1 / 2$ hour with difficulty, and then she needs to sit down. She uses a chair in her shower. She wears slip on shoes because she cannot bend to put on her shoes. She is able to cook a little bit, but mostly she eats fast food. She has difficulty standing at the stove and cooking. If a pot is very heavy she can't pick it up. She is only able to do light grocery shopping. Riding in the car for distances is difficult. She now lives 620 miles from St. Louis.
Driving to St. Louis was difficult. Claimant has to make frequent stops and when riding she reclines and puts her feet up. She is unable to care for her grandson.
On April 24, 2008, Claimant was examined by Dr. Sandra Tate, for an IME to determine whether she was permanently and totally disabled. Claimant gave a history of low back pain since 1992. She reported her pain was fairly mild in nature and she would usually receive some physical therapy treatment that would completely resolve her symptoms over a short period of time. Claimant reported to Dr. Tate that she last worked in October 2006, due to the fact that she just could no longer perform the activities of her job with lifting due to her complaints of back pain. She filed for FMLA at that time, and saw her primary care doctor several times and was given physical therapy and anti-inflammatory medications. She was then referred to Dr. Petkovich who ordered an MRI of her lumbar spine, and recommended epidural steroid injections which were performed in his office on two occasions without any significant improvement of symptoms. Dr. Tate opined Claimant would have significant difficulties performing any jobs that she may have a seniority of bargaining for in the plant. She therefore opined Claimant is permanently and totally disabled for the rest of her life.
Dr. Volarich examined Claimant on May 27, 2008, prepared a report, and testified on behalf of Claimant. Dr. Volarich testified the repetitive nature of Claimant's work lifting sheets of metal parts weighing approximately 23 pounds for several months leading up to October 2005 were the substantial contributing factors as well as the prevailing or primary factors causing disk protrusion with annular tear at L4-5 that required surgical fusion at the L4-5 level which resulted in post laminectomy syndrome. Dr. Volarich testified as a result of those lifting activities she also developed a disc bulge at C6-7 in the cervical spine and aggravated degenerative disc disease at the C7-T1 level that caused neck pain and regional myofascial pain. Dr. Volarich testified Claimant sustained 45 % PPD of the body as a whole rated at the lumbar spine as a result of the disk protrusion and annular tear at L4-5 due in part to posterior decompression, fusion ad instrumentation. He also rated 25 % PPD of the cervical spine due to the disk bulge at C6-7 and aggravation of the degenerative disk disease at C7-T1 all of which required conservative care.
Mr. James England, a rehabilitation counselor evaluated Claimant on August 6, 2008, prepared a report, and testified on behalf of Claimant. Mr. England testified Claimant would not be able to sustain any kind of work activity on a regular day to day basis.
Dr. David Irvine, an orthopedic surgeon examined Claimant on October 14, 2009, prepared a report, and testified on behalf of Employer. Dr. Irvine diagnosed degenerative disc disease in both the cervical and lumbar spine. Dr. Irvine testified Claimant's cervical and lumbar spine conditions were caused by degenerative changes and the aging process. Although Dr. Irvine assessed PPD in Claimant's lumbar and cervical spines, he did not believe the disability was caused by her work, but was rather the result of the degenerative process.