This forty-eight year old claimant, a siding installer, a high school graduate, began a siding business with a business partner. Eventually, his business partner left the company, and the claimant worked mostly on his own during the last five years before his January 2000 work injury. The claimant's physical job duties required him to bend, lift, stoop, climb ladders, stand for most of the day, kneel, and work overhead on a daily basis.
On January 7, 2000, the claimant experienced pain and felt a pop in his back while picking up a heavy siding brake that weighed approximately 100 pounds. On January 30, 2000, the claimant underwent a lumbar spine MRI revealing an L5-S1 disc desiccation with minimal disc bulging. On February 16 and 23, 2000, the claimant received epidural steroid injections. On May 25, 2000, Dr. Piper examined the claimant for back pain. The claimant reported that he was gainfully employed without problems with his back for 18 years prior to his January 2000 work injury. The claimant reported that he no longer rides the tractor or quad or do the things he normally did. Dr. Piper opined that the discogram was normal at the L4-5 level and positive and provocative and concordant at the L5-S1 level. See Exhibit C.
On June 22, 2000, Dr. Gragnani opined that the claimant was at maximum medical improvement and that no specific impairments arose from the January 2000 accident. See Exhibit C. On July 25, 2000, Dr. Piper opined that the claimant's anticipated surgery (fusion of the lumbar spine at the L5-S1 level) was related to a work related event that happened on January, 2000. See Exhibit C. On November 3, 2000, Dr. Abernathie examined the claimant and opined that he did not know that he would be willing to offer the claimant surgery, because he was not convinced that the surgery would help the claimant. Dr. Abernathie could not affirm that there is a lesion in his lower lumbar spine amenable to operative intervention, or that it was consistent with his complaint. Dr. Abernathie found the claimant at maximum medical improvement and found a 15 % permanent partial disability of the body as a whole. See Exhibit C.
On January 16, 2001, Dr. Kennedy examined the claimant and found no evidence of nerve root compression to suggest radiculopathy. Dr. Kennedy opined that given the fact that he does not have any significant degenerative changes in the disc, the results of the discogram are spurious and do not predict likely successful response to surgery. Dr. Kennedy opined that a fusion would fail to improve symptoms since they are poorly localized. Dr. Kennedy opined that there was not any particular reason to restrict the claimant's activities. Dr. Kennedy opined that the claimant may choose to not perform heavy lifting, but he did not see any correlative physical abnormalities that would explain this. Dr. Kennedy diagnosed a lumbar strain, recommended no operative intervention or specific activity restrictions, and found the claimant to be at maximum medical improvement.
On February 27, 2001, Dr. Piper examined the claimant, reviewed a discogram, and found an abnormal L5-S1 discogram with extravasation of dye in the epidural space. Dr. Piper noted that the L4-L5 was normal appearing. See Exhibit C. Dr. Piper noted that initially, after a positive discogram, he planned to do a one level ALIF at the level L5-S1 in August or September 2000. See Exhibit C. On April 16, 2004, Dr. Piper reviewed a discography and noted that level L4-L5 and L5-S1 were abnormal, that Level L5-S1 was grossly abnormal with a right radial tear, and that L4-L5 had a radial tear. Dr. Piper noted that he would schedule him for a 2 level ALIF. See Exhibit C.
On February 27, 2007, Dr. Kuklo examined the claimant and diagnosed degenerative disc disease with L5 radiculopathy. Dr. Kuklo noted that the discogram is positive for concordant pain at the L4-L5 and the L5-S1 level. See Exhibit C. On March 14, 2007, the claimant underwent a bilateral pedicle screw instrumentation at the L4-S1 level, transforaminal lumbar interbody fusion at the L4-L5 level and the L5-S1 level with interbody spacer and bony grafting, and a posterior spinal fusion with bone morphogenic protein and local bone L4 through S1. See Exhibit C. On July 31, 2007, at Dr. Kuklo's re-examination, the claimant reported that his left leg pain was gone, back pain was decreased, and that he experienced no more shooting pains. See Exhibit C. On March 17, 2008, Dr. Kuklo discharged the claimant and placed him at maximum medical improvement. See Exhibit C. On May 1, 2008, Dr. Kuklo examined the claimant and cleared the claimant to do whatever activities he desired. Although Dr. Kuklo provided no specific restrictions, he opined that the claimant should avoid a lot of bending, lifting, and twisting, but otherwise should be as active as he can. See Exhibit C.
On August 28, 2008, the claimant underwent a rotator cuff and impingement surgery on the left shoulder. See Exhibit C.
The claimant testified that he now has to lie down during the day to relieve his back pain and that he spends 65-70 % of the day lying down to relieve back pain. Until the primary work injury, he worked at a physical job without any other co-workers or helpers. The claimant testified that his job required him to bend, lift, climb, and stand or walk throughout the day. The claimant testified that before the work injury, he would hunt, fish, ride four wheelers, jog, play softball, and lift weights. The claimant testified that he has been unable to do these activities since his primary work injury. The claimant testified that before the primary work injury, he worked a physical job on a daily basis putting up siding alone.
The claimant testified that after his work injury, his wife, Sandy Gentry, started a company called S \& G Measures that measured windows. He testified that the business also did siding. See claimant deposition, page 8 . The claimant testified that his wife worked as a nurse during the time S \& G Measures operated. The claimant testified at the hearing that he did not run ads or put signs up looking for crews to do the siding and window jobs. The claimant testified that only on one occasion he worked for S \& G Measures to measure a window. However, in his 2004 deposition testimony, he testified that he would go pick up the paper work, even though the company was in Sandy's name. See claimant deposition, page 1