On November 5, 2004, Claimant was lifting heavy bags when he felt a pop in his back and shoulder, and felt instant numbness in his shoulder, arm, and back. Claimant received conservative treatment from Employer and was released to return to work when he injured his
low back again on December 28, 2004 when he was lifting a kennel onto an airplane. Claimant filed a claim for compensation for the December 2004 injury alleging injuries to his low back, left knee, right knee and body as a whole, but dismissed the claim as part of his settlement in the primary injury. Claimant never returned to work after his December 2004 injury.
Dr. Browdy provided treatment for Claimant's low back, and diagnosed a severe low back strain on February 1, 2005. Claimant gave Dr. Browdy a history of injuring his low back during two separate incidents at work in November and December. He reported being evaluated by Employer's physician, then receiving two weeks of physical therapy. Dr. Browdy diagnosed a severe strain on the lumbar spine. He indicated Claimant had physical therapy after the November injury but had a recurrent injury in late December, and did not have any treatment during the month of January. Claimant was prescribed a different anti-inflammatory medication and physical therapy. Claimant was released to work with permanent restrictions by Dr. Browdy on April 26, 2005. Although Dr. Browdy stated in writing on May 31, 2005 that Claimant was at maximum medical improvement, this was simply a response letter to the insurance carrier, and the last time Dr. Browdy examined Claimant was on April 26, 2005.
Claimant also received conservative treatment from Dr. Nogalski for his right shoulder. On January 18, 2005, Dr. Nogalski reviewed a January 11, 2005 right shoulder MRI and diagnosed right shoulder rotator cuff tendinitis and a possible tear of the subscapularis. He returned Claimant to work with restrictions. On February 1, 2005 Dr. Nogalski altered his diagnosis to right shoulder pain, right shoulder subscrapular partial thickness tear vs. tendinosis. On February 15, 2005, Dr. Nogalski noted that he explained to Claimant that the type of tear he had was not a type of tear that is typically considered a surgical problem. Additional physical therapy was ordered. On March 1, 2005, Dr. Nogalski recommended a functional capacity evaluation. Claimant was released to work on March 14, 2005 with a restriction of no use of his right arm overhead.
While Claimant was treating for his November and December injuries he was also treating with Dr. Berni for bilateral knee complaints. Dr. Berni performed a right knee arthroscopy with chondroplasty of the medial femoral condyle and partial medial meniscectomy of the anterior horn on February 2, 2005. The Preoperative History and Physical stated Claimant's right knee difficulties began in December of 2004 after crawling around in the belly of an airplane, which is consistent with the December 28, 2004 claim for compensation that was dismissed by Claimant. Claimant continued to have left knee complaints, and Dr. Berni offered a left arthroscopy on March 10, 2005.
A functional capacity evaluation was performed on April 19, 2005. While this FCE was performed with respect to the low back and right shoulder, Claimant had undergone a right knee surgery two and half months before this FCE, and a left knee surgery had been recommended one month before. Claimant performed at the physical demand level of medium for occasional lifting. On April 26, 2005, Dr. Browdy provided work restrictions of no lifting or carrying greater than 40 pounds on an intermittent basis.
Dr. Berni performed a left knee arthroscopy with chondroplasty of the medial femoral condyle and partial lateral meniscectomy on May 25, 2005.
Dr. Nogalski last examined Claimant on October 2, 2005, at which time Claimant was pushing for surgery. Dr. Nogalski opined that Claimant's symptoms did not correlate with any specific objective findings, and he did not feel Claimant was a surgical candidate. This was Claimant's last appointment with Dr. Nogalski.
Claimant continued to seek treatment for his low back and right shoulder. On November 15, 2005, Claimant told Dr. Vernon that his low back pain had been worsening over the last year. Dr. Vernon suggested the possibility of a pain clinic referral. Due to continued right shoulder pain, Dr. Vernon ordered a right shoulder MRI. That MRI was performed on December 8, 2005.
Claimant underwent a second FCE on February 1, 2007which concluded Claimant was capable of functioning in the sedentary physical demand level.
In addition to bilateral knee surgeries, Claimant also received treatment or diagnoses for other illnesses and conditions after November 5, 2004. Claimant treated for left elbow pain and tendinitis in October 2005. On February 12, 2008, Claimant was diagnosed with cervical spine degenerative disc disease, idiopathic peripheral neuropathy and chronic lymphocytic leukemia. Claimant testified he was diagnosed with ITP, a blood cancer, in the summer of 2007. After the November 5, 2004 date of injury, Claimant also underwent a number of surgeries, including a splenectomy, placement of a vena cava filter, surgery to the left ankle and toe, a cholosistectomy and a high pressure port-a-cath. He was also diagnosed with metastasized to back bone.
Dr. Raymond Cohen examined Claimant on October 2, 2008 and prepared a report. Claimant told Dr. Cohen he retired in November 2006, and has not worked since. As a result of the November 4, 2004 injury, Dr. Cohen diagnosed symptomatic multi level lumbar degenerative joint disease. As a result of the injury of December 28, 2004, Dr. Cohen diagnosed aggravation of lumbar spine degenerative spine disease, status-post right knee surgery for medial meniscus tear and aggravation of chondromalacia, and status-post left knee surgery for lateral meniscus tear and aggravation of chondromalacia. Dr. Cohen diagnosed pre-existing conditions of 1997 L1 vertebral fracture, 1999 low back musculoskeletal injury with chronic low back pain and right wrist ganglion cyst. Dr. Cohen also diagnosed subsequent conditions of chronic lymphocytic leukemia, cervical spine degenerative disc disease and chronic polyneuropathy. Dr. Cohen provided separate ratings for Claimant's November 5, 2004 injury and December 28, 2004 injuries. He opined Claimant had overall disability of 52.5 % PPD of the body as a whole with 17.5 % pre-existing, 20 % due to the November 5, 2004 injury, and 15 % due to the work injury of December 28, 2004.
Dr. Cohen opined Claimant had pre-existing 15\% PPD of the right wrist, and his preexisting conditions or disabilities combined with the primary work related injury to create a greater overall disability than their simple sum. He opined due to Claimant's combination of disabilities Claimant is permanently and totally disabled, and not capable of gainful employment in the open labor market, and his pre-existing conditions or disabilities were a hindrance or obstacle to his employment or re-employment. He found no disability at the right shoulder level, since Claimant was asymptomatic, and had no findings at that level. He deferred any rating regarding Claimant's memory loss or depression to a mental health professional.
Dr. Matthew Pelikan evaluated Claimant on January 15, 2013, more than eight years after the November 5, 2004 date of injury. Dr. Pelikan prepared a report and testified on behalf of Claimant. Dr. Pelikan diagnosed aggravation of degenerative disc disease of the lumbar spine and right shoulder strain and aggravation of degenerative disease of the right shoulder as a result of the November 5, 2004 injury. Dr. Pelikan also agreed that the degenerative diseases of both the lumbar spine and right shoulder could have progressed in the eight years between Mr. Steinkamp's November 5, 2004 injury and his January 15, 2013 examination.
Dr. Pelikan did not provide any ratings. He testified he included several subsequent injuries, illnesses and condition in his list of pre-existing conditions, including the bilateral knee surgeries, left elbow pain and tendinitis, cervical degenerative changes with radicular symptoms, chronic lymphatic leukemia, and sensory motor neuropathy. Dr. Pelikan also testified he did not review any medical records prior to November 5, 2004 diagnosing Claimant with any memory issues.
Mr. James England, a vocational expert, examined Claimant on December 1, 2010 and prepared a report. Mr. England opined Claimant is permanently and totally disabled. He included the December 28, 2004 work related injury in his analysis, and relied upon the February 1, 2007 FCE, which showed a marked reduction in Claimant's physical demand level when compared to the April 19, 2005 FCE. Mr. England also relied upon the October 2, 2008 report provided by Dr. Cohen. This report clearly contemplated both the November 5, 2004 injury, as well as the subsequent December 28, 2004 work injury.