Employee Snezana Kalajdzic, known as "Anna," was born in Prajedor, Bosnia in 1970. She described her childhood as easy. However, when employee was fifteen, her father died of a stroke. The employee worked for four years as a store salesperson and attended two years of college in Bosnia working toward a social work degree. Her pursuit of higher education ended with the start of the Bosnian war. For two years, starting in 1992, she remained secluded in her home for safety. She witnessed shooting and experienced harassment from soldiers because her father was Catholic. In 1997, the employee decided to emigrate from Bosnia to the United States. She testified, "I did not get so along with my mom and brother, and I didn't have work, I didn't have enough food, enough clothing. I was looking for something that I can come and work and have a roof over my head and my clothing, and that's it."4
After arriving in the U.S., the employee received limited instruction in the English language. She learned English primarily from working with people and watching TV. Her first U.S. job involved assembly line work for a chemical manufacturer. After working there less than a year, the employee took a job with a furniture company, cutting fabric for upholstery. She worked at the furniture company for six years, eventually becoming a lead in its upholstery trim department.
In February 2006, the employee started work for employer's children's hospital as a nurse aide. Employee testified, "First I have to pass the math test, then I pass, then [they] show me. . . exactly job that I'm going to do as a nursing aid [sic], which means I have to do ADL's [activities of daily living] on patients. I have to empty drains, I have to walk patients, turn patients, get them up out of the bed, anything that involved patient care." ${ }^{5}$ Other than performing secretarial work on a few occasions, employee worked exclusively as a nurse assistant on a surgical floor in employer's hospital. She worked twelve-hour shifts, three days a week. She occasionally worked two extra days a week overtime.
The employee experienced chronic back pain for about six years prior to her accident, treated with epidural shots. In December 2011, she experienced a flare up of her back pain and consulted orthopedic spine surgeon Dr. David Robson. He again ordered epidural shots which afforded her complete relief. On January 24, 2012, Dr. Robson released the employee for full duty work without restrictions.
As of February 16, 2012, approximately two to three weeks after her unrestricted work release, the employee was taking no medication for back pain and reported to work for her 7:00 a.m. shift. At hearing, she described the following event during her work shift that morning:
I went in a room to change the sheets, and then bed instead of - was putting on the middle, it was against the wall, so I had to bend over to raise the mattress to pull off the dirty sheets and put on new ones, and when I did that my back hurt so bad. My leg was so numb and I was
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[^0]: ${ }^{4} Transcript, page 58.
{ }^{5}$ Id. at 8 .
afraid I was going to fall . . . for few seconds I just stand there waiting what's going to happen, and then I pull all my strength to get to the door. And when my co-workers saw me crying and hardly moving they come to me to take me to the lunchroom. ${ }^{6}$
Relying on employee's handwritten statement taken shortly after the injury, the ALJ concluded mechanism of employee's work injury was "merely bending to change sheets on a bed." ${ }^{7}$ We disagree, for the following reasons.
Employee's statements to the examining experts Drs. David Volarich and Robert Bernardi regarding the mechanism of her February 16, 2012, injury. These accounts and employee's hearing testimony are consistent with employee's earlier handwritten statement, simply providing a more detailed description of how her injury occurred.
We find that employee's nurse aide duties on a surgery floor in employer's hospital required her to change bedsheets. The bed employee was changing at the time of her injury was positioned awkwardly against a wall or window as opposed to in the middle of the room. We find that employee had no control over placement of employer's hospital beds. We find the bed's awkward placement required the employee to reach across the bed without back support to lift up the mattress in order to change its sheets. ${ }^{8}$
After the employee's accident, her floor manager called Dr. Robson and scheduled an appointment for employee that day. The employee rode in a wheelchair to employer's Occupational Health department. There, a nurse assisted employee in completing a form called "Employee's Report of a Work-related Injury, Illness or Exposure." Employee provided the following handwritten statement: "I have problems with my beck I just bend to change sheets on bed and I had sharp pain cross my beck low part. Now I cant stand up [sic]."9 Employer's occupational health nurse documented the employee's treatment outcome as "sent home/Dr. office."10
At her appointment with Dr. Robson on the date of the accident, the employee reported severe pain in her lower back, numbness going down both legs, stiffness in the back muscles of her leg, and difficulty walking. Dr. Robson ordered a CT myelogram and discussed fusion surgery to relieve employee's back symptoms. On April 2, 2012, Dr. Robson performed a three level fusion of the employee's low back.
Since her fusion surgery, the employee has continued to experience pain in her back and legs. She stated, "I get up with the pain, I go to bed with the pain."11 If she bends over to pick something up, she experiences a sharp pain starting in her lower back and going up her back. If she bends to her left side, her right side hurts. If she bends to her
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[^0]: ${ }^{6} Transcript, page 12.
{ }^{7} Award, page 9.
{ }^{8}$ It might be argued, as a matter of common knowledge hospital beds are constructed in a manner that makes it more difficult or awkward to reach across them. In the absence of any direct testimony in the record, however, our finding does not take this conclusion into account.
${ }^{9} Id. at 1248.
{ }^{10} \mathrm{Id}.
{ }^{11} \mathrm{Id}$. at 11 .
right side, her left side hurts. She experiences constant tingling and occasional numbness in both legs. She is uncomfortable lifting anything heavier than a gallon of milk. She is able to stand for only a few minutes. She can comfortably sit for about an hour. She does some house cleaning while wearing a back brace but is only able to clean one room a day before she needs to lay down due to the pain. She does light cooking which she tries to complete as fast as possible because she has to sit down during the process. Her fiancé helps her with shopping and laundry. She lays down to rest no less than four times a day. She has difficulty sleeping because her back pain wakes her up.
Dr. Robson did not order physical therapy after the employee's spinal fusion but advised her to walk, swim, and ride a bike to assist her recovery. The employee swims and goes to the gym three to four times a week.
The employee experienced feelings of depression and anxiety prior to the accident. She took Xanax prescribed by her primary care physician to control her symptoms. Her feelings of depression and/or anxiety did not limit her ability to work or perform activities of daily living. After her February 16, 2012, injury and related back fusion surgery, the employee started hearing voices. She saw shadows and images of mice, and heard a door close when she knew no one was there. For a time she slept with a knife close to her bed. Twice subsequent to her work injury, the employee received outpatient mental health treatment under the supervision of psychiatrist Dr. Shazia Malik. Prior to her work injury, the employee had not been treated by a psychiatrist. She currently takes pain medication for pain and depression but has weaned herself from narcotic medications.
The employee feels she does not have an interest in anything. She no longer engages in social activities she enjoyed prior to her injury, such as volleyball and dancing. She does not attend events she frequently enjoyed in the past, such as weddings, birthdays, baptisms and funerals. She stopped attending church because she does not want to be around people. She no longer crochets. She neglects personal care such as bathing and eating regular meals. She does not actively plan to take her life but believes everyone would be better off if she was not around.
As of the date of hearing, the employee considered her mood stabilized to some extent. She has stopped hearing voices and no longer sleeps with a knife by her bed. However, problems with her memory cause her to forget to pay bills, take medication, keep appointments, or purchase things she needs at the store. Since her work injury, she has not returned to work or sought employment. She remains under the care of Dr. Malik.