Claimant is an unemployed, 53-year-old single woman with one adult child and no dependents. She resides in St. Clair, Missouri with her sister. She is a high school graduate and was honorably discharged after serving three years in the United States Army.
Following her stint in the military, Claimant worked as a security guard and in a fast food restaurant for about one year in Missouri. She then moved to Savannah, Georgia, where she worked as a waitress for three years. Claimant moved back to Washington, Missouri, where she started waitressing at Bartholomew's restaurant in 1991 and worked part-time at a McDonald's in the kitchen for several months. Beginning in 1995, she was a surface mount technician performing assembly line work for Trans Tech Incorporated ("TTI"), a company which manufactures circuit boards for vending machines. She continued to work at Bartholomew's part-time but stopped in 1997 when the restaurant closed. She did not have any physical problems or injuries from or during her work with those employers. She was laid off from TTI in 2001 and next found work with Employer in August 2001. She stopped working with Employer in February 2007 and was approved for Social Security Disability the same year.
Claimant started working for Employer in the winding department as a machine operator performing assembly line work. She worked eight hours a day, forty hours a week with occasional overtime. The work was very hand intensive and required constant standing. She later switched into the electrical wiring department, which was also hand intensive. The job required cutting wires, cleaning out copper, and making connections using air pressure guns. In addition, she assisted in moving the units up and down the assembly line which required pushing and pulling. She sometimes picked up reels of wire to move them to different work areas.
On May 5, 2005, Claimant was working in the electrical wiring department with very large wind forms on a mechanical line. She was helping push a heavy wind form transformer that was stuck on the assembly line when she felt like "something pulled or popped in (her) lower back." She felt immediate pain in her lower back but continued to work her shift. She reported the injury to her supervisor but felt she would be fine and didn't need to go to the doctor. However, by the next day her back was in such pain she could hardly stand. She was scheduled to go out of town but stayed home instead, due to her back pain.
Claimant was sent by Employer to Unity Corporate Health ("Unity") on May 10, 2005, where she was initially diagnosed with a left lower back strain and mid-back strain, placed on light duty. She continued to follow up at Unity, undergo physical therapy, and take medication. An MRI of the lumbar spine without contrast was performed on May 31, 2005 and revealed a radial tear to the left of her L4-5 midline and a mild central disk protrusion at L5-S1, with asymmetric disk bulging on the right at the L5-S1 neural foramina. The MRI was compared to Claimant's previous 2003 MRI exam, and both the L4-5 and L5-S1 areas of abnormality were deemed somewhat slightly worsened. Dr. Keefe at Unity diagnosed her with a lumbar disc herniation with left sciatic pain and recommended a referral to a back surgeon.
Claimant came under the care of Dr. Peter Mirkin, an orthopedic spine surgeon. His initial impression was Claimant had degenerative disc disease and small disc protrusions. He recommended aggressive therapy and epidural steroids and placed her on sedentary work duty.
1 This accidental low back injury is the subject of Injury No. 05-061902.
WC-32-R1 (6-81)
Page 4
Issued by DIVISION OF WORKERS' COMPENSATION
Injury No.: 06-061036
When she returned on July 15, 2005, Claimant told Dr. Mirkin she could not live with the pain anymore. Dr. Mirkin recommended an anterior/posterior lumbar decompression and fusion² which he performed on October 20, 2005.
On November 30, 2005, Dr. Mirkin returned her back to work light duty. According to Claimant, Employer assigned her office work where she scanned papers into the computer. She worked in the office until January, but not full-time. She testified she then worked eight-hour days but light duty on the floor making wires. This job allowed her to work in a seated position and move around to make herself comfortable. She described taking a wire and putting "insulation on them, crimp connectors on them."
However, Dr. Mirkin noted at her February 1, 2006 appointment she had resumed heavy tobacco use and recommended she cease smoking immediately. She returned on March 1, 2006, in persistent pain but continuing to smoke tobacco on a regular basis and at her March 29, 2006, appointment she returned smelling of tobacc