Danny Harris (employee) worked for the County of Ralls performing road work beginning July 2007, including driving a dump truck. On March 9, 2009, employee and a co-worker were told to change a tire on a backhoe. In order to do so, they commenced by breaking the seal on the tire away from the rim. After completing one side of the tire they needed to flip it over to get to the other side. This required some lifting motion while employee was in a stooped position. As he helped lift and flip the tire, he felt a sensation in his low back which he described as "like you were squishing a jelly donut," and "it was like someone was stabbing me in the back with a knife and it went down my legs, into my feet." Transcript, page 31. By the next day, he realized he may need medical attention and requested his employer allow him to see a doctor. After working a few hours, he went to the emergency room. Employee was about 30 years old at the time of the incident.
He was under conservative treatment from that day until June 17, 2009, during which time he had several imaging and diagnostic tests (MRI, EMG, X-ray), physical therapy and steroid shots. Dr. Russell Cantrell, a physiatrist at Orthopedic and Sports Medicine Inc., released him to return to limited duty, with restrictions on lifting up to 10 pounds, and driving only a personal vehicle, as opposed to a dump truck. He underwent a functional capacity evaluation on June 29, 2009. That evaluation found him capable of working safely in the heavy work demand level, but that his documented performance did not meet the employer-reported job demands. Transcript, page 234. At the evaluation session, employee was capable of lifting up to 55 pounds from floor to waist, 75 pounds from waist to shoulder and from shoulder to overhead, and could bilaterally carry up to 65 pounds and unilaterally carry up to 70 pounds, (either arm). Dr. Cantrell saw him again after the evaluation, on June 29, 2009, and July 21, 2009. A CT scan and myelogram were ordered because employee continued to complain of pain in July 2009. As of August 31, 2009, Dr. Cantrell found he could return to duty with permanent restrictions of no lifting over 50 pounds, and alternating sitting and standing every hour. The doctor approved driving the dump truck not to exceed one hour of sitting time. Employee was found to be at maximum medical improvement (MMI) at this time, per stipulation of the parties.
Employee indicates that when he returned to work, he used leave to account for some of his time, such that he did not consider himself to be working a full time schedule. Employee continued working until March 25, 2011, when he indicates he was laid off. Employee stopped working at that time for reasons that are not clear. On March 29, 2011, employee saw his primary care physician, Dr. Hevel, complaining of back pain, and his doctor noted possible depression. The doctor suggested he stay off work for a while at that point. Employee was undergoing marital and family issues beginning in early-mid 2011, which resulted in a separation from his wife and children, and ultimately, employee was jailed in August 2011 until August 2013. Employee experienced some episodes of depression during this time and consulted with a psychiatrist, Dr. Jonathan Colen and a therapist, Sean Meyer until July 2011. His employment was not terminated by the employer until December 2011.
At the hearing in November 2017, employee indicated he was not depressed at that time and that his physical pain had gotten worse. He indicated he was using a cane for two-three years because he would fall down for no reason. No doctor diagnosed any issues with his gait or recommended the need for any assisted walking device. Employee had knee surgery in 2006.
2 The only evidence of the weight of the object is from employee's testimony, when asked what he believed was the approximate weight of the tire. His response was about 350 pounds.
3 Repeat MRI and EMG studies were done in 2010, because of employee's continuing pain complaints.
4 There is no evidence in the record that employee was convicted of any crime. Employee reports he was acquitted of all charges.
5 Employer's psychiatric expert, Dr. Edwin Wolfgram opined in February 2015, that employee's depression was not work-related, but more likely from other family and social behavior factors. He noted concern that employee was addicted to pain medication and it was advisable to treat for opiate addiction in the future.
Injury No.: 09-018179
Employee: Danny L. Harris
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or 2007. Employee indicated at the hearing that he goes to the emergency room because of pain about twenty times a year. There are no medical records documenting this.
Employer provided medical care for employee through authorized physicians, Dr. James Coyle, a neurosurgeon (Midwest Spine Surgeons), and Dr. Russell Cantrell. The last documented visits with these treating doctors were in fall of 2010, but Dr. Cantrell, continued monitoring his medications. During the course of treatment, employee underwent the following objective medical tests.
- An x-ray within days of March 9, 2009, showing spondylolysis. *Transcript*, page 168. (Dr. Coyle's office)
- An MRI on March 16, 2009, identified degenerative discs L4-5, L5-S1, central disc prolapse L4-5, spondylolisthesis at L5-S1, with a very small disc protrusion. *Transcript*, page 163, (Dr. Coyle) and 168 (Nurse practitioner- Coyle's office). Dr. Cantrell opined degenerative conditions. *Transcript*, pages 174, 178.
- An EMG on June 6, 2009, with no abnormal findings, no lumbar radiculopathy or lumbosacral plexopathy. *Transcript*, pages 176, 179 (Dr. Cantrell, referring to Dr. Boris Khariton).
- A July 2009, myelogram and CT scan showed mild spondylolisthesis of L-5 on S-1, degenerative disc changes and small disc protrusions at L3-4. *Transcript*, pages 175, 179 (Dr. Cantrell)
- A second EMG was done in September 2010, generally, was within normal limits, but showed some abnormalities, consistent with bilateral S-1 radiculopathy, but not at the L4 or L5 level. *Transcript*, pages 175, 177, 183 (Dr. Cantrell).
- Another MRI performed in October 2010, was notable for degenerative discs, mild dessication at L4 and L5 with annular tears at each level, and spondylolisthesis at L5-S1. An abnormally small spinal canal, a congenital condition was noted. There was mild disc pathology but no focal compressive pathology. *Transcript*, pages 153, 156, 157 (Dr. David Niebruegge, Dr. Coyle).
This series of objective testing documents the authorized treating doctors' attempts to identify and diagnose the conditions underlying employee's reported symptoms of radiculopathy into the lower extremities and the causes of his low back pain. It is notable that while some variations appear in the interpretation of the test results, any radiculopathy identified in objective findings does not appear until long after the March 9, 2009 workplace event. One consistent observation is degenerative processes in the lumbar region.
The doctors we find most persuasive, Dr. Robert Bernardi, Dr. Coyle, and Dr. Cantrell conclude that the majority of employee's symptoms are from degenerative and congenital conditions, objectively identified through testing. These doctors also acknowledge that some of the symptoms asserted by employee can result from acute injury and that a spondylolisthesis (disc slippage) can be caused by injury.
Ultimately, Dr. Cantrell, opined on June 8, 2011, that there is no objective evidence to support employee's subjective complaints of radiating pain into both lower extremities. He noted that previous diagnostic studies revealed degenerative changes in his lumbar spine. *Transcript*, pages 178-179. He further noted that electrodiagnostic studies failed to show any evidence of radiculopathy, "and a myelogram and CT scan revealed evidence of spondylolisthesis of L5 on S1 that was of a mild degree, along with bilateral spondylolysis." *Id.* Dr. Cantrell's opinion in his final report was that the medications employee continues to use are more likely than not the
6 Employee also saw other primary care physicians, including Dr. Hevel, on occasion thereafter.
Injury No.: 09-018179
Employee: Danny L. Harris
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result of degenerative processes. Transcript, page 177.7 Employee had been prescribed Tramadol and Prevacid for stomach upset associated with the medic