The employee in this case had a history of low back pain but also sustained two admitted work injuries in Sept. 2008 and Feb. 2011. At the time of her 2008 injury, the employee had no work restrictions and could perform her job for Lowe’s without any accommodation. Even though she had treated at intermittent periods of time in 2001, 2003, 2005 and 2006, her symptoms worsened and she was in need of work restrictions after the Sept. 2008 injury. She also had an MRI which showed degenerative disc disease with a disc bulge at L3-4, which included some contact with the nerve root on the right side.
Thereafter, the employee treated conservatively with Physicians Diagnostic and Rehabilitation Center, but was not recommended for surgery. She treated intermittently in 2010 and then in 2011 fell in the employer’s parking lot while walking to her car after work. She received chiropractic care thereafter, and was referred to Dr. Jhanjee for an IME. Dr. Jhanjee felt the employee had reached MMI by June 2011. The employee was subsequently referred by her treating doctor for an epidural injection and eventually referred to Midwest Spine Center for additional epidural steroid injections.
The employee’s symptoms continued and manifested into urinary incontinence in 2012 and early 2013, and she then saw Dr. Thomas Rieser who recommended an SI joint injection, and eventually an L3-4 and L4-5 fusion.
The major fight at hearing was whether or not the employee’s two injuries at Lowe’s were permanent aggravations of her underlying condition and ongoing substantial contributing factors to her low back condition, including wage loss and medical benefits. This case was essentially a substantial evidence case because the employer and insurer argued that the record lacked substantial evidence that the employee’s disability is causally related to the two injury dates and instead were no longer substantial contributing factors to her claims for wage loss and medical benefits. The employer and insurer argued that because the employee did not have a narrative report or affirmative medical opinion on causation, there was not substantial evidence in the record to support that type of finding that she suffered permanent aggravation injuries of her underlying condition by the compensation judge.
However, the WCCA noted that the compensation judge based her opinion on the medical treatment records, employee’s testimony, the lack of symptoms prior to those injuries compared to symptoms after each injury, and work restrictions the injuries. Because the employee had a pre-existing, but asymptomatic condition, the compensation judge found that those injuries caused a substantial aggravation that was permanent in nature.
The WCCA affirmed the compensation judge’s findings.