Employer and Insurer appealed the compensation judge’s award of temporary partial and permanent partial disability benefits, as well as from the determination that the employee’s claimed medical expenses were reasonable, necessary, and causally related to the employee’s work injury.
While working for Foley Locker, Employee sustained an admitted injury on March 12, 2015, when she slipped and fell in the freezer landing on her buttocks and back. As a result of the fall, the employee sustained a sacral fracture and injuries to her low back. By June 3, 2015, the employee’s sacral fracture was healed, leaving only her low back symptoms.
Employer underwent a neurological evaluation in January 2016, at which time the doctor believed her back symptoms may be related to either a contusion or stretch injury to the nerves of the low back. Also in January 2016, the employee underwent an IME with Dr. Fey who found a temporary soft tissue sprain of the low back, which would have resolved in three months. He found pre-existing degenerative disease and a 0% PPD rating. Employee underwent a second IME on March 28, 2016 at the request of Employee’s attorney, conducted by Dr. Wengler. Dr. Wengler found that although Employee had degenerative disease, given the fracture to the sacral alar, it is reasonable to expect the spine to have absorbed enough energy in the fall to irritate and destabilize the existing degenerative changes. He found medical treatment has been reasonable and necessary, as well as a 13% PPD rating. Employer and Insurer stipulated to the employee’s pelvis and low back injuries, but alleged the injuries were only temporary with no PPD. The compensation judge found for the employee.
The WCCA affirmed, reasoning that an injury is compensable if it can be shown that employment is a substantial contributing factor to the employee’s condition, including a substantial contributing factor to the aggravation or acceleration of a pre-existing condition. In finding for Employee, the WCCA also discussed six factors used in determining a temporary vs permanent aggravation. These factors are the following: (1) the nature and severity of the pre-existing condition and the extent of restrictions and disability resulting therefrom; (2) the nature of the symptoms and extent of medical treatment prior to the aggravating incident; (3) the nature and severity of the aggravating incident and the extent of restriction and disability resulting therefrom; (4) the nature of the symptoms and extent of medical treatment following the aggravating incident; (5) the nature and extent of the employee’s work duties and non-work activities during the relevant period; and (6) medical opinions on the issue. World v. Olinger Trucking, Inc., slip op. (W.C.C.A. Aug. 29, 1994). The court also noted other factors were used.
Two brief additional issues were discussed. First, the WCCA found that MMI is not relevant for addressing TPD and does not terminate TPD. Therefore, the compensation judge did not err in failing to address the issue of MMI. Second, in looking at PPD ratings for radicular symptoms, the statute does not require persistent objective findings or that an absent reflex to be found repeatedly on exam.