Linder Konneh v. Sundog Enters., LLC, No. WC24-6589 (WCCA, June 5, 2025)
The employee, Linder Konneh, worked as a home health aide for the employer, Sundog Enterprises, LLC. Prior to working with the employer, she had treatment for her low back and knees. In both 2005 and 2015, she reported bilateral knee pain to medical providers and was referred to physical therapy. In addition, the employee also suffered from previous low back issues. In 2018 she fell down a walking ramp and, later in the same year she was involved in a motor vehicle accident, both resulting in low back problems. In addition, prior to the injury, Konneh “was diagnosed with mechanical low back pain, with likely deconditioning.”
The Date of Injury is April 23, 2021. The employee was sweeping stairs when she slipped and forcefully landed on her right foot. Allegedly, this incident led to injuries to the employee’s low back and right knee. From the date of injury until August of 2024, the employee had work restrictions which caused her to work at reduced wages. The employee resigned late in August 2024.
In the fall of 2023, the employee’s rehabilitation benefits were discontinued by administrative decision and the employee sought a formal hearing. She later filed a claim petition, and the two pleadings were consolidated at a hearing on September 24, 2024. The compensation judge determined that the employee suffered a temporary work injury to her low back and that a work injury to her right knee was ongoing. Employer/Insurer appealed. A comparison of the rulings regarding each injury by the Workers’ Compensation Court of Appeals provides insight into the Court’s handling of “commoner afflictions.”
Low Back
Initially, the employee did not report a back injury to the medical provider when she presented for treatment on April 28, 2021. The first time the back was mentioned as an area of concern was during a second visit to TRIA Orthopedics on May 9, 2021. At that appointment, the employee complained of right knee pain as well as right hip and low back pain, all as a result of her work injury. The employee was referred to physical therapy, and “underwent strengthening, motion exercises, and aquatic therapy for the next several months.”
In June of 2021, the employee presented to TRIA Orthopedics and reported “that physical therapy was not improving her symptoms.” She was diagnosed with a lumbar strain with radiculopathy and scheduled for an MRI of the low back. An MRI on September 1, 2021, revealed “no significant disc bulges or stenosis, but indicated multilevel disc disease, including some facet arthropathy and foraminal narrowing.” At a subsequent visit, the provider recommended continuation of her exercise program. On January 28, 2022, a medical provider noted improvement in the low back pain and “full range of motion of her lumbar spine.” She was discharged from physical therapy at this time. However, her low back pain persisted.
On July 11, 2023, at the request of the Employer/Insurer, an IME was performed and the IME provider determined the work injury did not cause or aggravate the employee’s low back degenerative disc disease.
At the September 24, 2024, hearing, the compensation judge ruled that the employee suffered a low back injury on the DOI which resolved when she was discharged from physical therapy in January 2022. The WCCA affirmed the compensation judge’s ruling even though “No doctors’ narrative opinions nor treatment notes were offered to support the claim that the employee’s work incident caused her low back injury.” The WCCA ruled that the injury was a “commoner affliction” and the compensation judge was allowed to “rely upon his or her own lay expertise without medical opinion evidence.”
Right Knee
The right knee injury initially seemed to improve, but in late October 2022, the knee flared up. However, the employee denied any new injury. An initial scan (completed on May 13, 2021) of the employee’s right knee showed no signs of an acute injury. This scan did show “advanced chondromalacia of the patella and articular cartilage loss along the undersurface of the medial femoral condyle.” In July 2021, another provider diagnosed the employee with osteoarthritis and a popliteal cyst “which were exacerbated by the work injury.” Due to a second flare up of knee pain an additional MRI was ordered in April 2023. This MRI revealed “radial tearing of the inner portion of the posterior horn medial meniscus,” and, “a second smaller tear peripherally with the posterior horn of the meniscus, and a possible tear in the medial meniscus.” A provider determined that the damage was too severe for any type of surgery except total knee replacement which was not recommended due to the employee’s young age.
The compensation judge determined that the right knee injury was ongoing and the work injury was a substantial contribution factor to the employee’s continuing need for rehabilitation and work restrictions. The employer admitted liability for the work injury through July 19, 2022, but not beyond that date. The compensation judge based this decision on the medical opinions of the medical providers through the medical records, but did not refer to any specific opinion in supporting her decision.
The WCCA modified part of the ruling and reversed part of the ruling regarding the right knee injury. The WCCA found that the compensation judge abused her discretion when she ruled that the current condition of the employee was casually related to the work injury without adequate medical opinions. The WCCA opined, “While a right knee condition with a meniscus tear may be considered a ‘commoner affliction’ in some situations, the employee’s right knee condition here is complicated by the amount of time between the employee’s injury and the occurrence of the meniscus tears, and therefore an adequately founded medical opinion relating the work injury to the employee’s current right knee condition was necessary.”
The WCCA ruling regarding these two injuries clarifies when compensation judges may rely upon their own expertise in determining the casual relationship between work incidents and injuries, and when they must have adequate medical opinions regarding the cause of injuries.