Workers’
Compensation Board
OPINION
ENTERED: October 16, 2015
CLAIM NO. 201298149
UNITED PARCEL SERVICE PETITIONER
VS. APPEAL FROM HON. WILLIAM
J. RUDLOFF,
ADMINISTRATIVE LAW JUDGE
CAELA HELMS and
HON. WILLIAM J. RUDLOFF,
ADMINISTRATIVE LAW JUDGE RESPONDENTS
OPINION
AFFIRMING
*
* * * * *
BEFORE: ALVEY, Chairman, STIVERS and RECHTER, Members.
ALVEY,
Chairman. United Parcel Service, Inc.
(“UPS”), appeals from the Amended Opinion and Order on Remand rendered May 7,
2015 by Hon. William J. Rudloff, Administrative Law Judge (“ALJ”), and the
Opinion and Order on Reconsideration rendered June 17, 2015, awarding temporary
total disability (“TTD”) benefits, permanent partial disability (“PPD”)
benefits, and medical benefits to Caela Helms (“Helms”) for injuries she
sustained on January 4, 2012.
On appeal, UPS again
argues the ALJ erred in awarding TTD benefits from August 15, 2012, the date
Helms returned to work, through January 4, 2013, the date Dr. Anthony
McEldowney opined she reached maximum medical improvement (“MMI”). UPS specifically stated the amended opinion
and order on remand does not correct an abuse of discretion, and misconstrues
controlling precedent concerning eligibility requirements for TTD
benefits. Because the ALJ’s
determination is minimally sufficient to satisfy the previous directives of
this Board and the Kentucky Court of Appeals, we affirm. Helms filed a Form 101 on November 16, 2012 alleging she injured her
right leg on January 4, 2012 when she was pinned between a van and a dolly
while loading an airplane at UPS. She
later described a dolly as a trailer which contained canisters of packages. Helms also alleged she subsequently developed
post-traumatic stress disorder (“PTSD”) due to the accident. The claim was subsequently assigned to the
ALJ.
Helms testified by
deposition on January 8, 2013, and again at the hearing held April 25, 2013. She began working twenty-five hours per week for UPS as a package handler in April
2008. She stated her job prior to
January 4, 2012 required loading aircraft which involved bending, lifting up to
seventy pounds, and driving various pieces of equipment. She was concurrently employed part-time as an
elder care provider. She no longer works
as an elder care provider, but now earns more working concurrently fifteen hours per week for Delta Global Services. The job there consists of marshaling, loading
and unloading aircraft.
On January 4, 2012, she
arrived in a van to unload an aircraft.
When she stepped out of the van, she was pinned against a ramp by a
dolly when a tug operator drove away.
She was taken to the University of Louisville Hospital where she
received twenty-two stitches and a leg brace.
She was off work from the date of the accident until she returned on
August 15, 2012. She has received
psychological counseling for PTSD which she stated has been beneficial. She stated her right knee constantly throbs,
and squatting increases her pain. She
also complained of numbness, tingling and pain in her right leg. She stated she no longer works with dollies or
drives tugs and can only lift up to forty-five pounds. Helms testified she works the same number of
hours now as she did prior to the accident, but is unable to perform all of her
pre-injury work duties.
Dr. McEldowney
evaluated Helms on January 4, 2013 at the request of her attorney. He diagnosed Helms with a crush injury to the
right knee with fractures of the right proximal fibula in the right medial
femoral condyle as well as a clinical ACL injury with insufficiency, and a
post-traumatic stress condition. He
assessed a 16% impairment rating pursuant to the 5th Edition of the
American Medical Association, Guides to the Evaluation of Permanent
Impairment (“AMA Guides”).
Regarding MMI, Dr. McEldowney stated as follows:
Date
on which maximum medical improvement was reached? This patient requires evaluation by an
orthopedic sports medicine specialist for her right knee ACL condition and
continued counseling for her post-traumatic stress condition. At the present time it is unknown if further
surgery will be required for these skin grafts and disfigured scar formation
around her right knee but I can place maximum medical improvement concerning
the impairment rating for this scarred tissue region as of today or one year
following the injury as I do not believe there will be any further improvement
for this condition. Rather, she will require
possible maintenance of her condition.
If in fact further surgery/ reconstruction is performed for the right
knee anterior cruciate ligament, I would re-evaluate the patient and reassess
my impairment rating related to that condition.
At a time in the future when she and her counselor feel she has
plateaued with treatment for her post-traumatic stress condition, an impairment
rating calculation will be made at that time if there is a residual
post-traumatic stress condition.
In a subsequent April 22,
2013 report, after reviewing Dr. Robert Baker’s report, Dr. McEldowney
reiterated his previous findings regarding impairment, diagnosis and
causation. Regarding restrictions, he
stated Helms can no longer work around dollies “or perform the heavy lift requirements
of UPS.”
Helms filed the August
13, 2012 office note from UPA-Surgery Clinic ACB-Plastics where she was seen
for follow-up of her healing leg wound.
The record was electronically signed by John Paul Tulela, RESMD and
Larry Florman, M.D. The note states
Helms was there for a follow- up of the crush injury to her right knee with
large epidermal/dermal loss with eschar which was treated with Slivadene
dressing changes. It was noted Helms had
refused surgery. It was further noted
Helms continued to smoke, despite being advised to stop to improve her healing
time. It was further noted her wound was
clean. The note reflects Helms was
allowed to return to work with no restrictions.
No additional records were filed until the evaluation report of Dr.
McEldowney.
Dr. Baker evaluated
Helms at the request of UPS on March 18, 2013.
He noted the history of injury, and the continued complaints of pain
with climbing stairs, climbing ladders or running. He assessed a 13% impairment rating pursuant
to the AMA Guides, and noted she could return to her regular work. Dr. Baker noted Helms had in fact returned to
her normal job, but cautioned her about being careful to avoid any blunt type
of injury. He noted Helms was doing the
essential duties of a baggage handler, but avoiding, whenever possible, contact
with dollies and tugs.
On May 16, 2013, the
ALJ issued a decision finding Helms sustained injuries to her right knee and
leg, and developed PTSD. He awarded PPD
benefits based upon a 16% impairment rating assessed by Dr. McEldowney, which
he enhanced by the three multiplier contained in KRS 342.730(1)(c)1. The ALJ awarded TTD benefits from January 5,
2012 through January 4, 2013, the date Dr. McEldowney performed an independent
medical evaluation.
UPS filed a petition
for reconsideration arguing the ALJ should have only awarded TTD benefits
through August 14, 2012, because Helms returned to work on August 15,
2012. UPS also argued the period of PPD
benefits should have commenced on January 4, 2013 instead of January 4,
2012. Helms also filed a petition for
reconsideration arguing the ALJ erred in commencing PPD benefits on January 5,
2012. On June 12, 2013, the ALJ entered
an order on reconsideration amending the commencement date of PPD benefits to
January 5, 2013. The ALJ denied the
remainder of UPS’ petition for reconsideration, stating it was merely an
improper attempt to reargue the case.
UPS appealed to this
Board. On appeal, UPS argued the ALJ
erred in awarding TTD benefits from August 15, 2012 through January 4,
2013. In a decision entered on October
11, 2013, this Board held as follows:
Temporary total disability
means the condition of an employee who has not reached MMI from an injury and
has not reached a level of improvement that would permit a return to
employment. KRS 342.0011(11)(a).
Generally, the duration of an award of TTD benefits may be ordered only through
the earlier of those two dates. Case law
establishes that a "return to employment" does not mean a return to
"any type of work" or "minimal work." KRS 342.0011(11)(a); Central
Kentucky Steel v. Wise, supra.
A "return to employment" means the claimant is capable of
returning to work that is "customary" or work that he or she was
"performing at the time of [the] injury." Central Kentucky Steel
v. Wise at 659.
In the May 6, 2013, opinion
and order the ALJ determined, based on the opinion of Dr. McEldowney, Helms
attained MMI on January 4, 2012.
Concerning Helms’ entitlement to TTD benefits, the ALJ should have then engaged
in an analysis as to whether Helms had "returned to employment," as
defined in Central Kentucky Steel v. Wise, supra, at any point
between August 15, 2012, through January 4, 2013. In the case sub judice, in awarding TTD benefits, the ALJ determined when Helms
attained MMI but did not determine the point at which Helms had reached a level
of improvement that would permit a return to employment. In awarding TTD benefits from January 4, 2012, through January 4, 2013,
the ALJ must make a determination Helms had not reached MMI and during this
period had not reached a level of improvement that would permit a return to
employment as defined herein. The ALJ
did not make such a determination in the opinion and order. In its petition
for reconsideration, UPS pointed out an award of TTD benefits terminates upon
obtaining MMI or a return to employment. It asserted since Helms had returned
to employment on August 15, 2012, TTD benefits should terminate on August 14,
2012. Although UPS did not request
additional findings of fact, we believe the issue of the ALJ’s failure to
engage in the requisite analysis was sufficiently preserved for review. Further,
as a matter of law the ALJ was required to engage in the two prong analysis in
determining whether an award of TTD benefits was appropriate.
In the June 17, 2013, opinion and order on reconsideration, the
ALJ declined to address UPS’ argument.
Thus, the ALJ failed to engage in the requisite analysis, as required by
the statute and applicable case law, regarding an award of TTD benefits. Therefore, the award of TTD benefits must be
vacated and remanded to the ALJ for additional fact-finding.
The ALJ must provide a
sufficient basis to support his determination. Cornett v. Corbin
Materials, Inc., 807 S.W.2d 56 (Ky. 1991). Parties are entitled to
findings sufficient to inform them of the basis for the
ALJ’s decision to allow for meaningful review. Kentland Elkhorn Coal
Corp. v. Yates, 743 S.W.2d 47 (Ky. App. 1988); Shields v. Pittsburgh and
Midway Coal Mining Co., 634 S.W.2d 440 (Ky. App. 1982). This Board is
cognizant of the fact an ALJ is not required to engage in a detailed discussion
of the facts or set forth the minute details of his reasoning in reaching a
particular result. The only requirement is the decision must adequately
set forth the basic facts upon which the ultimate conclusion was drawn so the
parties are reasonably apprised of the basis of the
decision. Big Sandy Community Action
Program v. Chafins, 502 S.W.2d 526 (Ky. 1973). However, as we lack fact-finding authority,
the ALJ must provide the basis for any award of TTD benefits utilizing the
criteria set forth in the statute and applicable case law.
Since there is no dispute
Helms was entitled to TTD benefits through August 14, 2012, the ALJ must
determine whether as of August 15, 2012, or any time thereafter Helms returned
to work that is customary or work she was performing at the time of the injury.
(Emphasis added).
Helms appealed the
Board’s decision to the Kentucky Court of Appeals. In a decision rendered July 11, 2014, the
Court of Appeals affirmed the Board’s decision stating as follows:
TTD
means the condition of an employee who has not reached MMI from an injury and
has not reached a level of improvement that would permit a return to
employment. KRS 342.0011(11)(a). Generally, the duration of an award of TTD
benefits may be ordered only through the earlier of those two dates. Case law
establishes that a "return to employment" does not mean a return to
"any type of work" or "minimal work." KRS 342.0011(11)(a); Central
Kentucky Steel v. Wise, supra. A "return to employment"
means the claimant is capable of returning to work that is
"customary" or work that he or she was "performing at the time
of [the] injury." Central Kentucky Steel v. Wise at 659.
The
ALJ must provide a sufficient basis to support his determination in awarding
TTD benefits. Cornett v. Corbin Materials, Inc., 807 S.W.2d 56 (Ky. 1991).
Parties are entitled to findings which clearly inform them of the basis for the
ALJ’s decision. Kentland Elkhorn Coal Corp. v. Yates, 743 S.W.2d 47 (Ky.
App. 1988); Shields v. Pittsburgh and Midway Coal Mining Co., 634 S.W.2d
440 (Ky. App. 1982). This does not mean that an ALJ is required to set forth a
detailed discussion of the facts or the minute details of his or her reasoning
in reaching the end result. It only requires the decision to adequately set
forth the basic facts upon which the decision was made. This allows for the
parties to be reasonably apprised of the basis for the decision. Big Sandy
Community Action Program v. Chaffins, 502 S.W.2d 526 (Ky. 1973). The ALJ
must provide the basis for his or her award of TTD benefits utilizing the
criteria set forth in the statute and applicable caselaw.
In
this case, there is no dispute that Helms was entitled to TTD benefits through
August 14, 2012. The only issue for the ALJ was whether as of August 15, 2012,
or any time thereafter, she returned to work in a customary manner or to work
which she was performing at the time of her injury. Based upon this, the Board
vacated those portions of the May 6, 2013, Opinion and Order awarding TTD
benefits, and the June 17, 2013, Opinion and Order of reconsideration
reaffirming the award of TTD benefits, and remanded to the ALJ for an amended opinion
and order containing additional findings of fact as to Helms’ entitlement to
TTD benefits from and after August 14, 2012, in conformity with the views
expressed herein.
We agree with the Board.
Thus, we affirm the decision of the Board.
On September 26, 2014,
the ALJ entered an Amended Opinion and Order on Remand. In the decision, the ALJ summarized Helms’
testimony regarding her post-injury abilities.
The ALJ further elaborated on Dr. McEldowney’s report. However, the ALJ again failed to provide an
analysis as directed by both this Board and the Court of Appeals. Regarding TTD benefits, the ALJ stated he
observed Helms at the hearing. He
additionally stated he was, “the only decision maker who actually saw and heard
her testify”. He then outlined the
discretion afforded to him. The extent
of the actual analysis for awarding TTD benefits from August 15, 2012 through
January 4, 2013 consists of the following:
Based
upon the plaintiff’s sworn testimony, as covered above, which I found to be very
credible and convincing, and the persuasive medical evidence from Dr.
McEldowney, which is covered above, I make the determination, that the
plaintiff was temporarily totally disabled from January 5, 2012 to and
including January 4, 2013, when Dr. McEldowney opined that she had reached
maximum medical improvement.
The ALJ also awarded
PPD benefits commencing on January 4, 2012 for a period 425 weeks. UPS filed a petition for reconsideration
again arguing PPD benefits should begin either on August 15, 2012 or January 4,
2013. An Opinion and Order on
reconsideration was rendered by the ALJ on November 17, 2014. The ALJ reiterated his analysis above
regarding the award of TTD benefits through January 4, 2013.
In a decision entered
March 27, 2015, this Board stated as follows:
Regarding Helms’ entitlement
to TTD benefits from August 15, 2012 through January 4, 2013, we find the ALJ’s
analysis remains deficient. It is acknowledged an ALJ has wide range
discretion. Seventh Street Road Tobacco Warehouse v. Stillwell, 550
S.W.2d 469 (Ky. 1976); Colwell v. Dresser Instrument Div., 217 S.W.3d
213, 219 (Ky. 2006). It is further
acknowledged KRS 342.285 designates the ALJ as the finder of fact, and is
granted the sole discretion in determining the quality, character, and
substance of evidence. Paramount
Foods, Inc. v. Burkhardt, 695 S.W.2d 418 (Ky. 1985). Likewise, the ALJ, as fact-finder, may choose
whom and what to believe and, in doing so, may reject any testimony and believe
or disbelieve various parts of the evidence, regardless of whether it comes
from the same witness or the same party’s total proof. Caudill v. Maloney’s
Discount Stores, 560 S.W.2d 15, 16 (Ky. 1977); Pruitt v. Bugg Brothers,
547 S.W.2d 123 (Ky. 1977).
However, such discretion is not unfettered. In
reaching his determination, the ALJ must also provide findings sufficient
to inform the parties of the basis for his decision to allow for meaningful
review. Kentland Elkhorn Coal Corp.
v. Yates, 743 S.W.2d 47 (Ky. App. 1988); Shields v. Pittsburgh and
Midway Coal Mining Co., 634 S.W.2d 440 (Ky. App. 1982); Big Sandy
Community Action Program v. Chafins, 502 S.W.2d 526 (Ky. 1973).
As both this
Board and Kentucky Court of Appeals noted previously, temporary total disability is
defined as the condition of an employee who has not reached MMI from an injury
and has not reached a level of improvement permitting a return to employment. KRS 342.0011(11)(a). This definition has been determined by our
courts to be a codification of the principles originally espoused in W.L. Harper Construction Company v. Baker, 858 S.W.2d 202, 205
(Ky. App. 1993), wherein the Court of Appeals stated generally:
TTD is payable until the
medical evidence establishes the recovery process, including any treatment reasonably
rendered in an effort to improve the claimant's condition, is over, or the
underlying condition has stabilized such that the claimant is capable of
returning to his job, or some other employment, of which he is capable, which
is available in the local labor market. Moreover, . . . the question presented
is one of fact no matter how TTD is defined.
Both prongs of the test in W.L. Harper
Const. Co., Inc. v. Baker, supra, must be satisfied before TTD
benefits may be awarded. In Central Kentucky Steel
v. Wise, 19 S.W.3d 657, 659 (Ky. 2000), the Court further explained, “[i]t
would not be reasonable to terminate the benefits of an employee when he is
released to perform minimal work but not the type that is customary or that he
was performing at the time of his injury.”
In other words, where a claimant has not reached MMI, TTD benefits are
payable until such time as the claimant’s level of improvement permits a return
to the type of work he was customarily performing at the time of the traumatic
event.
In Magellan Behavioral
Health v. Helms, 140 S.W.3d 579 (Ky. App. 2004), the Court of Appeals
instructed until MMI is achieved, an
employee is entitled to a continuation of TTD benefits so long as he remains
disabled from his customary work or the work he was performing at the time of
the injury. The Court stated as follows:
In order to be entitled to
temporary total disability benefits, the claimant must not have reached maximum
medical improvement and not have
improved enough to return to work.
. .
. .
The second prong of KRS 342.0011(11)(a) operates to deny eligibility
to TTD to individuals who, though not at maximum medical improvement, have
improved enough following an injury that they can return to work despite not
yet being fully recovered. In Central
Kentucky Steel v. Wise, [footnote omitted] the statutory phrase ‘return to
employment’ was interpreted to mean a return to the type of work which is
customary for the injured employee or that which the employee had been
performing prior to being injured. (Emphasis added)
Id. at 580-581.
In Double L Const., Inc.
v. Mitchell, 182 S.W.3d 509, 513-514 (Ky. 2005), the Supreme Court
elaborated as follows:
As defined by KRS 342.0011(11)(a), there are two
requirements for TTD: 1.) that the worker must not have reached MMI; and 2.)
that the worker must not have reached a level of improvement that would permit
a return to employment.
Central
Kentucky Steel v. Wise, supra, stands for the principle that if a worker has not
reached MMI, a release to perform minimal work rather than ‘the type that is
customary or that he was performing at the time of his injury’ does not
constitute ‘a level of improvement that would permit a return to employment’
for the purposes of KRS 342.0011(11)(a). 19 S.W.3d at 659.
It
is noted Helms was released to return to work without restrictions on August
13, 2012, and continues to work the same number of hours, and earns at least at
the same rate of pay. It is undisputed
Helms was entitled to an award of TTD benefits from January 5, 2012 through
August 14, 2012 based upon the fact she did not return to work until August 15,
2012. However, Helms returned to work
with no restrictions on August 15, 2012, although she stated her job was
accommodated. Dr. Baker opined she
performs the essential functions of her job, although Dr. McEldowney opined she
could not do her previous work. Despite
her return to work, the remaining issue is her entitlement to additional TTD benefits
from the date of her return until her evaluation by Dr. McEldowney.
The
ALJ’s analysis is again deficient, and fails to satisfy the requirements as set
forth above, and as previously held by this Board and Court of Appeals.
Therefore, the ALJ’s award of TTD benefits from August 15, 2012 through January
4, 2013 is vacated. This claim is
remanded to the ALJ for the appropriate analysis concerning Helm’s entitlement
to TTD benefits during the period of August 15, 2012 through January 4, 2013. We direct no particular result, and the ALJ
may indeed award TTD benefits during that time period, if it is supported by
the evidence. However, the ALJ MUST conduct the appropriate analysis
as explained above.
In the Amended Order on Remand rendered on May 7, 2015, the ALJ
provided the following statement which does not contain the analysis he was
directed to provide:
C. Temporary total disability.
KRS
342.0011(11)(a) defines “temporary total disability” to mean the condition of
an employee who has not reached maximum medical improvement from an injury and
has not reached a level of improvement that would permit a return to employment.
In
Magellan Behavioral Health v. Helms,
140 S.W.3d 579 (Ky. App. 2004), the Court of Appeals instructed until MMI is
achieved, an employee is entitled to a continuation of TTD benefits so long as
he remains disabled from his customary work or the work he was performing at
the time of the injury. The Court in Helms, supra, stated:
In
order to be entitled to temporary total disability benefits, the claimant must not
have reached maximum medical improvement and not have improved enough to return
to work.
Id.
at 580-581.
At
the Final Hearing I sat a few feet from Ms. Helms and carefully observed her
facial expressions during her testimony, carefully listened to her voice tones
during her testimony and carefully observed her body language during her
testimony. I am the only decision
maker who actually saw and heard her testify. I make the factual determination that she
was a credible and convincing lay witness and that her testimony rang
true.
This
case calls to mind the Opinion of the Kentucky Court of Appeals in Jeffries v. Clark & Ward, 2007 WL
2343805 (Ky. App. 2007), where the Court of Appeals quoted from Chief Judge
Overfield’s Opinion in the case, in which he made the following statement . . .
“It is often difficult to explain to litigants and counsel why one witness is
considered credible and another is not considered credible. No doubt many of the factors related to the
credibility by a trier of fact are subconscious and many are related to life
experiences” (emphasis supplied).
The Court of Appeals stated that it was within the Judge’s sole
discretion to determine the quality, character, and substance of the evidence,
and the Court of Appeals did not disturb Judge Overfield’s determination that
one witness was not credible, despite the fact that Judge Overfield used his “life
experiences” in making that determination.
In
Hush v. Abrams, 584 S.W.2d 48 (Ky. 1979),
the Kentucky Supreme Court stated that what it had in that case was lay
testimony descriptive of and supportive of a permanent disability, together
with medical testimony that was not in conflict with the lay testimony. The high court stated that where the medical
evidence clearly and unequivocally shows the actual body condition, then the
lay testimony is competent on the question of the extent of disability which
has resulted from the bodily condition.
The high court further stated that where there is medical testimony from
which the decision maker could have concluded that the plaintiff did suffer
from a work-related trauma, then, having reached that conclusion, the decision
maker could then use the lay testimony to determine the extent, if any, of the
occupational disability.
Based
upon the plaintiff’s sworn testimony, as covered above, which I found to be
very credible and convincing, and the persuasive and compelling medical
evidence from Dr. McEldowney, which is covered above, I make the
determination that the plaintiff was temporarily totally disabled from January
5, 2012 to and including January 4, 2013, when Dr. McEldowney opined that she
reached maximum medical improvement.
UPS filed a petition
for reconsideration arguing the ALJ once again failed to make the analysis he
was directed to provide. In the Opinion
and order on Reconsideration issued on June 17, 2015, the ALJ provided the
following:
KRS
342.0011(11)(a) defines “temporary total disability” to mean the condition of
an employee who has not reached maximum medical improvement from an injury and
has not reached a level of improvement that would permit a return to employment.
In
Magellan Behavioral Health v. Helms,
140 S.W.3d 579 (Ky. App. 2004), the Court of Appeals instructed until MMI is
achieved, an employee is entitled to a continuation of TTD benefits so long as
he remains disabled from his customary work or the work he was performing at
the time of the injury. The Court in Helms, supra, stated:
In
order to be entitled to temporary total disability benefits, the claimant must
not have reached maximum medical improvement and not have improved enough to
return to work.
Id.
at 580-581.
The
plaintiff, Caela Helms, testified
that while working for the defendant on January 4, 2012 she stepped out of a
van and was then pinned and struck several times by a vehicle. She sustained
injuries to her right knee and right leg.
Her injuries were painful. She
testified that she is still working for UPS, but is not physically able to do
her former job requirements. She
stated that she is being treated for post-traumatic stress disorder. Ms. Helms was off work from January 4, 2012
until August 15, 2012. She returned to
work at her regular job with accommodations.
She stated that she is not comfortable being around or moving dollies. Her supervisor allows her to rest if her leg
hurts or she feels she has been standing too long. She stated that she rests approximately
10-15 minutes at least once a day during her shift. She stated that she has not been able to
completely perform her previous job duties.
She stated that her injury has physically slowed her down. She stated that as a result of her injuries
she has problems with balance and is unable to walk for long periods of
time. She stated that she is unable to
squat without pain. She testified that
she can no longer lift 70 pounds and estimated that the maximum she has been
able to lift since her injury is 45 pounds.
The
plaintiff filed a medical report from Dr.
Anthony McEldowney. Dr. McEldowney examined the plaintiff on January 4,
2013. He took a history from her and
reviewed her medical records. The
plaintiff’s history was that she sustained injuries to her right leg and knee
while working for UPS on January 4, 2012, at which time she was between a van
and dolly and sustained a direct impact crush injury to her right lower
extremity. She related her subsequent medical treatment. Dr. McEldowney
performed a comprehensive physical examination of the plaintiff and reviewed
her diagnostic test results. His diagnoses
were that the plaintiff had sustained a crush injury to her right knee with
fractures of the right proximal fibula in the right medial femoral condyle as
well as clinical ACL injury with insufficiency and also post-traumatic stress
condition. Dr. McEldowney stated that
within reasonable medical probability Ms. Helm’s injuries were the cause of her
complaints and that within reasonable medical probability her present
complaints and objective findings are directly related to the crush injury to
her right knee on January 4, 2012, which constituted a harmful change in the
human organism. Dr. McEldowney noted
that because of her injury Ms. Helms has suffered significant skin
disfigurement and scar formation in a large portion of the region around her
right knee and also suffers from post-traumatic stress condition. Dr. McEldowney stated that using the AMA Guides
to the Evaluation of Permanent Impairment, Fifth Edition, the plaintiff
will sustain a 16% whole person impairment and that the plaintiff did not have
an active impairment prior to her work injuries. Dr. McEldowney stated that he placed the
plaintiff’s maximum medical improvement as of January 4, 2013, or one year
following her work injuries. Dr. McEldowney stated that the plaintiff
described the physical requirements of her work at UPS at the time of her
injuries and stated that she did not retain the physical capacity to return
to the type of work which she performed at the time of her injuries, since she
can no longer lift and carry the weight required of her former job and that she
is unable to operate the dollies which were a major part of her work duties.
In
Hush v. Abrams, 584 S.W.2d 48 (Ky. 1979),
the Kentucky Supreme Court stated that what it had in that case was lay
testimony descriptive of and supportive of a permanent disability, together
with medical testimony that was not in conflict with the lay testimony. The high court stated that where the medical
evidence clearly and unequivocally shows the actual body condition, then the
lay testimony is competent on the question of the extent of disability which
has resulted from the bodily condition.
The high court further stated that where there is medical testimony from
which the decision maker could have concluded that the plaintiff did suffer
from a work-related trauma, then, having reached that conclusion, the decision
maker could then use the lay testimony to determine the extent, if any, of the
occupational disability.
I
made and again make the determination that the plaintiff’s sworn lay testimony,
as covered above, is very credible and convincing and further that the medical
evidence from Dr. McEldowney, the orthopedic surgeon, which is covered above,
is very persuasive, compelling and reliable, leading me to make the
determination that the plaintiff was temporarily totally disabled from January
5, 2012 to and including January 4, 2013, when Dr. McEldowney opined that she
reached maximum medical improvement.
I
make the determination that when the plaintiff did return to work she did not
return to her customary work or the work she was performing at the time of her
injuries and she had not reached maximum medical improvement until January 4,
2013. I make the determination that she
did not return to the job she was doing at the time she was injured, since she
could not meet the 70-pound lifting requirement and was also psychologically incapable
of operating dollies. I make the
determination that those two job requirements were integral parts of her former
job and that it is clear that she was incapable of performing either task.
I
also make the determination that Dr. McEldowney’s rebuttal report dated April
22, 2013 was persuasive, compelling and reliable. Dr. McEldowney stated that Ms. Helms can no
longer work around dollies or perform the heavy lifting and carrying
requirements required by her job for the defendant, since her knee instability
precludes her from lifting and carrying 70 pounds and if she is placed in that
type of work environment, she runs the risk of further injuring her right knee,
which could lead to an additional surgical procedure.
All
of the above factors support the award of temporary total disability benefits
to the plaintiff for the period January 5, 2012 to January 4, 2013.
Although the order on remand
does not provide a clear and succinct analysis, it is minimally sufficient to
satisfy the requirements of the multiple directives previously provided to the
ALJ. Despite the fact Helms returned to
work for UPS in August 2012, the ALJ pointed to testimony which establishes she
was unable to perform the full gamut of her job duties, although she was
released to return to work with no restrictions. Likewise, Dr. McEldowney’s report supports
the ALJ’s determination she did not reach MMI until he saw her on January 4,
2013.
Although not clearly
stated, the ALJ’s June 17, 2015 Opinion and Order on Reconsideration is
sufficient to satisfy the requirements set forth in W.L. Harper Construction
Company v. Baker, 858 S.W.2d 202 (Ky. App. 1993), Central Kentucky
Steel v. Wise, 19 S.W.3d 657, 659 (Ky. 2000), Magellan
Behavioral Health v. Helms, 140 S.W.3d 579 (Ky. App. 2004), in finding
Helms entitled to TTD benefits during the disputed period after her return to
work for UPS until she reached MMI as assessed by Dr. McEldowney.
Accordingly, the ALJ’s
decision on remand rendered May 7, 2015 and the June 17, 2015 order on
reconsideration by Hon. William J. Rudloff, Administrative Law Judge, are
hereby AFFIRMED.
RECHTER,
MEMBER, CONCURS IN RESULT ONLY.
STIVERS, MEMBER, DISSENTS AND WILL NOT FURNISH A SEPARATE
OPINION.
COUNSEL
FOR PETITIONER:
HON CHRISTOPHER G NEWELL
10503 TIMERWOOD CIRCLE, STE 112
LOUISVILLE, KY 40223
COUNSEL
FOR RESPONDENT:
HON JAMES D HOWES
5438 NEW CUT RD, STE 201
LOUISVILLE, KY 40214
ADMINISTRATIVE
LAW JUDGE:
HON WILLIAM J RUDLOFF
PREVENTION PARK
657 CHAMBERLIN AVENUE
FRANKFORT, KY 40601