CHARLES PAULLEY v. MCMILLAN LANDSCAPING; HON. JAMES L. KERR, ADMINISTRATIVE LAW JUDGE; HON. ROBERT L. WHITTAKER, DIRECTOR OF SPECIAL FUND; AND WORKERS' COMPENSATION BOARD AND MCMILLAN LANDSCAPING v. CHARLES PAULLEY; HON. JAMES L. KERR, ADMINISTRATIVE LAW JUDGE; HON. ROBERT L. WHITTAKER, DIRECTOR OF SPECIAL FUND; AND WORKERS' COMPENSATION BOARD
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RENDERED: June 9, 2000; 10:00 a.m.
NOT TO BE PUBLISHED
C ommonwealth O f K entucky
C ourt O f A ppeals
NO.
1999-CA-002128-WC
CHARLES PAULLEY
v.
APPELLANT
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS' COMPENSATION BOARD
ACTION NO. WC-96-86412
MCMILLAN LANDSCAPING; HON.
JAMES L. KERR, ADMINISTRATIVE
LAW JUDGE; HON. ROBERT L.
WHITTAKER, DIRECTOR OF SPECIAL
FUND; AND WORKERS’ COMPENSATION BOARD
AND:
NO. 1999-CA-002312-WC
MCMILLAN LANDSCAPING
v.
APPELLEES
CROSS-APPELLANT
CROSS-PETITION FOR REVIEW OF A DECISION
OF THE WORKERS' COMPENSATION BOARD
ACTION NO. WC-96-86412
CHARLES PAULLEY; HON. JAMES
L. KERR, ADMINISTRATIVE LAW JUDGE;
HON. ROBERT L. WHITTAKER, DIRECTOR
OF SPECIAL FUND; AND WORKERS’
COMPENSATION BOARD
CROSS/APPELLEES
OPINION AND ORDER
AFFIRMING &
DISMISSING SPECIAL FUND AS A PARTY
** ** ** ** **
BEFORE:
GUDGEL, CHIEF JUDGE; GUIDUGLI AND McANULTY, JUDGES.
GUIDUGLI, JUDGE.
Charles Paulley (Paulley) appeals from an
opinion of the Workers’ Compensation Board (the Board) entered
August 6, 1999, affirming an opinion and award of the
Administrative Law Judge granting him benefits for a 30%
occupational disability.
McMillan Landscaping (McMillan) has
filed a cross-appeal from the Board’s opinion arguing that the
Board erred in reversing the ALJ’s reduction of Paulley’s award
by 15% pursuant to KRS 342.165.
We affirm as to both Paulley’s
appeal and McMillan’s cross-appeal.
Paulley sustained a closed head injury and lacerations
as a result of a traffic accident which occurred on July 1, 1996,
when his company vehicle was broadsided on the passenger side by
a tractor-trailer.
Paulley was removed from the scene of the
accident and taken to a local hospital, where he was treated for
a concussion.
Although Paulley attempted to return to work some
seven weeks after the accident, he found he was unable to
continue working in his former employment after approximately
three weeks.
At his deposition, Paulley was unable to testify with
any certainty whether he was wearing a seat belt at the time of
the accident, although he did indicate that the police report
said he was wearing a seat belt.
Paulley also stated that the
ambulance crew cut through the seat belt while freeing him from
the wreckage.
Paulley testified at the hearing that he generally
uses a seat belt while driving.
Records from the ambulance crew
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responding to the wreck indicate that Paulley was not wearing a
seat belt.
Paulley was treated by Dr. Charles Oates (Dr. Oates)
following the accident.
In a letter to Paulley’s attorney dated
October 2, 1998, Dr. Oates stated that Paulley was suffering from
“significant” post concussive syndrome as a result of the
accident.
Dr. Oates indicated that Paulley was reporting
migraines, vertigo, neck and shoulder pain, panic attacks, and
problems with memory and concentration.
Dr. Oates stated that
Paulley:
remains with a permanent impairment, which
now two years out, does not appear to have
any chance of abatement in total. My
estimation of his permanent disability would
be at 30%. I do not ascribe to the American
Medical Association’s guidelines for
evaluation of impairment, in as much, as this
does not give aggregate summing of multiple
disorders as for etiology of a patient’s
whole body systems [sic] abnormality.
Paulley was also seen by Dr. Burton Cohen (Dr. Cohen),
an otorhinolaryngologist.
Dr. Cohen initially saw Paulley on
March 11, 1997, at which time he diagnosed bilateral benign
paroxysmal positional vertigo.
Dr. Cohen recommended vestibular
rehabilitation, and indicated that Paulley should “be very
careful about . . . working around any equipment, driving a
truck, climbing ladders or anything that require his balance
because if he turns his head he may become vertiginous and fall
and injury himself.”
In a follow-up visit on June 7, 1997,
following rehabilitation, Dr. Cohen noted some improvement with
regard to vertigo, but indicated that Paulley was still having
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problems with panic attacks.
Dr. Cohen recommended that Pauley
be referred to a neurologist and psychiatrist.
Paulley was also treated by Dr. David Petruska, a
neurologist.
In his deposition, Dr. Petruska gave a diagnosis of
post-concussive syndrome.
In regard to whether a seat belt would
have prevented Paulley’s head injuries, Dr. Petruska stated:
Well, the theory behind a shoulder harness is
that basically it should prevent those sort
of injuries. However, you know, it really
depends on the angle of trajectory of the
car, and, as you say, whether or not the seat
belt was functioning properly. The theory is
that should prevent any sort of chest or
forward movement of the body during an
impact.
Dr. Petruska indicated that patients with post-concussive
syndrome typically improve over time.
Finally, Paulley was evaluated twice by Dr. David
Shraberg (Dr. Shraberg), a psychiatrist.
Following an evaluation
on August 14, 1997, Dr. Shraberg indicated that he found no
evidence of panic attacks, and noted in his history that while
Paulley complained of migraines, he denied experiencing panic
attacks.
Dr. Shraberg did note the presence of anxiety, and felt
that the vertigo and headaches were caused by Paulley’s high
anxiety level.
Dr. Shraberg diagnosed post-concussive syndrome
with residual vertigo, mild tinnitus, and hyperacusis with
anxiety.
He believed Paulley would reach maximum medical
improvement (MMI) within eighteen months after the accident.
Dr. Shraberg evaluated Paulley again on January 22,
1998, and noted minimal improvement.
Paulley appeared to have reached MMI.
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Dr. Shraberg indicated that
In what appears to be a
follow-up report from this evaluation, Dr. Shraberg assigned an
impairment rating of 12-15% to the body as a whole arising from
his neurological findings and symptomatology.
Of that rating,
two-thirds was attributed to vertigo and the remainder to
anxiety. At his deposition, Dr. Shraberg stated that the severity
of Paulley’s condition would improve over time and that he would
not have a permanent significant impairment.
Dr. Shraberg
believed that Paulley would not have any further difficulty
operating heavy machinery once free from vertigo.
If the vertigo
did not improve, Dr. Shraberg indicated that with vocational
rehabilitation, Paulley would be able to perform other jobs aside
from operating heavy equipment.
McMillan also offered testimony from Jan McMillan, one
of its employees.
According to Ms. McMillan, the driver’s side
seat belt of the truck Paulley was driving at the time of the
accident was not cut and was fully operational.
On March 10, 1999, the ALJ entered an opinion and award
of benefits pursuant to a 30% occupational disability rating.
so holding, the ALJ stated:
[I]n determining that plaintiff has a 30%
occupational disability, the Administrative
Law Judge has relied upon the testimony of
all of the physicians testifying herein but
must say that plaintiff’s constellation of
symptoms does not fit easily into a
determination of occupational disability. As
Dr. Oates said, it is difficult to assess
plaintiff’s impairment pursuant to the AMA
Guidelines. He did assess a 30% impairment
outside the guidelines and the Administrative
Law Judge finds that the 30% impairment
rating adequately translates into plaintiff’s
occupational disability. While plaintiff
complains of a multitude of symptoms, it is
apparent that his primary problem is vertigo
-5-
In
which may prevent him from working in
hazardous areas and in operating heavy
equipment, but it appears to the
Administrative Law Judge that there are a
number of other positions which the plaintiff
could perform with his restrictions. The
Administrative Law Judge notes that the
plaintiff has no neurological problems and
all objective tests are normal. No physician
has assessed restrictions upon the plaintiff
except Dr. Shraberg who stated that if
plaintiff continues to have vertigo, he
cannot operate heavy equipment. When all the
factors are considered, the Administrative
Law Judge finds that 30% adequately addresses
plaintiff’s occupational disability.
The award further provided:
[McMillan] has requested a 15% reduction for
plaintiff’s failure to wear a safety belt as
found in KRS 342.165. That statute requires
the plaintiff to intentionally fail to have
used a safety appliance furnished by the
employer or to obey any law enacted for the
safety of employees or the public. By law,
plaintiff was required to wear a seat or
shoulder belt at the time of the injury. The
Administrative Law Judge finds that plaintiff
was an unrestrained driver based upon the EMS
report. The Administrative Law Judge finds
that plaintiff’s failure to wear a seatbelt
was a substantial contributing factor in
causing plaintiff’s head injury and therefore
plaintiff’s occupational disability award
shall be reduced by 15%.
In an opinion rendered August 6, 1999, the Board
affirmed the ALJ’s holding in regard to Paulley’s occupational
disability rating, but reversed the ALJ’s decision to reduce
Paulley’s award by 15% pursuant to KRS 342.165.
In so ruling,
the Board stated:
Kentucky law has long distinguished between
the accident and the injury. Fiorella v.
Clark, 298 Ky. 817, 184 SW2d 208 (1944).
Injury is defined in KRS 342.0011 as a workrelated harmful change in the human organism
while an accident is that event which arises
out of and is in the course of employment and
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gives rise to the injury. Here, the ALJ
based the reduction upon the injury and not
the accident. However, we believe that the
statute is unambiguous on its face and, in
such circumstances, it must be construed
without resort to outside aid and words are
to be used according to common and approved
usage. [citations omitted] Further, while
some might assume that the policy behind the
ALJ’s decision to reduce benefits make [sic]
a great deal of sense, statutory construction
mandates following the plain meaning of that
statute and not ignoring it simply because
there may be a better policy. [citation
omitted] The plain language of this statute
requires the accident to be caused by the
intentional failure to use a safety device
and not the injury or symptomatology. The
ALJ therefore erred, in our opinion, in
reducing the benefits by 15%.
This appeal and cross appeal followed.
On his appeal, Paulley maintains that the evidence
contained in the record compels a finding that he is totally and
permanently disabled.
Having reviewed the evidence contained in
the record on appeal, we disagree and adopt the following portion
of the Board’s opinion as our own:
When, as here, the party with the burden of
proof is unsuccessful before the ALJ, then we
must view the evidence to determine whether
it compelled a contrary result. Special Fund
vs. Francis, 708 SW2d 641 (1966); and Wolf
Creek Collieries vs. Crum, Ky. App., 673 SW2d
735 (1984). As previously noted, the ALJ
concluded that based upon the totality of the
evidence and specifically noting that the
only restrictions of record were those
assessed by Dr. Shraberg, although likewise
these were confirmed by Dr. Petruska, that
Paulley should avoid operating heavy
equipment, he was not totally disabled and
30% disability was appropriate. Paulley
believes that the evidence compelled a
finding of total occupational disability.
We, however, cannot agree.
Certainly, another ALJ viewing the same
evidence could have concluded that Paulley
-7-
was totally occupationally disabled at this
time. That, however, is not the standard.
McCloud vs. Beth-Elkhorn Corp., Ky., 514 SW2d
46 (1974). The determination of occupational
disability is uniquely the function of the
fact finder/ALJ. It requires the ALJ to
consider a variety of factors and at the time
those factors were set out in KRS
342.0011(11) and Osborne vs. Johnson, Ky.,
432 SW2d 800 (1968). It is clear that the
evidence, including the evidence from Dr.
Shraberg, supports the conclusion that
Paulley continues to experience
symptomatology associated with the vehicular
accident that prevents him from operating
heavy equipment. While the operation of
heavy equipment was his most recent job
function, the Court in [Osborne] noted that
in determining occupational disability the
fact finder is not limited to an analysis of
only an individual’s regular job. The ALJ
further noted both the testimony of Dr.
Shraberg and Dr. Petruska which he found to
be credible as indicating that this type of
injury would be expected to dissipate in its
symptomatology over time. It is further
clear in the ALJ’s award in permitting the
award of temporary total disability benefits
from July 1996 through January 1988 that he
recognized the testimony of Dr. Oates and Dr.
Cohen, both of whom directed most of their
treatment and comments to late 1996 through
1997. In assessing occupational disability,
no single factor is controlling and it can
rarely be said that a specific level of
occupational disability is mandated. Seventh
Street Road Tobacco Warehouse vs. Stillwell,
Ky., 550 SW2d 469 (1976); and Millers Lane
Concrete Co., Inc., vs. Dennis, Ky. App., 599
SW2d 464 (1980). Further, while evidence
from Paulley himself is probative, it is not
controlling. Caudill vs. Maloney’s Discount
Stores, Ky., 560 SW2d 15 (1977).
On its cross-appeal, McMillian argues that the Board
erred in reversing the ALJ’s decision to reduce Paulley’s
benefits by 15% pursuant to KRS 342.165 for failing to wear his
seat belt.
We disagree.
KRS 342.165 provides in pertinent part:
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If an accident is caused in any degree by the
intentional failure of the employee to use
any safety appliance furnished by the
employer or to obey any lawful and reasonable
order or administrative regulation of the
commissioner or the employer for the safety
of employees or the public, the compensation
for which the employer would otherwise have
been liable under this chapter, shall be
decreased fifteen percent (15%) in the amount
of each payment.
We agree with the Board that KRS 342.165 is unambiguous.
As the
Board noted, “[t]he plain meaning of the statute requires the
accident to be caused by the intentional failure to use a safety
device and not the injury or symptomatology.”
If the General
Assembly intended there to be a causal connection between the
injury and the failure to use a safety device, it was quite
capable of substituting “injury” for “accident” in the statute.1
“It is our responsibility to ascertain the intention of the
legislature from the words used in enacting the statute rather
than surmising what may have been intended but was not
expressed.”
Flying J Travel Plaza v. Com., Transp. Cabinet,
Dept. of Highways, Ky., 928 S.W.2d 344, 347 (1996).
Although the Special Fund was included as a party to
Paulley’s claim, it was dismissed by the ALJ in his opinion and
award without objection by either party.
As the Special Fund is
not implicated in any way in this appeal, we order that it be and
hereby is dismissed from these proceedings as well.
1
In fact, other jurisdictions have done so. See, i.e.,
Swillum v. Empire Gas Transport, Inc., 698 S.W.2d 921 (Mo.App.
1985)(Section 287.120.5 RSMo 1978 requires 15% reduction where
injury is caused by employee’s disregard of safety rule);
McKenzie Tank Lines, Inc. v. McCauley, 418 So.2d 1177(Fla.App.
1982)(Florida law requires nexus between violation of safety
statute and injury for 25% reduction to apply).
-9-
Having considered both parties’ arguments on appeal and
cross appeal, the opinion of the Workers’ Compensation Board is
affirmed in its entirety.
ALL CONCUR.
/s/ Daniel T. Guidugli
JUDGE, COURT OF APPEALS
ENTERED:
June 9, 2000
BRIEF FOR APPELLANT/CROSSAPPELLEE:
BRIEF FOR APPELLEE/CROSSAPPELLANT, McMillan
LANDSCAPING:
Edward A. Mayer
Louisville, KY
Stuart E. Alexander
Dana M. Taylor
Louisville, KY
BRIEF FOR APPELLEE, SPECIAL
FUND:
Joel Zakem
Frankfort, KY
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