DENHAM-BLYTHE CO ., INC . V. RUFUS WOOTEN ; HON . LLOYD R . EDENS, ADMINISTRATIVE LAW JUDGE ; HON . ROBERT L . WHITTAKER, DIRECTOR OF WORKERS COMPENSATION FUNDS, SUCCESSOR TO SPECIAL FUND ; AND WORKERS' COMPENSATION BOARD
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SUPREME COURT, CR 76.28 (4) (c), THIS OPINION
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RENDERED : May 20, 2004
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2003-SC-0451-WC
DENHAM-BLYTHE CO., INC.
V.
APPEAL FROM COURT OF APPEALS
2002-CA-1604-WC
WORKERS' COMPENSATION BOARD NO. 92-26541
RUFUS WOOTEN; HON. LLOYD R. EDENS,
ADMINISTRATIVE LAW JUDGE; HON. ROBERT L.
WHITTAKER, DIRECTOR OF WORKERS COMPENSATION
FUNDS, SUCCESSOR TO SPECIAL FUND; AND
WORKERS' COMPENSATION BOARD
APPELLEES
MEMORANDUM OPINION OF THE COURT
AFFIRMING
At the reopening of the claimant's workers' compensation award, an Administrative
Law Judge (ALJ) determined that he had become totally disabled due to a worsening of
his physical condition and that he was suffering from work-related depression
for which
he
was entitled to medical treatment. Having failed to convince the Workers' Compensation
Board (Board) or the
Court of
Appeals that the decision was erroneous as a matter of law,
the employer now appeals to this
Court.
It maintains that the psychiatric claim was
nonwork-related and barred by limitations under Slone v. Jason Coal Co. , Ky., 902 S .W .2d
820 (1995), and also that there was no substantial evidence to support the finding of total
disability . We affirm.
The claimant was born in 1950 and has a twelfth-grade education as well as
training in diesel mechanics . He had prior work experience in a factory, in park
maintenance, as a welder, and as a manager of an aluminum recycling business . He
worked for the defendant-employer as a construction laborer. On June 23, 1992, he
sustained neck and lower back injuries when a co-worker who was working above him
fell and landed on him . The ALJ who considered the claim determined that there was
evidence of a bulging or herniated cervical disk, which caused nerve root impingement
and radiculopathy into the arms . Although convinced that the injury was not totally
disabling as the claimant alleged, the AU determined that the claimant could not return
to manual labor or to a full range of medium-duty jobs. In an award that was rendered
in September, 1995, the claimant received a 50% occupational disability. Based on
evidence that the trauma aroused pre-existing degenerative changes, half of the liability
was apportioned to the Special Fund .
On August 9, 2000, the claimant moved to reopen the claim, alleging a
worsening of his back and neck conditions . He asserted that, since the award, surgery
had been recommended and also that he had developed severe depression . The
motion was granted, and the parties proceeded to take further proof.
The claimant testified at reopening that he had neither worked nor looked for
work since the 1992 injury because he was unable to work. He maintained that both his
physical and emotional condition had worsened since then . He experienced greater
pain in his neck and arms and began to lose the use of his arms. Although he was
referred to Dr. Natelson, who performed surgery in 1997, the pain returned and
increased after about two months. Although medication provided some relief from the
pain, he testified to constant numbness in his left arm and pain in his neck. He also had
difficulty standing or sitting for long periods and difficulty sleeping . He stated that after
the surgery he received a permanent social security disability award.
The claimant stated that after the 1997 surgery, he developed severe depression
and underwent counseling at his own expense . He stated that it was helpful . He
denied having previously experienced depression or having previously taken medication
for the condition . When asked whether a Dr. Wright had prescribed antidepressants at
the time of the hearing on the initial claim, he testified that he saw Dr. Wright shortly
after the injury . He stated that Dr. Wright was his family doctor at the time and referred
him to a neurosurgeon in Lexington . He did not know what Dr. Wright prescribed . At
the hearing, he testified that he presently took Xanax for his psychiatric condition.
Dr. Natelson first saw the claimant on May 1, 1995, at which time he complained
of neck and low back pain. An MRI revealed a spinal stenosis, prompting Dr. Natelson
to recommend surgery. The claimant declined the procedure at that time, but he
returned on January 27, 1997, complaining of numbness and tingling in both hands and
neck pain, and later agreed to the surgery . Dr. Natelson performed a decompressive
cervical laminectomy at C3, C4, C5, and C6 on June 17, 1997. He testified that the
spinal stenosis was a dormant condition that was brought into disabling reality by the
work-related injury . As of December 10, 1997, the claimant indicated that his right arm
had returned to normal, but he continued to experience numbness in the index and long
finger of the left hand . Dr. Natelson assigned a 15% impairment .
When the claimant returned on January 19, 2001, he complained of numbness in
the left hand that was made worse by holding things and of low back pain with radiation
into the left leg . Dr. Natelson ordered an MRI, which revealed a ruptured disc at C7-T1
and a slight central bulge at L5-S1 that also explained his symptoms . Dr. Natelson
prescribed physical therapy and medication. On July 11, 2001, the claimant continued
to have symptoms that Dr. Natelson viewed as being "real" but for which he did not think
surgery was appropriate .
On December 8, 2000, Dr. Chaney testified that he had treated the claimant for
seven to eight years . In his opinion, the 1997 surgery was not successful because it did
not relieve the claimant's pain . He thought that the claimant was worse physically than
he had been in 1995 and that he now suffered from depression . Dr. Chaney assigned a
15% impairment for the neck and back conditions, using the Fourth Edition of the AMA
Guides to the Evaluation of Permanent Impairment (Guides ). He restricted the claimant
from repetitive bending, stooping, twisting, and turning and limited him to lifting a
maximum of twenty pounds and to lifting ten pounds occasionally . He acknowledged,
however, that the claimant's restrictions were the same as they had been in 1994 and
that, in his opinion, the claimant was unable to return to his previous work when he
received the initial award.
Dr. Chaney testified that, after the surgery, the constant pain, the fact that it did
not improve, and the claimant's inability to work caused him to develop anxiety and
depression . He received counseling from a psychologist who worked at Dr. Chaney's
office for a period of time and was prescribed antidepressants and anxielitic medication.
Dr. Chaney stated that his records indicated that he first prescribed medication for
anxiety in 1997 . He testified that he did not begin treating the claimant for depression
until about 1999. In his opinion, the psychiatric condition caused a 10-20% impairment .
Dr. Rapier examined the claimant in April, 2001, and diagnosed a contusion and
strain to the neck and back which aggravated a preexisting, dormant, degenerative
disease . He noted the prior surgery for a cervical spinal stenosis . Furthermore, he
assigned a 29% impairment and limited lifting to a maximum of twenty pounds and
frequent lifting to ten pounds.
Dr. Travis examined the claimant in February, 2001, on behalf of the employer. He
noted a cervical laminectomy involving C3, C4, C5, and C6 and the claimant's continuing
complaints of pain in the neck and left arm . He reported, however, that his examination
revealed no objective findings with respect to the cervical spine or related nerve roots and
that it did reveal overt and flagrant symptom magnification . He assigned a 0% lumbar
spine impairment and a 15-18% cervical impairment . He found no objective evidence of a
worsening of condition since 1995, no evidence of spinal stenosis or of a herniated disc,
and no evidence of nerve root or neuro-foraminal involvement . In his opinion, the 1997
surgery was successful . He also reported that a February, 2001, MRI revealed nothing to
indicate the need for additional cervical or lumbar surgery .
Dr . Granacher, a psychiatrist, examined the claimant in February, 2001, and
concluded that he had a 10% psychiatric impairment due to depression . He stated that
the claimant gave a history which indicated that Dr. Chaney had treated him with some
type of medication for bad nerves in 1992. Dr. Granacher noted, however, that he could
not document the history from the information at hand . He indicated that the claimant's
mood was depressed, that his affective range appeared to be constricted, and that no
external stressors accounted for his current mental state . He actively complained of
pain, had numerous pain behaviors, appeared uncomfortable, and had a distressed
facial expression . Dr. Granacher stated that if the claimant did, in fact, have depression
in 1992, his present depression would be related to the 1992 condition .
As reflected in the memorandum of the Benefit Review Conference conducted on
October 17, 2001, the AU indicated that the contested issues were limited to "work-
relatedness/causation of the psychiatric condition" and to "increase in occupational
disability." Nonetheless, the employer's brief to the AU asserted that no medical
evidence established that the psychiatric condition was work-related and that even if the
psychiatric condition was work-related, compensation was barred under Slone v. Jason
Coal Co. , supra . As the basis for the second assertion, the employer referred to
testimony by the claimant in the initial proceeding that he experienced depression and
that a physician had prescribed antidepressants .
After reviewing the evidence, the ALJ relied upon Dr. Chaney's testimony that the
claimant was diagnosed with depression after his surgery and determined that the
condition was due to the work-related injury . Relying upon Drs. Natelson and Chaney,
the ALJ determined, however, that the claimant's present physical condition, by itself,
caused him to be totally disabled . Based on the findings, the ALJ increased the
claimant's income benefits and awarded medical benefits for treatment of the depression .
The employer's petition for reconsideration reiterated its position that the
psychiatric condition was present at the time of the initial award and was barred . Although
the ALJ did not address its argument that the claim was barred by Slone v. Jason Coal
Co., supra, the employer did not bring that fact to the ALJ's attention or request specific
findings concerning the presence of depression before 1995 . Nonetheless, it argued on
appeal that the psychiatric condition was not work-related and also that the claim was
barred at reopening because the claimant knew of the condition in 1995 but failed to raise
it in his initial claim . Slone v. Jason Coal Co., supra . The employer also argues that the
evidence did not support the finding of total disability.
In Slone v. Jason Coal Co., supra , the worker filed workers' compensation and
social security disability claims at about the same time. It was undisputed that his
mental condition was present at the time, for a psychiatric evaluation was one of the
grounds for the social security disability claim. Yet, he failed to offer evidence of the
condition when litigating the workers' compensation claim. At reopening, he alleged
that the condition had been dormant at the time of the initial award and had only
recently become disabling . The Court determined, however, that attempting to claim
benefits for the condition by means of a subsequent reopening amounted to piecemeal
litigation, which was prohibited in Wagner Coal & Coke Co. v. Gray , 208 Ky. 152, 270
S.W.2d 721 (1925). Furthermore, because KRS 342 .125 based reopening on a change
of occupational disability, the Court pointed out that a motion to reopen cannot be based
upon a condition that was known during the pendency of the initial action but not
litigated . Id. At 822 .
Unlike the situation in Slone v. Jason Coal Co . , supra , the present reopening
was premised on a worsening of the claimant's orthopedic condition and on the
development of depression as a result of the post-award surgery . None of the
testimony from the claimant's 1995 proceeding appears in the record at reopening .
Although the employer asserts that the claimant testified to experiencing depression
due to his neck pain and to taking antidepressants at that time, the opinion and award
did not mention any lay or medical testimony which indicated that the claimant was
depressed or had a psychiatric condition. It may well be that the ALJ who considered
the matter simply ignored the claimant's testimony that he was depressed because
there was no psychiatric claim . It may also be that in the absence of supporting medical
evidence, the ALJ did not find the self-serving testimony to be persuasive . In any event,
although the testimony was relevant to the question of occupational disability, it did not
compel a finding that the claimant suffered from work-related depression at that time or
a rejection of the claim for medical benefits at reopening. Hush v. Abrams , Ky., 584
S.W .2d 48 (1979); Grider Hill Dock v. Sloan , Ky., 448 S.W.2d 373 (1969).
Contrary to the employer's assertion that the only treatment the claimant
received for depression after 1995 was some counseling, Dr. Chaney testified he began
treating the claimant for depression in about 1999 and that he prescribed anxielitic
medication in 1997. Furthermore, he stated that the claimant's anxiety and depression
resulted from his pain, the failure of the surgery to relieve it, and his inability to work.
Dr. Granacher determined that the depression was present in 1992, but he made it clear
that his conclusion was based solely on a history given by the claimant, which indicated
that Dr. Chaney had treated him with some type of medication for bad nerves in 1992 .
Under the circumstances, we are not persuaded that the evidence that was introduced
at reopening compelled a finding that the claimant suffered from work-related
depression in 1995 or a finding that the depression he alleged at reopening was caused
by anything other than the persistent symptoms of pain, the unsuccessful post-award
surgery, and the claimant's inability to work. Under the circumstances, we find no error
in the decision to award medical benefits for the condition .
At reopening, the ALJ determined that the claimant's physical injury, by itself, had
become totally disabling . The employer's second argument is that the evidence did not
support the finding that the claimant was totally occupationally disabled . Pointing to
medical evidence that the claimant's restrictions were unchanged and to what the
employer characterizes as a successful surgery, the employer maintains that his
condition has actually improved. It asserts, therefore, that the award should not have
been increased .
Contrary to the employer's assertion, the medical evidence established a
worsening of the claimant's physical condition since 1995. Furthermore, although Dr.
Chaney did not think that the claimant could return to his previous work in 1995, his
opinion at reopening was that the claimant could no longer perform even the medium or
light-duty work of which he had been capable at that time. Despite the employer's
medical evidence to the contrary, there was substantial evidence from which the ALJ
could reasonably conclude that the claimant's physical condition had worsened since
the initial award and that he was no longer capable of even the light to medium-duty
work that the previous ALJ envisaged when awarding a 50% occupational disability in
1995. Under the circumstances, the award was properly affirmed on appeal . Special
Fund v. Francis , Ky., 708 S.W.2d 641, 643 (1986).
The decision of the Court of Appeals is affirmed .
All concur.
COUNSEL FOR APPELLANT :
W . Kenneth Nevitt
Nevitt Law Office
804 Stone Creek Parkway, Ste. 4
Louisville, KY 40223-5361
COUNSEL FOR APPELLEE, RUFUS WOOTEN:
Phyllis L. Robinson
P .O. Box 130
Manchester, KY 40962
COUNSEL FOR APPELLEE, WORKERS' COMPENSATION FUNDS:
David W . Barr
Workers' Compensation Funds
1047 U.S . Hwy., 127 South, Suite 4
Frankfort, KY 40601
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