PEABODY HOLDING, INC., N/K/A PATRIOT COAL COMPANY V. GREGORY MCGUIRE; HONORABLE JOHN B. COLEMAN, ADMINISTRATIVE LAW JUDGE; AND WORKERS' COMPENSATION BOARD
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THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED."
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RENDERED: AUGUST 25, 2011
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2010-SC-000746-WC
PEABODY HOLDING, INC.,
N/K/A PATRIOT COAL COMPANY
V.
APPELLANT
ON APPEAL FROM COURT OF APPEALS
CASE NO. 2010-CA-000684-WC
WORKERS' COMPENSATION NO. 07-75229
GREGORY MCGUIRE;
HONORABLE JOHN B. COLEMAN,
ADMINISTRATIVE LAW JUDGE; AND
WORKERS' COMPENSATION BOARD
APPELLEES
MEMORANDUM OPINION OF. THE COURT
AFFIRMING
The Court of Appeals affirmed a decision by the Workers' Compensation
Board to vacate a finding that the claimant's injury produced a 9% permanent
impairment rating. The Board remanded the claim, directing the
Administrative Law Judge (ALJ) to determine whether the rating was assigned
under the Fifth Edition of the AMA Guides to the Evaluation of Permanent
Impairment (Guides) and to proceed accordingly. Appealing, the employer
asserts that the claimant must rely on the 9% rating, which he submitted, and
that the Board erred by directing the AI.0 to interpret the Guides, a matter that
requires medical expertise.
We affirm. Dr. Johnson assigned a 9% "disability." The Board did not
direct the ALJ to interpret the Guides but to "ensure the appropriate guideline
was used." KRS 342.730(1)(b) and the medical evidence required the ALJ to
base the claimant's award of income benefits on a "permanent impairment
rating" determined in accordance with the section of the Fifth Edition of the
Guides that pertains to total hip replacement.
The claimant sustained a work-related injury to his head, back, left side,
and left leg on September 24, 2007. He missed several weeks' work and then
returned to work until September 28, 2008. He had total hip replacement
surgery on November 18, 2008. His condition improved after the surgery, but
he alleged when claiming workers' compensation benefits that he lacked the
physical capacity to continue to work as an underground coal miner.
Dr. Johnson, the treating orthopedic surgeon, testified when deposed in
June 2009 that the claimant had not reached maximum medical improvement
(MMI) and remained temporarily totally disabled. He did not state when he last
saw the claimant but did testify that they had an appointment scheduled in
August 2009, "probably for a final check on his hip." He anticipated that the
claimant would have a good recovery and that he would assign a 15% wholebody impairment rating at that time, using Table 15-33 on page 546 of the
Fifth Edition of the Guides. He thought it more probable that the claimant
would not be able to return to coal mining than that he would be able to do so.
2
Dr. Johnson's treatment note from August 13, 2009 stated that the
claimant could not return to underground mining but failed to mention
whether he had reached MMI. The claimant submitted into evidence a letter
from Dr. Johnson, dated October 7, 2009, which stated that the claimant
reached MMI with a 9% "disability." Dr. Johnson also assigned restrictions.
Dr. Loeb performed a peer review in October 2008 based on medical
records; evaluated the claimant in May 2009; and testified by deposition in
August 2009. Having received a history of the September 2007 accident and
the subsequent return to work for 11 months, Dr. Loeb reported in October
2008 that the accident would have caused no more than an aggravation of his
pre-existing dormant arthritic condition and produced some transient left hip
pain. He attributed the current complaints to the natural progression of the
arthritis in the claimant's left hip and knee.
Dr. Loeb reported in May 2009 that the claimant's left hip discomfort had
improved since his hip replacement surgery. Noting that the initial emergency
room notes recorded no complaints of immediate hip pain after the accident, he
continued to attribute the need for hip replacement surgery to a natural
progression of his arthritic condition. Noting that the surgery achieved a good
result, he assigned a 15% whole-person impairment rating using Table 15-33
from page 546 of the Fifth Edition of the Guides. He also assigned various
work restrictions.
The AL.J found that the claimant lacked the physical capacity to return to
mining and would be unable to earn the same or a greater wage indefinitely
although he had done so for a time after his injury. Rejecting the claimant's
assertion that the injury left him permanently and totally disabled, however,
the ALJ relied on the October 2009 letter from Dr. Johnson to find that he
sustained a 9% permanent impairment rating for the purpose of awarding
permanent partial disability benefits.
The claimant appealed following the denial of his petition for
reconsideration. He asserted among other things that the ALJ erred by relying
on the 9% figure stated in Dr. Johnson's letter rather than the 15% figure to
which he testified when deposed and with which Dr. Loeb agreed.
Noting that Dr. Johnson's letter referred to "disability" rather than
"impairment" and that the ALJ failed to determine whether the 9% figure was
assigned in accordance with the Fifth Edition of the Guides, the Board vacated
the decision and remanded the claim for additional consideration. The Court of
Appeals affirmed, convinced that an ALJ is not only authorized but required to
determine whether an impairment rating is based upon the Guides.
The employer argues that the claimant should not be permitted to
challenge the 9% rating assigned by Dr. Johnson because he was the party
who offered the October 2009 letter as evidence. Relying on Kentucky River
Enterprises, Inc. v. Elkins' for the principle that the proper interpretation of the
Guides is a medical question, the employer also argues that the Board erred by
directing the ALJ to interpret the Guides on remand. We disagree with both
arguments.
1
107 S.W.3d 206, 210 (Ky. 2003).
Dr. Johnson's August 2009 treatment note failed to address MMI. His
subsequent letter stated the claimant had reached MMI and assigned a 9%
"disability." The employer cites no authority for the proposition that the
claimant must rely on the letter with respect to his permanent impairment
rating.
Contrary to the employer's assertion, the Board did not direct the ALJ to
interpret the Guides but to "ensure the appropriate guideline was used." KRS
342.730(1)(b) and KRS 342.0011(35) require an ALJ to base an award of
income benefits on a whole-body permanent impairment rating that is
determined in accordance with the latest edition of the Guides. Drs. Johnson
and Loeb agreed that the appropriate table to use when assigning a permanent
impairment rating following total hip replacement surgery is Table 15-33,
found on page 546 of the Fifth Edition of the Guides.
A review of Table 15-33 does not require medical expertise. 2 The table
clearly does not authorize a 9% impairment rating for total hip replacement. It
authorizes a 15% rating based on good results, a 20% rating based on fair
results, or a 30% rating based on poor results. The ALJ must render an award
on remand that is based on a permanent impairment rating determined under
Table 15-33.
The decision of the Court of Appeals is affirmed.
All sitting. All concur.
2
See Caldwell Tanks v. Roark, 104 S.W.3d 753 (Ky. 2003).
5
COUNSEL FOR APPELLANT,
PEABODY HOLDING, INC.,
N/K/A PATRIOT COAL COMPANY:
Peter J. Glauber
Boehl Stopher & Graves, LLP
2300 Aegon Center
400 West Market Street
Louisville, KY 40202
COUNSEL FOR APPELLEE,
GREGORY MCGUIRE:
Jerry P. Rhoads
Rhoads & Rhoads, PSC
9 East Center Street
P.O. Box 1705
Madisonville, KY 42431
6
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