MWCC NO. 84-01379-D-0132

JESSE L. HUGHES                                                                                                                              CLAIMANT

vs.

PORT GIBSON OIL WORKS                                                                                                           EMPLOYER
SELF-INSURED

APPEARING FOR CLAIMANT:
Honorable Terry B. Germany, Attorney at Law, Jackson, Mississippi

APPEARING FOR DEFENDANT:
Honorable Kenneth B. Rector, Attorney at Law, Vicksburg, Mississippi
 

The Commission heard the above styled cause on April 17, 2000 in the offices of the Mississippi Workers' Compensation Commission in Jackson, Mississippi on Employer's "Petition for Review".

Having heard the arguments offered on behalf of the parties and having thoroughly studied the record and the applicable law, the Commission affirms the "Order of Administrative Judge" dated December 29, 1999.

SO ORDERED, this the 19th day of April, 2000.

MISSISSIPPI WORKERS' COMPENSATION COMMISSION
BY: Barney Schoby
Beverly Bolton
COMMISSIONERS

ATTEST:
Brenda H. Goolsby, Secretary
___________________________

MWCC NO. 84 01379-D-0132-C

JESSE L. HUGHES                                                                                                                               CLAIMANT

vs.

PORT GIBSON OIL WORKS                                                                                                             EMPLOYER
SELF-INSURED

APPEARING FOR THE CLAIMANT:
Terry B. Germany, Esquire, Jackson, Mississippi

APPEARING FOR THE EMPLOYER:
Kenneth B. Rector, Esquire, Vicksburg, Mississippi
 

On January 25, 1999, and July 29, 1999, this matter came on before the undersigned. Administrative Judge for conference/hearing on the claimant's motion to compel home modifications, payment of nursing services, and in-home physical therapy filed March 11, 1998, and the employer's response thereto filed March 27, 1998. After the conferences/hearings, the parties agreed to try to resolve these matters by agreement and/or to gather additional evidence. The parties have been unable to resolve the matter, however, a major difficulty being that the claimant lives in Pawnee, Illinois (near Springfield), and the Administrative Judge has reviewed and considered all the evidence submitted by the parties. After due consideration, the Administrative Judge finds that the claimant's motion should be granted as set out in this order.

This case was originally controverted on September 10, 1986, when the claimant filed a petition to controvert alleging that he received various work-related injuries on February 2, 1984, resulting in permanent total occupational disability. The employer admitted the compensability of the injuries and voluntarily provided disability and medical benefits but disputed the extent of permanent disability. A hearing was held before Administrative Judge Martha R. Griffin.

By order dated August 19, 1987, Administrative Judge Griffin described the claimant's injury as altratimatic amputation of the claimant's left leg which required a left hip disarticulation, a complete removal of the hip pocket from the pelvis. The Administrative Judge found that the claimant was permanent totally disabled from the date of the injury and awarded him 450 weeks of permanent total disability benefits beginning February 2, 1984, the date of injury. The Administrative Judge also ordered the employer to provide "all reasonable and necessary medical services and supplies as the nature of claimant's injury or the process of his recovery may require including but not limited to a ramp providing access to and from his home and a properly maintained hospital bed" pursuant to the medical statute in the Mississippi Workers' Compensation Act.

On December 12, 1995, the claimant filed a motion to compel payment of nursing services, seeking reimbursement for the value of nursing services provided by claimant's spouse, Lou Ella Hughes, to her husband since the date of his injury. The claimant and the employer subsequently entered into a compromise settlement regarding nursing services rendered the claimant prior to the date of the order approving settlement which was approved and signed by the Commission on April 17, 1997. In the order approving the settlement, claimant was allowed to reserve and retain "any claims arising hereafter for nursing services rendered to him after the date hereof " The employer has paid all disability benefits owed to the claimant.

On March 11, 1998, the claimant filed the motion to compel home modifications, payment of nursing services, and in-home physical therapy. In the motion, the claimant contended that his wife, Lou Ella Hughes, continues to provide nursing services to the claimant and that since April 17, 1997, the employer has refused to pay her for these services; that the employer has refused to pay for a course of in-home physical therapy as recommended by one of his treating physicians, Dr. Ronald R. Romanelli; and that the employer has refused to make housing modifications requested by the claimant and as set forth in a home evaluation prepared August 11, 1997, by Jackie Moore, R.N., B.S.N., C.R.R.N., rehabilitation nurse consultant, and as also recommended by Dr. Romanelli. The claimant moved the Commission to order the employer to provide payment for these requested nursing services, in-home physical therapy, and housing modifications.

The employer responded that the services performed by Mrs. Hughes, such as massages, handing out medicine, and showering, are duties expected of a wife for a husband and that the claimant has not presented medical evidence to justify a claim for nursing services. The employer is refusing to consider home modifications until the claimant is totally wheelchair bound and no longer able to walk with crutches.
 

The following exhibits have been marked for introduction into evidence:

1. The affidavit, dated May 7, 1998, and medical records of Dr. Ronald Romanelli of the Orthopaedic Center in Springfield, Illinois.

2. The affidavit, dated May 8,1998, and medical records of Dr. Alfred Harney of the Central Illinois Medical Associates in Springfield, Illinois.

3. The September 3, 1997, office note of Dr. Ronald R. Romanelli.

4. The December 1, 1997, office note of Dr. Ronald R. Romanelli.

5. The August 11, 1997, report of Jackie Moore, R.N., B.S.N., C.R.R.N., Rehabilitation Nurse Consultant, Rehabilitation, Inc., Brandon, Mississippi.

6. The August 4,1997, letter of Dr. Ronald R. Romanelli.

7. The October 28, 1997, letter of Dr. Ronald R. Romanelli.

8. The June 11, 1999, office note of Dr. Brian Russell of the Orthopaedic Center of Illinois in Springfield.

9. The June 23, 1999, report of Tech Builders, Springfield, Illinois.
 

After carefully considering the pleadings, the documentary evidence submitted by the parties, and the argument of counsel, the Administrative Judge finds as follows:

1. The claimant, Jesse L. Hughes, suffered a severe physical disability on February 2, 1984, completely losing both his left leg and left hip, and his wife, Lou Ella Hughes, has rendered valuable nursing assistant services to him, a compensable medical benefit under Mississippi Code Annotated Section 71-3-15(l). See Mississippi Transportation Commission v. Dewease, 691 So.2d 1007, 1012 (Miss. 1997). The employer has paid Mrs. Hughes through the date of April 17, 1997, and should immediately reimburse her for services on and after April 18, 1997, and continuing after the date of this order as long as she renders nursing assistant services. The employer should pay her for four hours of nursing assistant services a day, seven days a week, at the rate of minimum wage. While there may be a fine line between some of the services Mrs. Hughes renders as a spouse and some of the nursing assistance tasks she performs, it is reasonable to allot four hours a day for such tasks as helping him to shower and dress, keep up with his medication schedule, help him to ambulate about the house, keep his bed clean, and so forth, tasks that otherwise would be performed by a certified nursing assistant sent in by a home health agency.

In his August 4,1997, letter to the claimant's attorney, Dr. Romanelli advised that Mr. Hughes was "having increasing pain and discomfort in his back and leg. His leg is getting weaker. He is only able to walk and stay up about 2 hours per day because of his progressive medical deterioration and significant pain and discomfort." (Exhibit 6). If that is the case, then four hours of nursing assistant services are reasonable and necessary.

2. The employer should immediately provide whatever program of physical therapy is recommended by Dr. Ronald R. Romanelli or any other treating physician to whom Dr. Romanelli should refer Mr. Hughes, whether in-home or at another facility. Dr. Romanelli has indicated that Mr. Hughes needs the therapy, prescribing physical therapy in both his September 3, 1997, and December 1, 1997, office notes. The employer should contact Dr. Romanelli for the specific details. (Exhibits 3 and 4).

3. The employer should immediately provide the modifications recommended by Jackie Moore in her report dated August 11, 1997 (Exhibit 5), and as agreed to by Dr. Romanelli in his letter dated October 28, 1997 (Exhibit 7). On September 3, 1997, Dr. Romanelli said that Mr. Hughes needed a lightweight wheelchair in order to get around. (Exhibit 3). It is clear from the medical records that Mr. Hughes' condition is deteriorating, and he has difficulty getting around. Jackie Moore, the rehabilitation nurse consultant, has made very easy-to-understand and specific recommendations, and the claimant has obtained one estimate for construction modifications from Tech Builders (Exhibit 9). The employer is not bound by the estimate from Tech Builders, as it appears to include modifications over and above that required for wheelchair accessibility, but must follow the recommendations of Ms. Moore.

4. The employer shall continue to provide all other reasonable and necessary medical services and supplies as the nature of Mr. Hughes' work injury or the process of his recovery may require, pursuant to Mississippi Code Annotated Section 71-3-15 and the Commission's Medical Fee Schedule, including but not limited to a ramp providing access to and from his home and a properly maintained hospital bed, as ordered by Administrative Judge Martha R. Griffin in her order of August 19, 1987.
 

IT IS THEREFORE ORDERED that the employer

1. Pay the claimant's wife, Lou Ella Hughes, for four hours of nursing assistant services a day, seven days a week, beginning April 18, 1997, and continuing as long as she renders medical assistance to her husband, at the rate of minimum wage.

2. Provide the course of physical therapy recommended by Dr. Romanelli.

3. Provide the modifications to the residence of the claimant in Pawnee, Illinois, according to the recommendations made by Jackie Moore in her report of August 11, 1997.

4. Provide all other reasonable and necessary medical services and supplies as the nature of the claimant's work injury or the process of his recovery may require pursuant to Mississippi Code Annotated Section 71-3-15 and the Commission's Medical Fee Schedule.

SO ORDERED, this the 29th day of December, 1999.

LINDA A. THOMPSON
ADMINISTRATIVE JUDGE

ATTEST:
Brenda H. Goolsby, Secretary