MWCC NO.
84 10078-E-3586
| CHARLES
JACK WILLIAMS
vs. JOE N. MILES
AND, SONS, INC.
|
CLAIMANT
EMPLOYER
CARRIER
|
REPRESENTING
CLAIMANT:
Honorable
Kimberly A. Castle, Attorney at Law, Hattiesburg, Mississippi
Honorable
Derek L. Hall, Attorney at Law, Jackson, Mississippi
REPRESENTING
DEFENDANT:
Honorable
David B. McLaurin, Attorney at Law, Tupelo, Mississippi
The Commission heard the above styled cause on July 2, 2001 in the offices of the Mississippi Workers' Compensation Commission, Jackson, Mississippi on the Employer/Carrier's "Petition for Review", by the Full Commission.
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 October 17, 2000.
SO ORDERED, this the 3rd day of July, 2001.
MISSISSIPPI
WORKERS' COMPENSATION COMMISSION
BY:
BARRETT SMITH
BARNEY SCHOBY
LYDIA QUARLES
COMMISSIONERS
ATTEST:
Jo Ann McDonald, Secretary
____________________________
MWCC NO.
84 10078-E-3586
| CHARLES
JACK WILLIAMS
vs. JOE N. MILES
AND SONS, INC.
|
CLAIMANT
EMPLOYER
CARRIER
|
APPEARING
FOR CLAIMANT:
Ms Kimberly
A. Castle, Attorney at Law Hattiesburg, Mississippi
Mr. Derek
L. Hall, Attorney at Law Jackson, Mississippi
APPEARING
FOR EMPLOYER-CARRIER:
Mr. David
B. McLaurin, Attorney at Law Tupelo, Mississippi
Claimant injured his lower back on July 30, 1984, while working for the Employer. The Employer-Carrier admitted compensability of the lower back injury and paid medical expenses and temporary disability benefits. Claimant alleges a psychological overlay beginning March 1, 1994, from the initial work injury to Claimant's back. The threshold issue is the compensability of the alleged psychological overly. The hearing was held at the Forrest County Courthouse in Hattiesburg, Mississippi, on May 31, 2000.
1. That a work-related accident occurred on July 30, 1984, injuring Claimant's lower back.
2. There is no remaining issue to be decided regarding the existence and extent of temporary or permanent disability since Claimant has received maximum disability benefits under the Mississippi Workers' Compensation Law.
3. The parties
stipulated that if Mrs. Gladdis Williams (Claimant's spouse) were called
to testify at the hearing, she would substantially and materially corroborate
Claimant's testimony.
1. Whether or not Claimant has an additional work-related injury in the form of a psychological overlay. More specifically, the extent of the Employer-Carrier's financial responsibility for psychological treatment beginning March 1, 1994.
2. Whether or not there has been a superseding, intervening cause of Claimant's alleged psychological overlay.
3. The reasonableness
and necessity of the medical treatment pertaining to Claimant's alleged
psychological condition.
Claimant is a 63-year-old resident of Lumberton, Mississippi. He completed the sixth grade and served in the military. Claimant worked over 25 years at the Employer, a furniture upholstery factory. Claimant was working as a Chipping Saw Operator when he injured his lower back on July 30, 1984. Claimant was hospitalized and underwent numerous back surgeries.
While receiving treatment for his back injury, Claimant was admitted for prescription pain medication addiction. Claimant stated that he was depressed from being in pain and from not being able to work after his back injury. Claimant said he had no problems with depression or anxiety until after his back injury in 1984.
Claimant testified that he has had several back surgeries and that he also had to have periodic surgery to change his spinal cord stimulator's battery. Claimant described severe pain in his back as feeling like a "hot rod" up his spine. Claimant said he was depressed and often cried because he could not work and had no income when his workers' compensation disability checks were slow in arriving.
Claimant said he initially received treatment for his depression by Dr. Morse, but he was admitted to the Pine Grove Recovery Center since he could not eat or talk. Claimant admitted that he did not want to live anymore at that point in his life due to his back pain, his inability to work, and his inability to have an intimate relationship with his spouse.
Claimant was later treated at Sand Hill. He said he was not allowed to return to Pine Grove because the Employer-Carrier no longer covered his psychological treatment under workers' compensation. He thought the Employer-Carrier paid for the initial treatment at Pine Grove. Claimant felt that the prescription medication given to him for his back injury altered his perception and caused psychological problems. Claimant testified that his current medication "fuzzes" his mind and makes it hard for him to recall dates.
Claimant said he was committed to Sand Hill by his wife after he tried to commit suicide. Claimant said he was discharged from Sand Hill so that he could seek treatment from Dr. DeFraites. He acknowledged that the Sand Hill commitment papers listed an incident where he pushed his daughter and his wife after a fight at home. Claimant said he is currently being treated by Dr. DeFraites for depression, which he feels is now under control with Prozac.
Claimant returned to work within four weeks after the surgery, but Dr. Attix still treated Claimant regularly. In February 1985, Dr. Attix felt that Claimant had an irritation of the right sciatic nerve root and spinal stenosis. In 1985, Claimant underwent episodes of traction and steroid injections, along with prescription pain medication. Claimant continued to complain of pain in his lower back and right leg.
On September 6, 1985, Dr. Attix performed a complete decompression laminectomy at the L4-5 level of Claimant's spine and a bilateral lateral spinal fusion from the L4 level to Claimant's sacrum. Although Claimant initially received relief from the surgery, Claimant later began complaining of pain again. In April 1986, Dr. Attix opined that Claimant would be restricted from any lifting or bending from the waist, any operating foot pedal, and any extensive sitting.
Dr. Attix continued to treat Claimant in 1986 for back and leg pain with injections, pain medication, a TENS unit and traction. In December 1986, Dr. Attix referred Claimant to the Chronic Pain Clinic at the Touro Infirmary in New Orleans, although Claimant was not admitted until 1987. Dr. Attix continued to treat Claimant after Claimant was discharged from the Touro Infirmary. In September 1987, Dr. Attix, based upon the recommendations of the Touro Infirmary physicians, referred Claimant for physical therapy and psychiatric care.
On December 1, 1987, Dr. Attix noted that Claimant had depression and severe pain. Dr. Attix noted that Claimant requested amputation of his right lower extremity due to the severe and debilitating pain. Dr. Attix referred Claimant for evaluation of implantation of a dorsal column stimulator. The last notation in Dr. Attix's records was on January 20, 1988, at which time Dr. Attix referred Claimant back to Dr. Morse at the Touro Infirmary and also to Dr. Lowry. Claimant was still complaining of severe pain in his lower back and right leg.
In January 1988, Dr. William Johnston saw Claimant for a neurosurgical consultation as requested by Dr. Attix. He diagnosed Claimant with chronic pain syndrome and noted a long history of recurrent and progressively intractable pain. In February 1988, Dr. George Wilkerson saw Claimant for a neurological evaluation as requested by Dr. Attix. Dr. Wilkerson diagnosed Claimant with probable nerve root compression.
Dr. Michael W. Lowry, neurosurgeon, began treating Claimant on January 25, 1988, for back and right leg pain. On February 12, 1988, Dr. Lowry admitted Claimant to the Methodist Hospital and implanted a spinal cord stimulator at the T11-12 level in Claimant's spine. Dr. Lowry continued to treat Claimant by regulating the stimulator and prescribing medication. He diagnosed Claimant with chronic back and right leg pain due to perineural fibrosis from severe scar tissue around the lower spine nerve roots.
On December 6,1988, Dr. Lowry placed Claimant at maximum medical improvement even though Claimant continued t o complain of severe pain in the back and leg. Dr. Lowry stated that Claimant had an 80% disability. He continued to treat Claimant throughout 1989 and 1990. Dr. Lowry was advised of Claimant's admission to Pine Grove Hospital for psychiatric care. In January 1990, Dr. Lowry thought Claimant might be a candidate for brain lesioning or perhaps thalamotomy.
In November 1990, Dr. Lowry referred Claimant for a sympathetic nerve block. Claimant still complained of pain. In December 1991, Dr. Lowry referred Claimant to another psychiatrist (Dr. William Turner) since Claimant's previous psychiatrist (Dr. Jones) had his "DEA license pulled." Dr. Lowry's records are replete with Claimant's complaints of pain and depression. In June 1996, Dr. Lowry felt that it was "essential" for Claimant to receive psychiatric treatment. Throughout the years, Dr. Lowry replaced Claimant's spinal cord stimulator and batteries. He continued to treat Claimant until January 1999, with a notation that Claimant was to return for a regular appointment in two months.
On June 27,19.88, Dr. Kurt Bruckmeier, internist, saw Claimant upon referral by Dr. Michael Lowry for an evaluation of Claimant's chest pains. Dr. Bruckmeier decided that Claimant had chest pain syndrome due to the spinal cord stimulation. After diagnostic tests, Dr. Bruckmeier opined that Claimant was having abdominal discomfort exacerbated by the nonsteroidal anti-inflammatory agents Claimant was taking for low back pain.
Dr. Hal Liddell, urologist, began treating Claimant on January 23, 1990, upon referral by Dr Bruckmeier, for Claimant's problems with impotence and urinary leakage. Dr. Liddell stated that the tests and examination suggested that Claimant's problem was neurogenic impotence which was related to Claimant's back injury. On August 30, 1990, Dr. Liddell inserted an inflatable penile prosthesis. In April 1991, Dr. Liddell continued Claimant's follow-up treatment and noted that Claimant was at maximum medical improvement with regard to the complaint of impotence. Claimant's last treatment with Dr. Liddell was May 1998.
Dr. Robert McGuire saw Claimant on, October 4, 1991, for a consultation. He noted Claimant' complaints of significant pain in the back and legs. Dr. McGuire diagnosed Claimant with perineural fibrosis and chronic pain syndrome. He decided that Claimant was unlikely to improve enough to work. Dr. McGuire opined Claimant had a 37% permanent medical impairment. He said Claimant would "most likely remain in a chronic pain syndrome situation."
Dr. Morse noted that Claimant was agitated, depressed, and withdrawn and that Claimant was experiencing insomnia. However, Dr. Morse found no evidence that Claimant had a personality disorder. He noted Claimant's stable pre-injury work history. At that time, Dr. Morse decided Claimant could not even work-part-time due to Claimant's physical injuries.
On March 4, 1987, Claimant was admitted to the Touro Infirmary under the primary care of Dr. Morse (upon referral from Dr. Attix). Claimant underwent numerous diagnostic tests and evaluations by specialists. Claimant was found to have a historical monoparesis and sensory loss in the right lower extremity, low back pain secondary to disc injury and surgery, and possible sciatic nerve root involvement. Additionally, Dr. Murphy with the Touro Infirmary noted Claimant's self identity and self esteem were tied into Claimant's employment status. Dr. Murphey advised Claimant to undergo intensive psycho-therapy.
On March 10, 1987, Dr. Morse treated Claimant at the Touro Infirmary for detoxification and treatment for Claimant's back and leg pain. Dr. Morse reviewed Claimant's extensive diagnostic tests, examinations, and psychological testing. On March 19, 1987, Dr. Morse wrote,
The Touro psychologist found Claimant to have a strong pain disorder with possible cognitive impairment. The psychologist opined that Claimant had severe depression but no evidence of a personality disorder.
Claimant continued his treatment as an out patient at Touro until August or September 1987. Claimant had seven different prescription medications. There are numerous notations of Claimant's severe back pain and depression. Upon discharge of the program, Dr. Morse said Claimant did not have the endurance or strength to engage even in a part-time basis sedentary work. He found Claimant to have severe residual lumbar radiculopathy with a "great deal of diminished range of motion" and weakness. Dr. Morse noted that Claimant had a poor gait and balance and that Claimant's depression and pain experience were "quite overwhelming." Dr. Morse referred Claimant back to Dr. Attix.
Dr. Neil Baum, urologist, saw Claimant in March 1987 at the request of Dr. Richard Morse of the Touro Infirmary. After a physical examination and diagnostic tests, Dr. Baum opined that Claimant's erectile dysfunction and urinary symptoms were related to his back injury and/or surgery. Dr. Baum felt that Claimant's prognosis from a urologic standpoint was "guarded" and that Claimant would require repeated urologic evaluation and examinations monitoring for urinary tract infections and post-voiding residual.
The psychiatrist at Duke felt Claimant had limited intelligence and education. He said Claimant exaggerated his pain and depression. He diagnosed Claimant with an adjustment disorder and depression along with alcohol and narcotic dependence and abuse. The psychiatrist recommended Claimant be hospitalized for extensive evaluation and psychological testing.
Dr. Jones continued to treat Claimant, and in June 1990, Dr. Jones decided that Claimant's involutional depression was being maintained without severe intrusive thoughts or pseudoperception. Dr. Jones wrote that Claimant's depression was "associated with and subsequent to [Claimant's] back injury and the neurological deficit that has come along with this and the urologic involvement that he has now and difficulties with coital relationships." He diagnosed Claimant with "ongoing depressive reaction secondary to his back injury." Dr. Jones ordered complete profile tests and stress tests.
Dr. Jones treated Claimant again at the Pine Grove Recovery Center from June 28, 1990, until August 30, 1990, at which time Claimant also underwent urologic surgery. Dr. Jones's discharge diagnosis was major depression without psychosis. Dr. Jones continued to prescribe medication and psychotherapy.
Claimant was admitted to Forrest General Hospital under Dr. Jones's care from April 20, 1991, until May 16, 1991. Dr. Jones noted that Claimant was undergoing outpatient psychotherapy for ongoing agitative depression which was "associated with both acute and chronic post traumatic stress." He noted Claimant's continuing battle with chronic back pain. Dr. Jones discharged Claimant from the hospital with prescription antidepressant and anti-psychotic medications. The last recorded date of Dr. Jones's treatment was November 1991.
Dr. Robert Ritter, neuropsychiatrist, saw Claimant on October 3, 1991, for an evaluation. He noted Claimant's complaints of chronic pain and inability to perform any physical activities. After taking an extensive history and performing a physical examination, Dr. Ritter noted that. Claimant was completely oriented with low normal intelligence. He diagnosed Claimant with postoperative lumbar disc. syndrome with questionable urologic incontinence, dysthymia (reactive and discomforting but not incapacitating), and passive dependent personality. Dr. Ritter did not feel Claimant needed psychiatric or psychological intervention, although he suggested a vocational rehabilitation consultation.
Dr. William S. Turner, psychiatrist, evaluated Claimant on January 6, 1992, upon request of Dr. Michael Lowry. Dr. Turner saw Claimant one time only. He diagnosed Claimant with the following: Consider Major Depression, recurrent; Personality Disorder, not otherwise specified with Passive Aggressive Traits and Dependent Traits; and History of chronic back pain and failed back syndrome. Dr. Turner did not treat Claimant since he felt Claimant was non-compliant with his advice.
Dr. Emanuel DeFraites, psychiatrist, began treating Claimant at Sand Hill Hospital in June 1992 for depression. He diagnosed Claimant with organic affective syndrome, depressed with psychotic features. He related Claimant's organic affective syndrome to Claimant's previous back surgeries and pain. Dr. DeFraites noted that Claimant made a modest amount of progress and was discharged for out-patient treatment. On October 7, 1992, Dr. DeFraites wrote, "It appears that the patient has a long-standing depression that goes back to being injured on the job."
Dr. DeFraites went on to say that Claimant's self-esteem had been severely compromised since Claimant related his worth as a human being to his ability to work and be productive. He noted that Claimant had been treated by Dr. Franklin Jones, but Dr. Jones had lost his license. Dr. DeFraites felt Claimant had deteriorated without continued treatment. Dr. DeFraites diagnosed Claimant with major depression with melancholia and severe anxiety.
Dr. DeFraites continued to regularly treat Claimant in 1992, 1993, and 1994. On February 1, 1994, Dr. DeFraites wrote that Claimant had "depression secondary to an injury he received in his back some years ago." Dr. DeFraites felt that Claimant's "overwhelming" pain problems were complicated by drug addiction, for which Claimant had been treated at the Touro Pain Center in New Orleans. In 1994, Dr. DeFraites felt Claimant began having a manic component to his organic affective disorder.
Dr. DeFraites recommended electro-convulsive therapy for Claimant's melancholic depression complicated by auditory hallucinations. Dr. DeFraites noted that Claimant had severe anxiety attacks in the past. In May 1994, Dr. DeFraites again recommended consideration of the electro-convulsive therapy. On November 11, 1994, Dr. DeFraites confirmed that Claimant had been under his care for several years for the treatment of organic affective syndrome and depression. He wrote, "This is a depressive illness secondary to the pain he suffers from a back injury."
On June 13, 1996, Dr. DeFraites wrote that it was "abundantly clear that [Claimant's] psychiatric difficulties are a direct result of his injury." He noted that Claimant had no prior psychiatric troubles before the work accident and that Claimant had a "highly productive" pre-injury life.
Dr. DeFraites treated Claimant throughout 1996, 1997, and 1998. Dr. DeFraites' notes were replete with Claimant's complaints of pain in his back and legs. Dr. DeFraites treated Claimant's psychological problems with prescription medication and counseling. The last record was dated September 1, 1998. Dr. DeFraites retired in October 1998.
Under Dr. DeFraites treatment, Claimant was seen in group and individual therapy by Rebecca DeFraites, a licensed social worker. Her records indicate Claimant's difficulties dealing with his injury, the workers' compensation process, his family problems, and his constant pain. Claimant reported being in constant pain and having been suicidal in the past. Claimant continued to see DeFraites throughout the years with the last record being in February 1999.
Dr. James Rusch, psychiatrist with CPC Sand Hill Hospital, treated Claimant during Claimant's hospitalization from March 1, 1994, until March 17, 1994. Claimant was admitted by court commitment after pushing his spouse and daughter at home during a fight. Dr. Rusch ordered and reviewed psychiatric testing and therapy for Claimant. He consulted with Dr. DeFraites and ultimately referred Claimant back to Dr. DeFraites.
In the Discharge Summary, Dr. Rusch diagnosed Claimant with major depression with psychotic features in remission and long-term paranoid personality disorder. Dr. Rusch testified as to the cause of Claimant's hospitalization,
Dr. Patrick Evans, clinical psychologist with CPC Sand Hill Hospital, saw Claimant in March 1994 while Claimant was hospitalized at Sand Hill. He noted that Claimant had been hospitalized by commitment affidavit filed by Claimant's spouse. This occurred after Claimant shoved his spouse and daughter at home. Dr. Evans administered tests which showed Claimant to be at the upper end of the Borderline Range of Intelligence. He diagnosed Claimant with paranoid personality disorder and depressive disorder. Dr. Evans wrote, "The history suggests very poor adjustment, especially since his physical disability." He recommended therapy, counseling, medication, and regular monitoring of Claimant's condition.
Dr. Mark Webb with the Mississippi Neuropsychiatric Clinic saw Claimant for an employer psychological evaluation on February 27,1997. He opined that Claimant had a long-standing, nondisabling depression and dependent, passive-aggressive personality traits which pre-dated Claimant's 1984 work injuries. Dr. Webb stated, "This work injury did not exacerbate, augment or prolong any of these psychiatric illnesses." However, in Dr. Webb's Impression Section of his report, he listed stressors as being "[p]sychiatric illnesses, difficult childhood, family discord, work injury." Dr. Webb first said he did not review Dr. DeFraites' records, but later said he did. Dr. Webb admitted that there were no medical records showing Claimant had pre-injury psychological problems.
The Pine Grove Recovery Center records indicate that on June 28, 1990, Claimant was admitted by Dr. Franklin Jones. The admitting social worker noted that Claimant was experiencing depression and feelings of worthlessness "because of his inability to support his family." Claimant reported his previous work injury and the numerous surgeries. The Pine Grove psychologist found Claimant to be in the borderline range of intellectual functioning. Claimant reported to the psychologist that he had been admitted in March 1987 for detoxification of prescription medications and in November 1989 for an attempted suicide.
Claimant was again admitted to Pine Grove for depression and medical evaluation on April 20, 1991, upon referral of Dr. Jones. The report indicated that Claimant attempted suicide two years prior. There is a notation that Claimant had difficulties due to his disability after a work injury. The Pine Grove social worker reported Claimant's continuing problems with depression and ongoing suicidal ideation and intent.
The Forrest General Hospital Records show Claimant was admitted several times for replacement of his spinal cord stimulator batteries. On January 28, 1990, Claimant was admitted to the hospital for involutional melancholia, major depression with psychotic features, secondary to laminectomy and chronic pain. The treating physician was Dr. Franklin Jones. Claimant was admitted again on June 28, 1990, by Dr. Jones for recurrent depression and psychosis. In May 199 1, Claimant was hospitalized by Dr. Jones for depression. On June 4, 1991, Claimant was admitted for post-traumatic stress with severe agitated depression.
The Northshore
Psychiatric Hospital Records indicate Claimant was treated in August 1994,
February 1996, and March 1998. On March 6, 1998, Claimant was admitted
by Dr. Hiram Haynie for major depression and chronic pain. Claimant was
treated with counseling and prescription medication. Dr. Haynie discharged
Claimant from the hospital on March 17, 1998. The records indicate Claimant
had frequent crying spells, was withdrawn, and had no interest in living.
Claimant, also reported his back and leg pain.
I base the following findings on a preponderance of the evidence, including medical proof as required by the Mississippi Workers' Compensation Law:
1. The parties stipulated that Claimant had a work-related accident on July 30,1984, injuring his back. Additionally, Claimant has met his burden of proof that he sustained a psychological overlay to his physical injury. The test of causal connection between a work-related accident and a psychological disability subsequent to that accident is "clear evidence." Myles v. Rockwell International, 445 So.2d 528 (Miss. 1984). Claimant has proven by clear evidence that his psychological problems are causally connected to his 1984 work-related back injury. Moreover, I find that the Employer-Carrier has not proven that a subsequent, intervening cause interrupted the causal connection between Claimant's work injury to his back and his resulting psychological overlay.
2. The Employer-Carrier raised the issue of the reasonableness and necessity of Claimant's psychological treatment. The evidence shows that the treatment received by Claimant to date has been reasonable and necessary. The Employer-Carrier shall, therefore, be financially responsible for the past treatment (particularly from March 1, 1994, forward) and shall provide such reasonable and necessary psychological/medical treatment for Claimant's physical and psychological injuries in the future.
3. The parties
stipulated that there were no remaining issues to be decided since Claimant
has been paid the maximum allowed disability compensation under the Mississippi
Workers' Compensation Law.
IT IS THEREFORE ORDERED AND ADJUDGED that the Employer-Carrier pay, furnish and provide to Claimant all reasonable and necessary medical services and supplies as the nature of his injury or the process of his recovery may require in accordance with Miss. Code Ann. §71-3-15 (Rev. 1995) and the Medical Fee Schedule.
SO ORDERED AND ADJUDGED this 17th day of October, 2000.
TAMMY GREEN HARTHCOCK
ADMINISTRATIVE JUDGE
ATTEST:
Jo Ann McDonald, Secretary