Ann Taylor Inc. v. James McDowell

Kentucky Supreme Court·Decided December 13, 2018·No. 2018-SC-0091·Unpublished

Opinion

IMPORTANT NOTICE

NOT TO BE PUBLISHED OPINION

THIS OPINION IS DESIGNATED "NOT TO BE PUBLISHED." PURSUANT TO THE RULES OF CIVIL PROCEDURE PROMULGATED BY THE SUPREME COURT, CR 76.28(4)(C), THIS OPINION IS NOT TO BE PUBLISHED AND SHALL NOT BE CITED OR USED AS BINDING PRECEDENT IN ANY OTHER CASE IN ANY COURT OF THIS STATE; HOWEVER, UNPUBLISHED KENTUCKY APPELLATE DECISIONS, RENDERED AFTER JANUARY 1, 2003, MAY BE CITED FOR CONSIDERATION BY THE COURT IF THERE IS NO PUBLISHED OPINION THAT WOULD ADEQUATELY ADDRESS THE ISSUE BEFORE THE COURT. OPINIONS CITED FOR CONSIDERATION BY THE COURT SHALL BE SET OUT AS AN UNPUBLISHED DECISION IN THE FILED DOCUMENT AND A COPY OF THE ENTIRE DECISION SHALL BE TENDERED ALONG WITH THE DOCUMENT TO THE COURT AND ALL PARTIES TO THE ACTION.

RENDERED: DECEMBER 13, 2018 NOT TO BE PUBLISHED

2018-SC-000091-WC

ANN TAYLOR, INC. APPELLANT

ON APPEAL FROM COURT OF APPEALS V. CASE NO. 2016-CA-001265 WORKERS’ COMPENSATION BOARD NO. 14-WC-65846

JAMES MCDOWELL; APPELLEES HON. STEVEN G. BOLTON, ADMINISTRATIVE LAW JUDGE; AND WORKERS’ COMPENSATION BOARD

MEMORANDUM OPINION OF THE COURT AFFIRMING

An Administrative Law Judge (ALJ) awarded temporary total disability (TTD), permanent partial disability (PPD), and medical benefits for injuries to James McDowell’s right elbow. However, the ALJ dismissed claims for benefits for McDowell’s right shoulder injuries, finding a failure to establish a causal relationship for the injury and a failure to provide the employer, Ann Taylor, Inc. (Ann Taylor) due and timely notice. The Workers’ Compensation Board (the Board) affirmed the ALJ regarding the elbow injuries but reversed in part, holding that McDowell gave due and proper notice as a matter of law. The

Board also vacated in part and remanded the matter for the ALJ to make more sufficient findings to support the conclusions on causation. The Court of Appeals affirmed. For the following reasons, we affirm the Court of Appeals.

I. BACKGROUND.

McDowell began working for Ann Taylor in 2011, where he first worked in the sorting department. He later worked in the receiving and shipping departments, where he loaded and unloaded boxes from the delivery trucks. The boxes ranged from forty to sixty pounds. On October 2, 2014, McDowell was loading boxes onto a truck with two other employees. The boxes were typically stacked five or six boxes high from the floor to the top of the tractor trailer. One of the rows of boxes started to fall and McDowell and the other two employees tried to back out of the way. The boxes hit McDowell causing him to fall and hit his elbow on the conveyor that brings boxes to the truck for loading. McDowell also claims to have hit his right shoulder on the side of the truck as he was falling down.

McDowell continued to work after falling but alleged he did inform his supervisors, Gene Lilly and Laura Whitlock, of the incident. Whitlock told him he could get himself checked out, but McDowell said he was okay. As the day progressed, McDowell’s elbow started swelling and getting stiff. McDowell informed Whitlock that he was going to go home and put ice on the elbow. The next day McDowell continued to work even though his elbow continued to swell. Whitlock said she was going to send him to BaptistWorx, a medical provider across the street from Ann Taylor. There is conflicting evidence in the

record of whether McDowell went to BaptistWorx on Friday, October 3, 2014, or Monday, October 6, 2014. McDowell testified in his deposition that Whitlock filled out an incident report on October 6, 2014, when McDowell came back from BaptistWorx. McDowell testified that he told Whitlock he experienced pain in his right elbow all the way up to his shoulder and he later informed his physical therapist of pain in his right shoulder.

McDowell went to physical therapy, at the end of which he informed his orthopedic doctor, Dr. Bonnarens, that he was having pain in his right shoulder. Dr. Bonnarens then scheduled an MRI of McDowell’s shoulder and began treating the right shoulder pain and recommended surgery. The surgery occurred in May 2015 and McDowell testified that the symptoms did not improve after the surgery, even after subsequent physical therapy on the shoulder. Ann Taylor’s workers’ compensation carrier denied approval for the surgery, so McDowell obtained coverage for the surgery through his private health insurance provider. McDowell did not return to work after October 6, 2014. McDowell did not disclose a shoulder injury on his New Patient Information Form at BaptistWorx on October 6, 2014. McDowell did not report falling in the truck when he first saw Dr. Bonnarens on October 9, 2014.

McDowell testified via deposition, and a final hearing was conducted with McDowell testifying and Ann Taylor and McDowell both submitting medical records to the ALJ, The ALJ outlined the testimony in the Opinion, Award and Order. The ALJ found “multiple versions of when the employer was notified of the Plaintiffs work-related injury.” When McDowell presented to BaptistWorx

on October 6, 2014, he only disclosed injury to his right elbow and made no mention of any symptoms or injury to his shoulder. The First Report of Injury or Illness (FROI) form completed in McDowell’s presence by McDowell’s supervisor, Laura Whitlock, says nothing about a shoulder injury; however, McDowell did not sign the injury report. Dr. Bonnarens described McDowell’s history on the initial appointment as an injury to his right elbow. The ALJ found that Dr. Bonnarens was informed on December 16, 2014, of an alleged right shoulder injury. McDowell spoke with an insurance adjuster, Jessica Whitmire, on February 6, 2015, and failed to mention any specific injury to his right shoulder or any fall occurring on October 2, 2014. McDowell now reports that he injured both his right elbow and right shoulder during a fall that occurred when the boxes fell on him on October 2, 2014. Thus, the ALJ found that the employer, Ann Taylor, was only apprised of the injury to McDowell’s right elbow.

The ALJ further found that Dr. Bonnarens determined that the right shoulder injury and need for subsequent surgery was not related to the incident on October 2, 2014. Dr. Bonnarens reviewed McDowell’s deposition transcript and testified that McDowell’s version of events would be physically impossible because it would require a 180-degree spin of his body to injure his right elbow and his right shoulder. McDowell’s contradictory version of events, and the medical evidence in the record, created serious concerns regarding McDowell’s credibility, and compelled the ALJ to find that the shoulder injury was not caused by the incident on October 2, 2014. The ALJ concluded that

the right elbow injury was compensable, but that McDowell had failed to carry his burden in proving a work-related injury to his right shoulder due to a lack of notice to his employer and a lack of proof of causation.

McDowell filed a motion to reconsider before the ALJ requesting additional findings of fact on the notice issue. Specifically, McDowell requested the ALJ indicate how Ann Taylor was harmed by the notice on the right shoulder injury and how the notice provided by McDowell was non-compliant with Ann Taylor’s policy. McDowell further requested findings on how he was supposed to provide notice of the right shoulder injury before knowing that such injury existed. McDowell also requested further findings regarding Dr. Bonnarens’s conclusions on lack of causation and argued patent error in the ALJ’s failure to mention the independent medical examination (IME) performed by Dr. Craig Roberts, which presented a medical opinion in support of the causation element.

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Ann Taylor Inc. v. James McDowell, (Ky. 2018).

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