Baumann v. Workers' Compensation Appeal Board

147 A.3d 1283, 2016 Pa. Commw. LEXIS 408, 2016 WL 5323129
CourtCommonwealth Court of Pennsylvania
DecidedSeptember 23, 2016
Docket2603 C.D. 2015
StatusPublished
Cited by20 cases

This text of 147 A.3d 1283 (Baumann v. Workers' Compensation Appeal Board) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Baumann v. Workers' Compensation Appeal Board, 147 A.3d 1283, 2016 Pa. Commw. LEXIS 408, 2016 WL 5323129 (Pa. Ct. App. 2016).

Opinion

OPINION BY

JUDGE COVEY

David Baumann (Claimant) petitions this Court for review of the Workers’ Compensation (WC) Appeal Board’s (Board) November 20,2015 order affirming the Workers’ Compensation Judge’s (WCJ) decision on remand granting Kellogg Company’s (Employer) Petition .to Terminate Claimant’s WC benefits (2010 Termination , Petition), and granting Claimant’s Petition for Penalties (Penalty Petition). The issues before this Court are: (1) whether the Board erred by affirming the WCJ’s decision granting Employer’s 2010 Termination Petition; and (2) whether the Board erred by affirming the WCJ’s decision granting Claimant’s Penalty Petition, but awarding a 0% penalty. After review, we affirm.

On May 5, 2007, Claimant suffered a right shoulder and upper back strain as a result of a car accident that occurred during the course and scope of his employment as a sales representative for Employer. Employer issued a notice of compensation payable (NCP) and paid Claimant WC benefits. By August 28, 2008 WCJ order, Claimant’s injury description was amended by stipulation to include a right C-6 radiculopathy.

*1286 On • March 16, 2009, Employer filed a petition to terminate Claimant’s WC benefits (2009 Termination Petition). Hearings were held before WCJ Bruce Doman (WCJ Doman), at which Employer offered the June 2, 2009 deposition of neurologist Richard Bennett, M.D. (Dr. Bennett) who conducted a January 7, 2009 independent medical evaluation (IME), and Claimant testified and offered the September 15, 2009 deposition of orthopedic surgeon Norman Stempler, M.D. (Dr. Stempler). By November-23, 2009 decision, WCJ Doman denied the 2009 Termination Petition. See Certified Record (C.R.), Claimant Ex. C-2.

On December 2, 2009, Employer filed a petition to modify Claimant’s WC disability benefits from full to partial (Modification Petition), based upon the results of an October 26, 2009 IME. Claimant denied the allegations in the Modification Petition.

On March 11, 2010, Claimant filed the Penalty Petition, wherein he averred that Employer violated the WC Act (Act) 1 when it notified Claimant’s surgeon that Employer would not pay for Claimant’s March 18, 2010'right shoulder surgery, which resulted in the surgery’s cancellation. Employer denied the allegations in the Penalty Petition.

On May 4, 2010, Claimant underwent a second IME conducted by Dr. Bennett, following which Dr. Bennett opined-that Claimant had fully recovered from his May 5, 2007 work accident and could return to full-duty work without restriction. On July 21, 2010, Employer filed the 2010 Termination Petition based upon Dr. Bennett’s conclusion.

Hearings were conducted before WCJ Tina Rago (WCJ Rago) 2 relative to Employer’s Modification and Termination Petitions, and Claimant’s Penalty Petition. At the WCJ hearings, Employer presented Dr. Bennett’s November 2, 2010 deposition wherein Dr. Bennett testified that, as part of Claimant’s May 4, 2010 IME, he reviewed Claimant’s electromyogram (EMG) and magnetic resonance imaging (MRI) history, and his 2009 and 2010 medical records from Dr. Steven Cohen (Dr. Cohen), Craig Rubenstein- M.D. (Dr. Ruben-stein) and others. See Supplemental Reproduced Record (S.R.R.) at 101b, 126b-130b; Reproduced Record (R.R.) at 2a-6a. Dr. Bennett reported that Dr. Cohen’s records paralleled his in terms of Claimant’s pathology, Dr. Cohen recommended surgery only as a last resort, Claimant’s July 14, 2009 right shoulder MRI appeared normal, and his July 13, 2009 cervical spine MRI reflected only minor bulges and degenerative changes similar to Claimant’s June 4, 2007 MRI. See S.R.R. at 104b-105b. Dr. Bennett declared that Claimant’s May 14 and August 25, 2009 EMG report results were non-specific, non-diagnostic and not consistent with multi-level cervical radiculopathy. See S.R.R. at 105b, 109b. Dr. Bennett also observed that Dr. Ruben-stein did not feel that Claimant was a good candidate for right shoulder surgery, but rather referred him to a sports specialist. See S.R.R. at 105b, 107b.

Dr. Bennett recalled that during the May 4, 2010 IME, Claimant complained of persistent right shoulder clicking with pain and intermittent numbness down his arm and into his fingers. See S.R.R. at 101b-102b. Dr. Bennett described, based *1287 upon Claimant’s physical exam, that Claimant did not demonstrate obvious muscle wasting, weakness or scapula winging, he had no right arm or wrist muscle atrophy or weakness -or spasms and Claimant had normal wrist flexion and upper arm strength. See S.R.R. at 102b. Dr. Bennett opined within a reasonable degree of medical certainty that, based upon his review of Claimant’s history, records and his physical examination, Claimant was “fully recovered from all aspects of [his work accident]” (S.R.R. at 105b-106b), did not require any further treatment, inter-ventional therapy or surgery, and could return to his pre-injury job “without any restrictions whatsoever.” S.R.R. at 106b.

•Claimant offered his April 29, 2010 deposition testimony, and also appeared at the November 22, 2010 WCJ hearing. Claimant testified that although he continues to see Dr. Stempler approximately every four to eight weeks, he has not undergone physical therapy since 2007, he has not treated with a neurologist since the beginning of 2009, he has not received any epidural injections, and Dr. Stempler has not prescribed medications for him since the end of 2009. See S.R.R. at 9b, llb-13b, 17b, 22b, 47b, 77b, 84b-85b. Claimant stated that he sees his family physician Jonathan Levin, M.D. (Dr. Levin), approximately every two months just to talk and, although Dr. Levin has not treated him for work-related injuries, he has prescribed Vicodin and Xanax for him. See S.R.R. at 8b, 12b-14b, 75b, 77b. Claimant added at the November 2010 hearing that his counsel referred him to pain specialist Daphne Golding, M.D. (Dr. Golding), with whom he treats approximately every 3 weeks, and who has prescribed medications including Xanax, Diazepam, Phenazepam, Morphine and Oxycodone. See S.R.R. at 75b, 77b, 84b.

Claimant reported that he has limited rotation and range in his right shoulder, and he experiences a painful popping whefi he moves it. See S.R.R. at 27b. He explained that a thoracic nerve in his right shoulder makes it “feel[ ] like it’s on fire all the time.” S.R.R. at 28b. Claimant related that his neck pain radiates into his shoulder, which causes numbness in spots in his right arm and into his right thumb, ring and index fingers, and also results in sleeping difficulties. See S.R.R. at 28b-29b, 78b. He contends that his pain has worsened over the year leading to his deposition, particularly since the beginning of December 2009. See S.R.R. at 53b-54b, 79b. Claimant also declared that his injuries have caused him to suffer depression 3 and anxiety, which has led to him becoming a recluse. See S.R.R. at 30b, 36b, 40b, 42b, 80b.

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Bluebook (online)
147 A.3d 1283, 2016 Pa. Commw. LEXIS 408, 2016 WL 5323129, Counsel Stack Legal Research, https://law.counselstack.com/opinion/baumann-v-workers-compensation-appeal-board-pacommwct-2016.