Burnett v. Mohegan Tribal Gaming Authority

12 Am. Tribal Law 245
CourtMohegan Gaming Disputes Trial Court
DecidedAugust 15, 2013
DocketNo. GDTC-WC-12-111-PMG
StatusPublished

This text of 12 Am. Tribal Law 245 (Burnett v. Mohegan Tribal Gaming Authority) is published on Counsel Stack Legal Research, covering Mohegan Gaming Disputes Trial Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Burnett v. Mohegan Tribal Gaming Authority, 12 Am. Tribal Law 245 (Mo. 2013).

Opinion

MEMORANDUM OF DECISION

GUERNSEY, C.J.

Claimant William C. Burnett, II appeals from the decision of the Mohegan Tribal Workers Compensation Trial Commissioner’s Finding of Facts, Award in Part/Dismissal in Part dated August 9, 2012, focusing primarily on the Trial Commissioner’s Findings regarding laparoscopic gastric band surgery that Claimant underwent prior to the performance of his latest lumbar spinal surgery. Claimant also challenges the Trial Commissioner’s refusal to award attorney’s fees, as well as a limitation placed on future “post-specific” disability benefits. Inasmuch as a determination of these issues in this case is intensely fact-based, review of the extensive eviden-tiary record is essential.1

I

FACTUAL BACKGROUND

As documented by the Trial Commissioner, Claimant has been a large and heavily muscled individual for a long period of time, weighing 293 pounds when first hired as a table games dealer for Mohegan Sun in May, 1993. His employment with Respondent Mohegan Tribal Gaming Authority (MTGA) lasted until December 23, 2006, during which time he suffered two compensable injuries arising out of and in the course of his employment. In the first, on May 11, 2003, he slipped and fell on a wet surface and developed low back pain, which eventually led to a diagnosis of a herniated disc at L5-S1 on the right with nerve root compression. For this he underwent a right-sided hemilaminectomy and disc excision, performed by Dr. Michael Halperin of Norwich Orthopedic Group on August 18, 2003. His weight at the time was 328 pounds according to hospital records. Although he returned to full duty on December 4, 2003, he soon suffered a recurrence of severe pain, which resulted in Dr. Halperin performing a repeat right-sided L5-S1 discectomy on March 4, 2004. Hospital records at that time indicated his weight was 339 pounds. On October 26, 2004 Dr. Halperin ascribed a 15% impairment of the lumbar spine as a result of the May 11, 2003 injury.

The second compensable injury, and the subject of the instant appeal, occurred on May 1, 2005 while Claimant was attempting to step over a velvet rope and was bumped by a patron, causing him to slip and jar his back. This claim was accepted by Respondent, and Claimant’s medical care was again provided by physicians associated with Norwich Orthopedic Group, P.C. (Drs. Pasha, Halperin and Abella). Treatment included a right SI transfora-minal epidural steroid injection on September 6, 2005, and lumbar discography on [247]*247October 21, 2005 to determine the feasibility of further surgery, An LS-Sl discecto-my and fusion was performed on January 1, 2006 by Dr. Halperin. Hospital records at that time indicated Claimant’s weight was 335 to 341 pounds. Unfortunately, the complications at the two levels above the fusion predicted by Dr. Jeffrey B. Steckler in an independent medical examination and medical records review on April 17, 2006 were confirmed by an MRI on October 10, 2006. On February 2, 2007 Claimant was assigned a 27% impairment of the lumbar spine by Dr. Halperin, who attributed 15% of this to preexisting conditions, leading the Trial Commissioner to conclude an impairment of 12% of the lumbar spine was attributable to the May 1, 2005 injury,2 Permanent partial disability benefits for the 12% impairment were paid by Respondent (44.88 weeks) pursuant to MTC § 4-232(d).

Continued left sided sciatic pain led to a caudal epidural steroid injection on November 8, 2007 and a left-sided L4-5 hemi-laminectomy and disc excision (and related procedures) on March 13, 2008 by Dr. Halperin. Hospital records show Claimant’s weight at the time to be 341 to 346 pounds. Although Claimant continued to suffer left-sided sciatica, he was released for light duty on May 26, 2008, leading to the approval of a Form M36 for a May 26, 2008 and release to light duty with job searches. An EMG on May 28, 2008 suggested left acute L4 radiculopathy, with Claimant’s weight reported as 335 pounds. On June 8, 2008 Dr. Halperin reeom-mended both L4 and L3 transforaminal epidural steroid injections prior to surgery. These were performed by Dr. Abel-la on June 23, 2008 and July 7, 2008 and provided only transient pain relief.

II

THE WEIGHT ISSUE

Concern over Claimant’s weight as a surgical factor apparently commenced on September 28, 2005 with a discussion of weight loss with Dr. Halperin. Later, Dr. Philo F. Willets, Jr., in a second independent medical examination and records review performed January 9, 2008, noted claimant’s “massive obesity” but stated that it was only a minor contributor to his injuries and need for surgery. At the time of the June 8, 2008 examination, Dr. Halperin noted that he was reluctant to perform surgery due to Claimant’s “large size” and past surgeries. By July 22, 2008 Dr. Halperin was recommending conservative treatment rather than surgery due to Claimant’s size, but relented due to Claimant’s wishes and scheduled him for an L3-4 extraforaminal discectomy, which he later decided against performing over doubts as to its effectiveness in providing pain relief.3 After further discography performed by Dr. Abella, on October 29, 2008 Dr. Halperin noted that “surgery was tentatively possible, but since he is at risk for complications, if the Claimant could lose more weight, that would make things more ideal.”4 Claimant’s weight was 340 [248]*248pounds and he was to return after discussing weight loss with his primary care physician. Upon returning to Dr. Halperin on December 30, 2008, having been unsuccessful at losing weight, Claimant raised the issue of lap band surgery, which was endorsed by Dr. Halperin, whose office note reads as follows:

HISTORY: The patient returns today. We discussed his possible surgery in the lower back. He is still overweight, and is having great difficulty losing weight despite trying,
RECOMMENDATION: He has met with a doctor regarding the possibility of lap band surgery for weight control. I would completely endorse this. I think that the patient desperately needs to lose weight, and if he cannot do it on his own, if it could be accomplished surgically, I think that it would certainly be beneficial for his lower back. Certainly, if he needed surgery on his back, if he could lose weight, this would make the surgery technically much easier to accomplish. The patient is what I would consider to be a surgical nightmare at this point because he is just so large and muscular, he has had prior surgery and has scarring, and it would be a very difficult surgery to accomplish, given the current circumstances.

Record at 42, Office notes of Norwich Orthopedic Group, P.C. 12/20/2008.

When next seen by Dr. Halperin on April 1, 2009, Claimant related that he may “possibly” be undergoing lap band surgery within the next few weeks. Dr. Halperin’s office note reads as follows:

RECOMMENDATION: At this point I would defer any surgical considerations until after Mr. Burnett has his lap band surgery. Not only do we have to wait for him to have lap band surgery, but we also have to wait for the results of the surgery, and that may take months.... I explained that I would not recommend doing anything surgically before his lap band surgery because he is a high surgical risk for complication at this point. I certainly would much rather operate on him when I think that there is a chance that we could do a safer and more effective procedure.

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Bluebook (online)
12 Am. Tribal Law 245, Counsel Stack Legal Research, https://law.counselstack.com/opinion/burnett-v-mohegan-tribal-gaming-authority-mohegangct-2013.