Cramer v. Presbyterian Manors

CourtCourt of Appeals of Kansas
DecidedSeptember 20, 2019
Docket119581
StatusUnpublished

This text of Cramer v. Presbyterian Manors (Cramer v. Presbyterian Manors) is published on Counsel Stack Legal Research, covering Court of Appeals of Kansas primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cramer v. Presbyterian Manors, (kanctapp 2019).

Opinion

NOT DESIGNATED FOR PUBLICATION

No. 119,581

IN THE COURT OF APPEALS OF THE STATE OF KANSAS

MARY PHILLENE CRAMER, Appellant,

v.

PRESBYTERIAN MANORS and SENTRY CASUALTY CO., Appellees.

MEMORANDUM OPINION

Appeal from Workers Compensation Board. Opinion filed September 20, 2019. Affirmed.

Jan L. Fisher, of McCullough, Wareheim & LaBunker, of Topeka, for appellant.

Jeffery R. Brewer, of Jeffery R. Brewer, P.A., of Wichita, for appellees.

Before LEBEN, P.J., BUSER and STANDRIDGE, JJ.

BUSER, J.: Mary Phillene Cramer appeals the Kansas Workers Compensation Appeals Board's (Board) order awarding her permanent partial disability benefits for a 7.5% functional impairment and denying her claim for work disability benefits. Cramer contends the Board made two errors. First, she claims the Board erred by denying her compensation for the aggravation of her degenerative disc disease caused by a work accident. Second, Cramer asserts the Board erred when it found that her percentages of functional impairment and wage loss were below the threshold levels required in order to receive work disability benefits.

1 Upon our review we find no reversible error and, therefore, we affirm the Board's rulings.

FACTUAL AND PROCEDURAL BACKGROUND

Cramer, who was born in 1954, began working for Presbyterian Manors in August 2014 as a laundry service assistant. Her employment required loading 50-pound or 30- pound capacity washers. She worked about 33 hours per week earning an average weekly wage of $382.37.

On December 2, 2015, while performing her job duties, Cramer experienced a sudden and excruciating pain in her back. The pain started on the left side of her back and went down her left leg to her ankle. Cramer reported the injury to Presbyterian Manors. Six days later, she sought treatment with her family physician, Dr. Timothy Penner. She also was treated by Dr. John H. Gilbert, an orthopedist. Dr. Gilbert administered three epidural steroid injections which did not relieve Cramer's back pain.

Dr. Douglas Burton, an orthopedic spine surgeon at the University of Kansas Hospital, also evaluated Cramer and became her treating physician. Dr. Burton diagnosed Cramer with a back strain and referred left leg pain, but he did not believe that surgery was appropriate. Instead, Dr. Burton recommended physical therapy. After Dr. Burton concluded that Cramer had reached maximum medical improvement, he referred her for a functional capacity assessment (FCA).

The FCA report determined that Cramer met the material handling demands for a "[l]ight demand vocation." The report stated that Cramer could safely lift 14.34 pounds occasionally and carry up to 12.5 pounds occasionally. Cramer was unable to tolerate sustained standing, walking, kneeling, or full squatting.

2 Dr. Burton released Cramer from his care in October 2016. At that time, he did not believe that her left leg pain was due to a herniated disc that would cause radiculopathy. Moreover, on M.R.I. Dr. Burton did not observe substantial narrowing around the nerve that would cause radiculopathy. Dr. Burton confirmed that Cramer had degenerative discs in her spine.

Based on the Sixth Edition of the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment, Dr. Burton opined that Cramer had sustained a 2% whole person impairment from her work injury. Dr. Burton also concluded that, if he were to use the Fourth Edition of the AMA Guides, Cramer's condition would qualify for a 5% impairment rating. Dr. Burton clarified that the 2% impairment rating was based on diagnosing Cramer's injury as a "soft tissue injury"—a category that includes strains. The soft tissue injury was superimposed on Cramer's degenerative conditions aggravated by the work injury. But Dr. Burton agreed that degenerative disc disease is not ratable under the Sixth Edition of the AMA Guides.

Dr. Burton recommended work restrictions of a 15 pound limit for occasional lifting and 10 pound limit for frequent lifting. No other work restrictions were recommended. Dr. Burton opined that Cramer was capable of obtaining substantial employment within the work restrictions he imposed.

Cramer provided Presbyterian Manors with Dr. Burton's work restrictions. However, Presbyterian Manors could not provide Cramer with any work that accommodated the restrictions. As a result, Cramer applied for and received Social Security Disability benefits.

Dr. Anne Rosenthal, an orthopedic surgeon, examined Cramer in December 2016 to evaluate her back pain. Dr. Rosenthal specialized in treating hands and upper extremities, but she had diagnosed back injuries. Dr. Rosenthal diagnosed Cramer with

3 an L4-L5 herniated disc and left L5 radiculopathy as a result of her work injury. Dr. Rosenthal also confirmed that Cramer had preexisting multi-level degenerative disc disease affecting other areas of her back. Dr. Rosenthal referred Cramer to Dr. Florin Nicolae, a pain management physician for treatment which ultimately alleviated Cramer's leg pain.

Dr. Rosenthal obtained Cramer's pain management records from Dr. Nicolae. These records showed that Dr. Nicolae treated multiple discs in Cramer's back. Specifically, Cramer received injections at discs located at L1-L2, L3-L4, L4-L5, and L5- S1. Although Dr. Rosenthal opined that the work injury only caused the L4-L5 herniated disc, she explained that Dr. Nicolae provided the other injections to "cure or relieve the effects of the injury." Based on Dr. Nicolae's treatment records, Dr. Rosenthal concluded that Cramer had multiple level radiculopathy. As a result, Dr. Rosenthal rated Cramer at a 25% whole person impairment under the Sixth Edition of the AMA Guides.

Dr. Rosenthal conceded that the work injury was only a prevailing factor in causing the L4-L5 herniated disc. She did not believe the work injury caused permanent damage to other areas of Cramer's spine. In recalculating Cramer's whole person impairment resulting from only the L4-L5 herniated disc injury sustained at work, Dr. Rosenthal opined that Cramer had sustained a 13% whole person impairment.

Dr. Rosenthal found that Dr. Burton's lifting restrictions were appropriate. She also suggested restrictions of occasional walking, standing, bending, kneeling, and squatting. Despite the back injury, Dr. Rosenthal believed that Cramer was capable of working 40 hours per week if an employer accommodated her work restrictions.

Karen Terrill, a vocational rehabilitation consultant retained by Cramer, opined on Cramer's ability to obtain substantial and gainful employment. According to Terrill, Cramer had a high school education. Prior to her employment with Presbyterian Manors,

4 Cramer performed housekeeping duties at a medical center, worked as an advertising assistant, and for 11 years was program director and a classroom teacher for a Head Start program.

Based on Cramer's work history and Dr. Burton's restrictions, Terrill determined that Cramer had lost the ability to perform 12 of 33 work tasks she had performed previously. This resulted in a task loss of 37%.

After reviewing Dr. Burton's work restrictions and the FCA report, Terrill considered Cramer's wage loss. Terrill first noted that "Cramer was not working at the time of the interview; she currently has a 100% loss of wages." As a result, she concluded that no presumption arose that Cramer was capable of earning her actual average post- injury weekly wage. Terrill determined that Cramer was now only able to perform a light level of work with no readily transferable job skills.

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