Garassino, Louis v. Western Express

2016 TN WC 100
CourtTennessee Court of Workers' Compensation Claims
DecidedMay 3, 2016
Docket2014-07-0013
StatusPublished

This text of 2016 TN WC 100 (Garassino, Louis v. Western Express) is published on Counsel Stack Legal Research, covering Tennessee Court of Workers' Compensation Claims primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Garassino, Louis v. Western Express, 2016 TN WC 100 (Tenn. Super. Ct. 2016).

Opinion

TENNESSEE BUREAU OF WORKERS’ COMPENSATION IN THE COURT OF WORKERS’ COMPENSATION CLAIMS AT NASHVILLE

LOUIS GARASSINO, ) Docket No. 2014-07-0013 Employee, ) ) State File No. 79380-2015 v. ) ) Judge Joshua Davis Baker WESTERN EXPRESS, ) Employer. )

COMPENSATION HEARING ORDER

This matter came before the Court for a Compensation Hearing on May 19, 2016. The employee, Louis Garassino, and the employer, Western Express, stipulated to the majority of the dispositive legal issues, so the only remaining disputed issue concerned Mr. Garassino’s degree of permanent impairment. The parties presented competing impairment ratings from the authorized treating physician and Mr. Garassino’s evaluating physician. In comparing these two, the rating provided by the authorized treating physician enjoys a presumption of correctness. The Court, however, finds Mr. Garassino presented sufficient evidence to overcome the presumption and adopts the rating provided by the evaluating physician.

History of Claim

Mr. Garassino is a fifty-nine-year-old resident of Stewart County, Tennessee, who worked as an over-the-road truck driver for Western Express. On July 3, 2014, he injured his back while using a crank to raise the height of a semi-trailer to attach to his truck. Western Express accepted the claim, provided medical care and temporary disability benefits. His compensation rate at the time of the injury was $223.43 per week. (T.R. 4 at ¶12.)

Mr. Garassino treated with Dr. Robert Weiss, who performed back surgery. On January 19, 2015, Dr. Weiss assigned Mr. Garassino an impairment rating of six percent to the body as a whole. (T.R. 4 at ¶7.) Dr. Weiss’ medical note of the same date states the following concerning calculation of the rating: The lumbar regional grid, table 17-4 is utilized and this patient falls into the classification of motion segment lesions, 1 to 9 percent, class 1. This is an intervertebral disc herniation at a single level with medically documented findings, with or without surgery. The patient had documented radiculopathy at the clinically appropriate level, present at the time of the initial examination, and now has resolved symptoms.

(Ex. 1 at 18.)

Dr. Weiss testified via deposition. Concerning the rating, he adamantly maintained Mr. Garassino rated as a class 1 on the lumbar regional grid because his radicular symptoms had resolved. (Ex. 3.)

Several months after receiving Dr. Weiss’ impairment rating, Dr. David West evaluated Mr. Garassino and opined he retained thirteen percent impairment to the body as a whole from his back injury. (T.R. 4 at ¶8.) Dr. West testified Mr. Garassino should be rated as a class 2 on the lumbar spine regional grid per the American Medical Association Guides to the Evaluation of Disability and Permanent Impairment (AMA Guides) due to his radicular symptoms. (Ex. 2 at 15.) He stated the following:

We know he falls into a motion segment lesion because he had an intervertebral disc herniation, so that either puts him into a class 1 or a class 2. And again, what we just stated was the fact, if you look at class 2, he has an intervertebral disc herniation at a single level with medically- documented findings with or without surgery and with documented residual radiculopathy at the clinically appropriate level. That basically summarizes his current examination when I examined him with the exception of a modifier that I added to the 12% which is the fall and it was 13%.

Id. at 14. He further explained that a patient will “generally” receive a rating grade of “C” in a particular rating class as the C is in the middle of rating spectrum. Id. at 15-17. Thereafter, the rating would be adjusted based on results from other impairment rating criteria. Based on the results from clinical studies, functional impairments, and physical impairments, Dr. West increased Mr. Garassino’s impairment rating by one percent from twelve to thirteen percent. Id. at 18.

Additionally, Dr. West agreed the only difference of opinion concerning his rating and that of Dr. Weiss concerned whether to place Mr. Garassino in a class 1 or class 2. He further agreed if Mr. Garassino’s radiculopathy resolved, placement in class 1 would be appropriate. Id. at 32-33. However, even if the radiculopathy resolved and Mr. Garassino suffered a class 1 injury, he disagreed with Dr. Weiss’ rating. He stated Dr. Weiss’ rating should have been an eight percent rather than a six percent under class 1. 2 Id. at 42-44. He explained that seven percent corresponds to a rating grade of C, the starting point for rating a class I injury for Mr. Garassino’s injury before applying modifiers. Id. at 24-26. He opined Dr. Weiss incorrectly utilized the guides in rating Mr. Garassino’s injury by starting his analysis with a five percent rating. Id. at 26.

At the hearing, Mr. Garassino testified that he had several surgeries on his left hip prior to the accident and still experienced substantial pain in that area of his body as well as his groin. He stated his right hip had been pain-free prior to the accident but acknowledged having right-hip replacement surgery prior to the accident. Following the accident, Mr. Garassino testified he experienced some pain, but the pain was more in his legs than in his hip. He stated: “I didn’t have this problem before I hurt my back.”

After the surgery, Mr. Garassino continued to experience pain in his right leg. He explained the following about his pain after the surgery:

It wasn’t as bad . . . he fixed what he had to fix. I mean I still have pains now down my . . . right leg—sporadic; well not sporadic but I mean it’s the weather. If it’s lousy out, I know I’ve had surgery. I’d be lying if I said it was everyday but more than once a week.

Mr. Garassino denied he told Dr. Weiss the pain in his right leg had resolved. He further stated he told Dr. Weiss during the exam in February 2016 that he still had back pain and pain “shooting down” his legs. Concerning the February exam, Mr. Garassino testified it was limited to Dr. Weiss inspecting his surgical scar and conducting a reflex test. He denied that Dr. Weiss laid him on the table and pulled his legs straight up. He stated the exam lasted only a few minutes.

In contrast, Mr. Garassino stated Dr. West’s exam lasted about an hour. He described how Dr. West laid him down on a hard table and lifted his legs up, sat him upright, and “grabbed both his legs” and performed a reflex test.

On cross-examination, Mr. Garassino admitted that the back surgery helped ease his back pain and also his leg pain “to some degree.” He further agreed he saw Dr. West only once, while he saw Dr. Weiss multiple times. Additionally, he stated Dr. Weiss treated him well.

Mr. Garassino argued he rebutted the presumption of correctness attached to Dr. Weiss’ impairment rating opinion. He argued Dr. Weiss erred when calculating the impairment under the AMA Guides. Specifically, Mr. Garassino argued Dr. Weiss used the wrong table and inappropriately calculated the modifiers. He claimed the table Dr. Weiss utilized was an example table and should not have been used to calculate impairment. Mr. Garasino also claimed Dr. Weiss erred in assigning a clinical study 3 modifier of zero because his MRI correlated with the diagnosis of a displaced S5-L1 nerve root that was compressed. Regarding the functional capacity modifier, Mr. Garassino argued Dr. Weiss also erred in assigning a zero. Because Mr. Garassino continued to suffer back and right-leg pain, his pain had not resolved and a functional capacity modifier of zero was inappropriate.

Mr. Garassino also argued that Dr. Weiss erred in concluding his radiculopathy resolved. He pointed to his own testimony that he never told Dr. Weiss his radiculopathy resolved and to the fact he continued to have right leg pain. Additionally, he argued the tests Dr.

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2016 TN WC 100, Counsel Stack Legal Research, https://law.counselstack.com/opinion/garassino-louis-v-western-express-tennworkcompcl-2016.