Johnette Wilczewski v. Brookshire Grocery Store

Louisiana Court of Appeal·Decided January 28, 2009·No. WCA-0008-0718·Unknown

Opinion

STATE OF LOUISIANA

COURT OF APPEAL, THIRD CIRCUIT

WCA 08-718

JOHNETTE WILCZEWSKI VERSUS BROOKSHIRE GROCERY STORE

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APPEAL FROM THE

OFFICE OF WORKERS’ COMPENSATION - # 2 PARISH OF RAPIDES, NO. 07-04536 JAMES L. BRADDOCK, WORKERS’ COMPENSATION JUDGE

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JOHN D. SAUNDERS

JUDGE

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Court composed of John D. Saunders, Billy Howard Ezell, and J. David Painter, Judges.

AFFIRMED.

Dale G. Cox Lemle & Kelleher, LLP 401 Edwards St. Shreveport, LA 71101-0000 (318) 227-1131 Counsel for Defendant/Appellant: Brookshire Grocery Store

Joseph Payne Williams Williams & Williams Post Office Box 15 Natchitoches, LA 71458-0015 (318) 352-6695 Counsel for Plaintiff/Appellee: Johnette Wilczewski

SAUNDERS, Judge.

This is a workers compensation case wherein an employee was injured while lifting a crate of hams weighing approximately fifty to sixty pounds. The employee claimed to have suffered an injury and, subsequently, pain in the thoracic area of her back.

After undergoing several unsuccessful treatments, the employee was seen by a pain management specialist. The specialist, after failed treatments via prescription drugs and epidural steroid injection, sought the approval of a trial using a spinal cord stimulator. The employer denied this request and sent the employee to its own medical experts who disagreed with the employee’s pain management specialist about the trial spinal cord stimulator. The employee then saw a independent medical examiner regarding the thoracic pain who disagreed with both the employee and the employer’s physicians about the source of the employee’s pain and how it should be treated.

The employee filed a disputed claim for compensation seeking approval of the spinal cord stimulator. In the meantime, during the course of treatment, the employee’s pain management specialist became concerned for the employee’s mental health and sent her to a psychologist. The psychologist recommended a behavioral pain management program. The employer denied this request and sent the employee to its own physicians who did not address whether the employee needed the program.

The workers’ compensation judge ruled in favor of the employee receiving the trial of the spinal cord stimulator and the behavioral pain management program. Further, he also awarded the employee penalties and attorney’s fees for the employer’s refusal to approve each. The employer has appealed, alleging nine assignments of error. We find no merit to any of the assignments and affirm the

workers’ compensation judge’s ruling in its entirety.

AFFIRMED.

FACTS AND PROCEDURAL HISTORY:

On December 22, 2005, Johnette Wilczewski (Wilczewski) claimed that she injured her mid-back when she lifted a case of hams while working for Brookshire Grocery Company (Brookshire). Unloading the boxes of hams, which weighed approximately fifty to sixty pounds, was a normal part of her regular duties in the meat market department for Brookshire.

Within twenty-four hours, Wilczewski saw her family physician, Dr. James Knecht, complaining of mid-back pain. Dr. Knecht’s nurse took a history from Wilczewski wherein she indicated that she has suffered from back pain for about the last twenty-four hours, and, further, that she has suffered pain from her left arm, wrapping around her back for the last month. Dr. Knecht testified that the wrapping- around pain was not related to the work incident, but the posterior mid-back pain was due to her accident citing objective findings of muscle spasm.

Dr. Knecht continued to see Wilczewski into January of 2006. He referred her for physical therapy where a TENS unit was prescribed to help with the pain in her thoracic spine. Due to continued pain, Dr. Knecht referred her to an orthopedic specialist, Dr. Phillip Bacilla.

Dr. Bacilla ordered an MRI of Wilczewski’s thoracic and lumbar spine as well as a bone scan. He interpreted an MRI and bone scan of Wilczewski’s thoracic spine to be normal, but noted the MRI of the lumbar spine showed a bulging disc at L2-3 and L3-4. Dr. Bacilla felt that the bulges could be causing some of the pain in her upper lumbar region, but did not explain the pain in the thoracic region that radiates

to the chest. He then referred her to Dr. Melanie Firmin, a pain management specialist, with Wilczewski to return to his office after seeing Dr. Firmin. Dr. Bacilla did not see Wilczewski again until February 2007, wherein he suggested she be seen by a neurosurgeon.

Dr. Firmin, a board certified anesthesiologist and pain management specialist, began treatment of Wilczewski in April of 2006 with various types of neuromodulator and anti-depressant medication in an attempt to discover the source of the thoracic pain. Dr. Firmin’s treatment progressed to a thoracic spine epidural steroid injection. That injection temporarily relieved Wilczewski’s pain, and also showed an immediate change in the discoloration pattern on the thoracic area of her spine. This lead Dr. Firmin to believe that a trial of a spinal cord stimulator would assist in both diagnosing the actual problem that Wilczewski had and in determining if a permanent spinal cord stimulator would be of any benefit. Given the unusual nature of this potential diagnosis, Dr. Firmin sought a second opinion of her idea to use the trial spinal cord stimulator from Dr. Steven A. Staires, an interventional pain management specialist.

Dr. Staires saw Wilczewski and wrote a report to Dr. Firmin with the results of his consultation. In the report Dr. Staires indicated that he did see signs of exaggeration of symptoms for secondary gain or desire to convince others of the seriousness of her plight. His impression was that Wilczewski suffered from chronic thoracic pain syndrome and possible complex regional pain syndrome in the thoracic spine. Further, Dr. Staires stated that he clearly saw no contraindication to the trial of the spinal cord stimulator that Dr. Firmin was considering recommending.

Eddie Crawford, the adjuster working on the workers’ compensation claim

filed by Wilczewski, received a copy of this report written by Dr. Staires. As a result of the findings by Dr. Staires, Dr. Firmin testified that her office requested the trial of the spinal cord stimulator in October of 2006. Eddie Crawford testified that he received no such request from Dr. Firmin’s office, but he did remember getting the request in October, but was not sure whether it was October of 2006 or 2007.

In February of 2007, per the recommendation of Dr. Bascilla’s office that Wilczewski see a neurosurgeon, Wilczewski obtained Brookshire’s approval to see Dr. Cavanaugh. She did not see him and instead saw Dr. Anil Nanda, a neurosurgeon.

Dr. Nanda saw Wilczewski for two visits. On the first visit, he reviewed the MRI of her lumbar spine. He also saw the disc bulges at L2-3 and L3-4. He then requested a myelogram/CT with flexion and extension of her lumbar spine to better evaluate the area. In the second visit, he read the results of the myelogram/CT to show moderate lumbar stenosis for L2 to L4, but he did not feel the films were dramatic. He did suggest that, should Wilczewski not improve, he would recommend a laminectomy from L2 to L4. In the two visits, Dr. Nanda noted the redness of Wilczewski’s back but attributed it to excessive use of a heating pad.

At Brookshire’s request, Wilczewski saw Dr. Karl Bilderback, an orthopedic surgeon. Dr. Bilderback saw her one time and concluded that she was at maximum medical improvement. Further, he found no objective finding to support Wilczewski’s complaints of thoracic pain. He opined that there was no reason for a spinal cord stimulator, that she was magnifying her symptoms, and that she could return to work without restrictions. With regards to the redness of Wilczewski’s back, Dr. Bilderback did not have any particular diagnosis and felt it would be helpful for Wilczewski to see a dermatologist.

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