Kriss Contracting v. Gonzalez

Superior Court of Delaware·Decided September 30, 2021·No. S20A-09-001 RHR·Published

Opinion

IN THE SUPERIOR COURT OF THE STATE OF DELAWARE

KRISS CONTRACTING, )

)

Employer-Below, )

Appellant )

v. ) C.A. No. S20A-09-001 RHR )

JOSE GONZALEZ, )

)

Claimant-Below, )

Appellee. )

Decided: September 30, 2021 MEMORANDUM OPINION

Upon Consideration of Appellant’s Appeal from the Decision of the Industrial Accident Board – AFFIRMED

John W. Morgan, Esquire, Heckler & Frabizzio, Wilmington, Delaware, Attorney for Employer Below-Appellant.

Walt F. Schmittinger, Esquire, Schmittinger and Rodriguez, Dover, Delaware, Attorney for Claimant Below-Appellee.

ROBINSON, J.

I. INTRODUCTION

Kriss Contracting (“Employer”) filed a Petition for Review with the Industrial Accident Board (“IAB”) to terminate the total disability benefits of Jose Gonzalez (“Claimant”). Claimant, meanwhile, filed a petition seeking approval for platelet- rich plasma (“PRP”) therapy. The IAB held a hearing on July 10, 2020 to consider the two petitions. It issued a written decision on August 3, 2020 finding that Claimant was a prima facie displaced worker and denying Employer’s Petition. The IAB also found that the proposed PRP therapy was not reasonable and necessary. Employer appealed to this Court challenging the finding that Claimant was a prima facie displaced worker. For the following reasons, the IAB’s decision is affirmed.

II. FACTUAL AND PROCEDURAL BACKGROUND Claimant was injured in several work-related accidents in 2007, including one on September 15, 2007. His case has been the subject of several prior hearings before the IAB.

At the IAB hearing, Employer presented testimony via deposition of Jason P.

Brokaw, M.D. Dr. Brokaw examined Claimant on four occasions: December 20, 2016; June 14, 2018; December 10, 2019; and June 3, 2020. After his examination and review of the three functional capacity evaluation (“FCE”) reports, Dr. Brokaw stated he believed it would be safe for Claimant to begin work with “sedentary to

light physical demand capacity up to four hours per day to begin with, and then gradually increasing to full time over the next two to three months.”1 Based on his review of the jobs listed in the labor market survey prepared for Employer, he opined that they were appropriate for Claimant.

Dr. Brokaw testified about the three FCEs in question. The first was performed by ATI Physical Therapy on August 23, 2018. It indicated Claimant could work in a sedentary to light duty capacity. Dr. Brokaw agreed with this report. The second began on April 23, 2020, but Claimant was unable to complete it that day but he completed it on May 5, 2020. This second FCE indicated that Claimant was capable of sedentary to light duty work but only in a part-time capacity. Dr. Brokaw also agreed with this report. The third FCE was performed by Comprehensive Spine Center on June 19, 2020. Dr. Brokaw testified that Comprehensive Spine Center is owned by Dr. Ganesh Balu who is one of Claimant’s doctors and that the FCE was performed by an athletic trainer employed by Dr. Balu. Dr. Brokaw testified that this third FCE was “absolutely unusual and inappropriate. It is a self-referral, and makes it a biased test that would not necessarily be a good, accurate test of the patient’s abilities.”2

1 I.A.B Hr’g Tr. 7/10/20, at 37:9-22 (hereinafter “Tr. at ___”).

2 Tr. at 41:4-14.

Employer’s next witness was Truman Perry, III who performed a labor market survey in early 2020. Mr. Perry considered that Claimant was sixty-three years old and had a 10th grade education. According to the information available to Mr. Perry, Claimant was a laborer for Employer and he previously worked as a farm laborer from March 1979 until September 2003. Mr. Perry identified nine job opportunities, including jobs at a local casino, a fast-food restaurant, and an area movie theater. Mr. Perry noted that these employment opportunities allowed for mostly sedentary work with limited need for walking. The jobs ranged from nineteen to thirty-eight miles from Claimant’s residence.

Mr. Perry acknowledged that his initial report considered only full-time employment opportunities. In response to information obtained by the parties from the depositions of the doctors, Mr. Perry updated his report prior to the hearing to include part-time work. Some of the identified jobs allowed for two-hour shifts, and others, four-hour shifts. Mr. Perry speculated, over objection by Claimant, that there were other, similar jobs available to Claimant.

On cross-examination, Mr. Perry did not seem particularly familiar with the opinions of the examining doctors or the prior decisions of the IAB related to Claimant. He acknowledged the most recent FCE was more restrictive than the prior ones. There was general disagreement, on cross-examination and on redirect, with whether the COVID-19 crisis helped or hurt Claimant’s prospects for employment.

Claimant argued that many people had been laid off and were unable to find work, but Mr. Perry testified that many employers had unusually high numbers of vacancies. The parties speculated whether increased unemployment benefits disincentivized people from looking for work. Mr. Perry acknowledged that of the potential employers with whom he consulted, none had offered Claimant a job, although they invited him to apply.

Claimant presented his case through the depositions of Kennedy Yalamanchili, M.D. and Ganesh Balu, M.D. Dr. Yalamanchili is Claimant’s treating spine surgeon. He testified that although he believed Claimant was “structurally able” to work,3 he believed it would be unrealistic for Claimant to return to gainful employment. Dr. Yalamanchili deferred to Dr. Balu, who has treated Claimant since his 2007 accident, for determining when Claimant could return to work. Dr. Balu reviewed his history of treating Claimant and the reasons he believed the PRP treatment was necessary. When asked to sum up his prognosis, Dr. Balu stated:

Our current diagnosis, so to speak, is failed back surgery with chronic lumbar radiculopathy and chronic pain, and he also has in the latest MRI that [sic] he has epidural scars causing pain from arachnoiditis, which is a painful condition, so he’s expected to feel or experience chronic pain. He’s expected to take certain medications from us in the least amount possible to manage his pain and also manage exacerbations either with therapy interventions or spinal injections.

These spinal injections could be a radiofrequency ablation, epidural

3 Tr. at 94: 5.

injections, nerve block injections, or, if he’s allowed to try, a PRP injection. That’s our treatment plan.4

Dr. Balu believes Claimant will need treatment for pain for the rest of his life. Dr. Balu also testified that Claimant was not fit for work at the time. Dr. Balu’s conclusion was based, in part, on Claimant’s worsening condition and his inability to perform the FCE in a single session.

On cross-examination, Dr. Balu was asked about all three FCEs, including the one performed at the Comprehensive Spine Center on June 19, 2020. Dr. Balu stated that the athletic trainer who did the evaluation was qualified to administer the test and to utilize the software that runs the test. Dr. Balu testified that this FCE indicated that Claimant was unable to work in any capacity. Finally, Dr. Balu testified that Claimant drives his own car and is capable of driving short distances.

Claimant also testified. He stated he had worked for Employer for three years before his injury. He was a general laborer and confirmed that his work was “heavy, physical, manual work.”5 Prior to working with Employer he did concrete work in Texas for seventeen or eighteen years and then he worked at a farm for twenty years. He testified he had no formal schooling after he dropped out of school in the 10th grade. He stated that after a surgery with Dr. Yalamanchili he began to feel better

4 Claimant’s Ex. No. 2 at 31-32.

5 Tr. at 116:23-24, 117:1.

and his medications were reduced, but after several months the pain returned worse than before.

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