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Crays v. PSL North America & Berkley National Insurance Co.

Court of Appeals of Mississippi

November 13, 2018

CLIFTON DALE CRAYS APPELLANT
v.
PSL NORTH AMERICA AND BERKLEY NATIONAL INSURANCE COMPANY APPELLEES

          DATE OF JUDGMENT: 12/04/2017

          MISSISSIPPI WORKERS' COMPENSATION COMMISSION

          ATTORNEY FOR APPELLANT: JAMES KENNETH WETZEL

          ATTORNEY FOR APPELLEES: M. REED MARTZ

          BEFORE LEE, C.J., BARNES AND WESTBROOKS, JJ.

          BARNES, J.

         ¶1. Clifton Dale Crays had a work-related accident on September 25, 2013. Although his employer, PSL North America, and its carrier, Berkley National Insurance Company (Appellees), compensated Crays for his neck injury, they denied compensability for his lower back/lumbar condition, claiming it was pre-existing and not causally related to the accident. After a hearing, the Mississippi Worker's Compensation Commission's (the Commission) administrative judge (AJ) determined that Crays's lumbar injury "arose out of and in the course of his employment." On appeal, the full Commission reversed the AJ's order, finding that "the greater weight of the medical proof fails to establish the necessary causation between Claimant's work injury and his alleged lumbar injury claim." Because the Commission's decision is based on substantial evidence, we affirm.

         STATEMENT OF FACTS AND PROCEDURAL HISTORY

         ¶2. On September 25, 2013, Crays "was lifting water coolers from [a] forklift to [a] deck[, ] and as [he] lifted one of the coolers[, he] felt a burning from [his] neck to [his] right shoulder and dropped the cooler." A witness confirmed that when Crays dropped the cooler, he "grabbed his right shoulder and [win]ced in pain." On the job-injury report, Crays identified the location of his injury as the neck area of his upper "front" torso. Crays was treated at Hancock Medical Center by Jamie Rutherford, NP-C. His chief complaint was "shoulder pain . . . [and r]eports picking up [a] heavy object with sudden onset of neck pain and radiation to right arm." Although Crays reported no back pain during his exam, his medical history did note "[c]hronic back pain." The medical assessment was of "cervicalgia" and "unspecified essential hypertension."

         ¶3. Crays had previously undergone two lumbar surgeries-one on July 14, 2009, and one on October 19, 2011-and had been taking Lortab and Soma several times daily since January 2010 to manage his pain. On September 19, 2013, days before the accident, Crays went to his neurosurgeon, Dr. Eric H. Wolfson, complaining of "increased back pain" and "neck and right arm pain." Dr. Wolfson ordered CT scans of Crays's cervical and lumbar spine; however, the scans were not performed until October 1, 2013, six days after the accident. The MRI of the cervical spine revealed "multilevel cervical degenerative changes . . . most severe at C5-6 where diffuse disc bulge, uncovertebral joint, and facet arthropathy, result in effacement of the right aspect of the ventral cord, moderate central canal stenosis, moderate right, and mild to moderate left neural foraminal stenosis." The lumbar-spine MRI was compared to one from November 13, 2012, and revealed that his lumbar condition was essentially "unchanged," but the comparison did note that mild neural foraminal stenosis was "present on the left at L4-5 and bilaterally at L3-4." Dr. Wolfson diagnosed Crays with "herniated disc, cervical w/o myelopathy" and ordered physical therapy (PT) three times a week for four weeks.[1]

         ¶4. Crays saw his pain-management specialist, Dr. Ramakrishna Settipalli, on October 3, noting pain in the "lower back, right side of neck and shoulder." The "history of present illness" reported:

[G]radual onset of constant episodes of severe bilateral lower back pain, described as sharp, burning and tingling, radiating to the bilateral buttock, bilateral thigh, bilateral lower leg and bilateral foot. Episodes started about 6 years ago. . . . Symptoms are unchanged. Risk Factors: smoking, but not . . . recent trauma . . . Medical History: herniated disc(s), but not depression, DJD of back, spondylosis, malignancy, sciatica and spinal fracture. . . . ([Patient] states has right side of neck and shoulder, lower back pain). . . . [G]radual onset of constant episodes of severe bilateral anterior upper, bilateral posterior upper and bilateral anterior lower leg pain, described as stinging, radiating to the bilateral thigh, bilateral knee and bilateral lower leg. Episodes started about 6 years ago. His symptoms are caused by no known event. . . . Symptoms are unchanged. . . . 46 y/o [C]aucasian male c/o severe back and leg pain caused by degenerative disc disease and wear and tear referred by Dr. Wolfson. He has tried [PT] and it didn't help much. He has had cortisone shots in his back and it didn't help. He then had [two] back surgeries afterwards. He currently takes Lortab, Flexeril[, ] and Soma for the pain and it helps a little with the pain.

(Emphasis added).[2] After reviewing the recent MRIs and conducting a physical examination, Dr. Settipalli's assessment was cervical and lumbar neuritis (L6-S1), lumbar radiculopathy (A1-L4), lumbar spondylosis, segmental dysfunction of the sacrococcygeal region, and failed back syndrome. With regard to the lumbar condition, Dr. Settipalli noted that an injection on March 6, 2013, had given Crays "relief without any complications," that Crays had hardware in his lumbar spine, and that the "[l]umbar [p]ain duration [and] intensity improved with Lortab." He recommended repeating both a sacroiliac joint injection and left greater trochanteric bursitis (GTB) injection "done on June 6th, [20]12, April 2nd, 2012 with good relief."[3]

         ¶5. On January 10, 2014, Crays reported to Dr. Wolfson and complained of neck and lower back pain and that PT provided no relief. Dr Wolfson's assessment was cervical radiculitis, and the treatment plan was for a Cervical Epidural Steroid Injection (CESI).[4] On January 17, 2014, Dr. ...


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