OF JUDGMENT: 12/04/2017
MISSISSIPPI WORKERS' COMPENSATION COMMISSION
ATTORNEY FOR APPELLANT: JAMES KENNETH WETZEL
ATTORNEY FOR APPELLEES: M. REED MARTZ
LEE, C.J., BARNES AND WESTBROOKS, JJ.
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,
OF FACTS AND PROCEDURAL HISTORY
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."
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.
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). 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, 12, April 2nd, 2012 with good
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). On January 17, 2014, Dr.