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State11/19/2004
hat radiated into the thigh and calf. Dr. Narotzky's notation about Parrish's lower back difficulty since 1997 may be placed into context with Parrish having visited Dr. Al Metz in early April 1998. Dr. Metz ordered an MRI of the lumbosacral spine, which was performed on April 7, 1998. The medical record for that MRI reveals a clinical history of " ow back pain with right groin pain for three weeks. Two episodes of pain shooting down to the level of the right heel." The MRI revealed a small to moderate sized right foraminal disk herniation at L2-3. Parrish asked Dr. Metz what may have caused this condition, and Dr. Metz told him he had no idea. When Dr. Narotzky saw Parrish in early December 1999, as mentioned above, he also ordered another MRI. That MRI revealed a far right lateral and foraminal disk herniation at L4-5 which had progressed from the previous examination and a far left lateral and foraminal disk herniation at L3-4, which was believed to be a new finding from the April 1998 MRI study. Parrish stopped doing physical labor at Excal in 2000.
[ ] In mid-April 2000, Dr. Narotzky performed a microlumbar diskectomy on Parrish's lower back. Dr. Narotzky's medical records in late April and late June 2000 reveal that Parrish was doing well and had no back or leg pain. Parrish saw Dr. Narotzky in early November 2000 and underwent another MRI. It revealed "some very slight disc bulging toward the right side of the L-4 level." On November 27, 2000, Dr. Narotzky's medical record discloses that Parrish complained of right-sided low back pain, which Dr. Narotzky attributed to the L4-5 disk. Dr. Narotzky's next medical record is dated March 21, 2001, and reports that Parrish had returned to see him. That medical record discloses:
He is getting a drastic significant low-back pain. This is now greater on the left side, although it had been alternating from one side to the other. In November of 2000 he fell on the ice; and since then, he has had increased pain in his low back on the left side with increased pain radiating in the left leg in the anterior thigh to the knee.
When asked at his hearing about this report of a fall on ice, Parrish testified, "I don't believe it ever happened." The MRI report dated March 30, 2001, reveals this clinical history:
42-year-old male with low back pain, eight week history of left leg pain extending into the left groin and medial aspect of left leg, fell on ice 15 November 200 .
On April 23, 2001, Dr. Narotzky noted that Parrish had significant disk degeneration at all four levels of the lumbar spine.
[ ] In early 2002, Parrish was seeing Dr. Narotzky for cervical herniations. According to Parrish's appellate brief, those cervical herniations "are not part of [the worker's compensation] claim." Dr. Narotzky did not give Parrish an opinion about whether his work was causing his back problems. Dr. Narotzky recommended that Parrish see Dr. Stenfors-Dacre for an evaluation to find out what may have caused his back problems.
[ ] Following Dr. Narotzky's direction, Parrish prepared a detailed work history, including the heavy lifting he had done, spanning the time from 1976 to 2002. Parrish handed that work history to Dr. Stenfors-Dacre on February 25, 2002, when she examined and evaluated his condition. As a result of that examination and evaluation, Dr. Stenfors-Dacre formed the opinions and conclusions identified above.
[ ] On May 6, 2002, Parrish submitted his injury report to the Division, making a claim against Excal for an injury that occurred over a substantial period of time. Parrish's submission did not refer to any specific injury or any specific date of injury. On May 10, 200
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