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Eller v. County of Pittsburg3/4/2003
ated with Spine Diagnostic Group, Inc. The Procedure Note prepared by the radiologist states that during the procedure needles were inserted guided under flouroscopy. Once the needles were in position, " ye was injected into each disc under direct flouroscopic visualization." During the procedure the radiologist stated that the "patient's pain response to the injection, volume of injection, endpoint of injection, morphology of the disc, and the pressure to injection were all recorded." The radiographic report contained in the note states that "AP and lateral views of the lumbar spine show needles in the nuclear region of the L1-2, L2-3, L3-4 and L4-5 discs" revealing "nuclear injection, diffuse internal disc derangement" at each disk. The radiologist noted that the "patient tolerated the procedure well with no complications."
The claimant's medical expert characterized the procedure and its results as follows:
Due to the persistence of his lumbar symptomatologies, the patient was referred once again to Dr. Eckman undergoing a discogram revealing evidence of painful disc at L1 L2, L2 L3 and probable recess stenosis at L4 L5. These findings did not result in recommendations for additional lumbar surgery. (Emphasis added.)
The expert's report, indeed the appellate record, is devoid of any indication that the diskogram procedure was a surgical treatment as contemplated by the Guides. In fact, based on the results of the diskogram, no further surgical treatment of the claimant's lumbar spine was recommended and none was performed. Nonetheless, the claimant's expert recommended that 13 percent impairment be awarded based on a " our-level awake lumbar discogram with disc injection."
We agree with the employer's conclusion that the " laimant's theory that any worker who undergoes diagnostic testing on the back in the form of a diskogram would automatically be entitled to an award of PPD is clearly an unreasonable interpretation of the AMA Guides." We conclude that a reasonable interpretation of Table 75 (II)(D) is that the Guides recommends additional impairment for the surgical treatment of a disk, including disk injection for treatment purposes, as opposed to diagnostic purposes. The claimant's interpretation could have a chilling effect on the availability of diagnostic procedures which are necessary to evaluate a claimant's need for corrective surgical treatment.
III.
We hold the order under review is supported by competent evidence. The order is therefore sustained.
ORDER SUSTAINED.
REIF, J., and RAPP, J., concur.
March 4, 2003
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