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Irikzarry v. Industrial Commission2/25/2003
CT scan in October of 1991 showed findings consistent with the prior MRI: Schmorl's nodes at L4 and a posterior disc bulge at L4-L5, but no stenosis or facet joint pathology.
Irizarry remained off work, and his workers' compensation claim proceeded to a section 19(b) hearing before arbitrator Caliendo on October 11, 1991. The arbitrator awarded TTD benefits covering the entire period between Irizarry's accident and the arbitration hearing. He also awarded medical expenses totaling $2,504.80. The expenses included bills from Drs. Morgenstern and Townsend.
A note from Dr. Morgenstern on October 30, 1991, reads: "Today, the patient additionally states he injured his low back." Irizarry subsequently complained of numbness and tingling in the fourth and fifth fingers of his right hand. An EMG of his upper extremities in November of 1991 revealed normal findings. Shortly afterward Doctor Morgenstern administered two epidural injections into Irizarry's lower back. In February of 1992 Doctor Morgenstern performed a second arthroscopic surgery on Irizarry's left knee. The procedure involved debriding a partial tear of the anterior cruciate ligament, and a partial synovectomy of the medial and lateral compartments.
On April 8, 1992, Townsend released Irizarry to work, noting that he was permanently incapable of performing "heavy and moderate work." Townsend restricted him from bending, stooping, lifting, pushing, pulling, climbing, elevation of the shoulders and arms, and repetitive head or neck movements involving flexion, extension, or rotation. During a functional capacity evaluation in mid-1992, Irizarry demonstrated abilities in the "light to sedentary" work category. Dr. Morgenstern issued a light-duty release on July 23, 1992, and Irizarry continued to complain of sciatica. A lumbar MRI in August of 1992 revealed disc degeneration at L4-L5 and L5-S1, with mild posterior bulging, but no stenosis or foraminal encroachment.
Dr. Morgenstern reviewed the MRI results and said Irizarry was "certainly not a surgical candidate." On September 3, 1992, the doctor opined that Irizarry was at maximum medical improvement and could not return to his usual work as a welder. Dynaweld gave him a referral for vocational rehabilitation services. Three months later he returned to Dr. Morgenstern with continued left knee complaints and received another injection.
In March of 1993 two rehabilitation consultants (Sylvia Sykes and Louisa Castellanos) issued a report describing Irizarry's participation in vocational rehabilitation. According to the report, Irizarry failed to contact three employers per week as requested. He cancelled two interviews with one employer before finally appearing. He told another employer he could only work the third shift and that he could not risk being cut because of a "blood problem." He refused to sit down during an interview with a third employer; instead, he stooped over the interviewer's desk and advised that he could not drive to and from work.
In April of 1993 Irizarry visited Dr. Benjamin Narrajos complaining of sharp, shooting lower back pain and dull neck pain. The doctor diagnosed chronic neck and lumbar strains with radiculopathy.
Castellanos prepared a follow-up rehabilitation report in April of 1993 stating that she had arranged for Irizarry to attend a job fair at Hollywood Casino. Irizarry asked her, " f I get the job do I have to work it?" He later told Castellanos that he attended the fair and completed a job application. However, she followed up and discovered that the casino did not have an application on file for Irizarry and that all applicants had received an interview. His rehabilitation file was close
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