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Burtell v. State Compensation Insurnace Fund3/18/2002
se's aide. (Id. at 7.) While transporting a patient to the bathroom, she fell and twisted her back. (Id.) She thereafter experienced low-back pain.
At the time of her accident, West Mont was insured by the State Fund, which accepted liability for her injury.
The State Fund paid medical and wage-loss benefits.
Claimant was initially treated by Dr. Earl E. Book, a family practitioner. (Ex. 20.) Dr. Book summarized her early treatment as follows:
Initially, [her injury] was felt to be a strain-type injury to her low lumbar spine. However, x-rays showed a decreased disc space at L-5-S-1. Subsequent MRI scan of the lumbar spine performed 2/27/91, shows a protruding and possibly herniating disc at the L-5-S-1. (Id. at 218.)
In March 1991, he referred claimant to Dr. M. Brooke Hunter, an orthopedic surgeon, for evaluation for possible surgery. (Id. at 218.)
Claimant was first examined by Dr. Hunter on March 13, 1991. He noted x-rays showing "degenerative changes" and an MRI showing "a possible disc herniation at the 5,1 level." (Ex. 17 at 197.) He testified that claimant "certainly had a disc bulge at that lowest level in her spine, at the L5-S1 level, a possible small amount of herniation there," but he was not convinced it was the source of her pain. (Id.; Hunter Dep. at 7.) He also found claimant to be "quite deconditioned" and suffering from "multisystems disease from her smoking." (Hunter Dep. at 6.) He informed her she was not a surgical candidate, advised her to quit smoking, and recommended aerobic conditioning and spine stabilization programs. (Ex. 17 at 197; Hunter Dep. at 7-9.)
Claimant returned to Dr. Hunter on April 26, 1991. (Ex. 17 at 198.) His office note records that she was continuing to experience low-back pain but that she was still smoking and "quit PT on her own feeling that she couldn't afford to get back and forth." (Id., emphasis added.) He recommended against going back to work as a nurse's aide but "told her that I think she can be doing some type of light or moderate activities." (Id.)
On May 28, 1991, claimant returned to Dr. Hunter. At that time he gave "her a return to work date for one month to give her time to get a little bit more conditioned" and told her to return "in a month after that if she is still having problems." (Id. at 199.)
The State Fund referred claimant for a vocational assessment and on June 14, 1991, claimant met with Colleen M. Lordemann (Lordemann), who is a vocational counselor. Claimant had been initially scheduled to meet with Lordemann on May 31, 1991, but did not "show for that appointment." (Ex. 7 at 101.)
During her initial interview by Lordemann, claimant said she was relocating to Nebraska and would not participate in a rehabilitation program. (Id. at 103.) Because claimant was planning to relocate, Lordemann did not make any final determination regarding employability. (Id.)
Claimant returned to Dr. Hunter on July 16, 1991. He recorded that she was continuing to complain of "grumbly low back pain" and difficulty sitting, as well as pain radiating into her buttock or neck. (Ex. 17 at 200.) Dr. Hunter testified that claimant's complaints were of a myofascial nature, were not objectively related to the disk, and would not be improved by disk surgery. (Hunter Dep. at 11-12.) "She was complaining of pain, basically, between her shoulder blades, down to her back or pelvis, which is a much larger area than just the disc-pain would be responsible for." (Id. at 11.) He told claimant surgery would not benefit her, however, claimant informed him "that she has decided that she is going to have surgery and th
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