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Alassaadi v. Davidson Transit Organization8/24/2005
cation by his various doctors. He is taking hydrocodone and neurontin and has been prescribed morphine in the past. He has tried to work since his injury, but when potential employers observe his condition they refuse to hire him. Moreover, he cannot read or write English.
Linda McCrary, a senior claims representative with Brentwood Services, testified for the defendant. Dr. Alassaadi's file was assigned to her around June 14, 2002. She statedMr. Alassaadi was given a panel of treatment facilities. He chose Concentra. Concentra referred him to physical therapy, but he did not attend. She attempted to telephone Mr. Alassaadi on two occasions but the child who answered said he was sleeping and would not wake him. On both occasions she stated her purpose in calling and left her number, but Mr. Alassaadi did not return her calls. Ms. McCrary filed a notice of denial with the Department of Labor for non-compliance. According to Ms. McCrary, he missed two appointments with the authorized physician and refused to cooperate. Brentwood Services paid Terry Wheeler, the nurse practitioner who saw Mr. Alassaadi at Concentra. The emergency room bill was not paid because the claim was denied and the employer had requested that he go to Baptist.
II. MEDICAL EVIDENCE
Dr. Neal Garrett Powell, Jr., a board-certified physician in neurological surgery, testified by deposition. He first saw Mr. Alassaadi on September 17, 2002, on a referral from Dr. Alkayyali. Mr. Alassaadi complained of neck and back pain lasting for several months and radiating into both lower extremities, more severely on the left. He did not relate to Dr. Powell an incident that may have caused the pain. Dr. Powell recommended a pain management program.
Dr. Powell next saw Mr. Alassaadi on February 4, 2003, for an independent medical examination. On this second visit, Mr. Alassaadi reported that on June 5, 2002, he was cleaning a bus when he slipped on a wet floor and fell and struck the left side of his head. He stated that he had sustained a loss of consciousness and was taken to the Vanderbilt Emergency Room.
A physical examination revealed that Mr. Alassaadi had a loss of range of motion in his cervical region. He had some weakness in his left arm and left leg that appeared to be related to the pain. Dr. Powell found some sensory changes in the left side of his body. Mr. Alassaadi's reflexes were essentially normal. When he walked, he did not put his full weight on his left leg. Dr. Powell also found that when he raised his left leg, it would cause pain in the leg.
As a part of his examination, Dr. Powell reviewed medical records from Dr. Lloyd Walwyn, Vanderbilt Emergency Room, and Concentra Medical Center. Additionally, he reviewed an MRI scan of Mr. Alassaadi's neck taken on June 25, 2002, and an MRI scan of lumbar scan of his spine done on June 27, 2002. There was no evidence of any acute injuries in any of the imaging studies that Dr. Powell reviewed. Dr. Powell had an EMG nerve conduction study done of the left arm and of the left leg which were normal. He also had a brain MRI which was normal. The MRI scan done on June 25, 2002, did show a shallow disc herniation at C4/5. Dr. Powell agreed that the presence of abnormalities on imaging studies does not necessarily mean that an individual has an impairment due to an injury. A person can have structural problems with the spine such as Dr. Powell found in the lower spine of Mr. Alassaadi simply as a result of the aging process. Dr. Powell felt that he had cervical pain, low back pain, left arm pain and left leg pain that developed as a result of an injury that occurred at work. He felt that he had myofacial pain and some depression rel
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