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Kelly v. Lay6/16/2005
th no restrictions and instructed him to exercise on his own. Dr. Knight found that Mr. Kelly had sustained no permanent impairment.
Dr. Sorensen saw Mr. Kelly on 4 occasions, with the first visit occurring on January 26, 2001. At that time, Mr. Kelly complained of low back pain with radiation into his legs with the pain being worse on the left side. An MRI showed a disc dessication, the loss of water content, at L3, L4, and L5, and a bulging disc at the L5-S1 level, but there did not appear to be nerve impingement or herniation. Dr. Sorensen made an initial diagnosis of lumbar strain which appeared to be an aggravation of pre-existing lumbar degenerative disc disease. He prescribed an anti-inflammatory medication and a muscle relaxer and returned Mr. Kelly to work with a fifteen-pound work restriction and no prolonged sitting or standing or repetitive flexion. On Mr. Kelly's last visit of March 5, 2001, Dr. Sorensen determined that Mr. Kelly had sustained no permanent impairment from the injury of December 1, 2000, and returned him to work with no restrictions.
Dr. Sorensen sent Mr. Kelly to a work-hardening program at Work Solutions. He also underwent a functional capacity evaluation on March 2, 2001. The report indicates that Mr. Kelly had numerous subjective complaints in his upper and lower back, showed initial signs of symptom magnification on the pain questionnaires, showed good mobility, showed no clinical signs of distress, and had been very cooperative in his program. He was somewhat guarded on the B200 testing for strength and mobility of the lumbar spine, but on other activities gave a good effort.
Dr. Boals examined Mr. Kelly on May 14, 2002. Mr. Kelly gave Dr. Boals the same history that he had given Dr. Knight and Dr. Sorensen. He described his injury ; he complained that his back continued to hurt and that he had radiation of pain into his right leg. Upon examination, Dr. Boals noted limited flexion with guarding, which meant that as Mr. Kelly started to bend forward, he would catch himself as if he were afraid of hurting himself. Other range of motion tests were within normal limits. The neurological examination was normal. Dr. Boals diagnosed degenerative arthritis of the lumbar spine, with degenerative disc disease and chronic lumbar strain aggravating the diagnosis. He opined that Mr. Kelly's back problems were caused or aggravated by pulling the float at work, and that his condition was permanent. He opined that Mr. Kelly had sustained an 8% impairment to the body as a whole, based upon Table 15-3, page 835, Lumbar Category 2, AMA Guidelines, 5th Edition. Dr. Boals recommended that Mr. Kelly avoid prolonged walking, standing, stooping, squatting, climbing, and repetitive flexion, extension, or rotation of the back. He suggested that Mr. Kelly determine the amount of weight he could lift by work trial.
Table 15-3 of the AMA Guidelines, 5th Edition states as follows:
DRE Lumbar Category II: 5% - 8% Impairment of the Whole Person:
Clinical history and examination findings are compatible with a specific injury ; findings may include significant muscle guarding or spasm observed at the time of the examination, asymmetric loss of range of motion, or non-verifiable radicular complaints, defined as complaints of radicular pain without objective findings; no alteration of the structural integrity and no significant radiculopathy. . . . (emphasis added).
Mr. Kelly meets the following criteria under this specific table:
(1) "Clinical history and examination findings compatible with a specific injury . . . ." Mr. Kelly injured himself while pulling a float on December 1, 2000;
(2A) ". . .sign
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