Shegog v SSM Health
Nov. 14, 2017
ALJ Kohner
The Commission reverses a denial of benefits and orders a temporary award to provide treatment for deQuervain's based on claimant's testimony about her job duties and medical opinion of her expert, Dr. Schlafly.
Claimant had long-standing symptoms in both arms, including a prior settlement, but the commission finds the deQuervain's a new occupational diseased despite medical opinion of her treating physician that the condition did not flow from her employment.
Claimant alleges she developed bilateral carpal tunnel syndrome and DeQuervain's tenosynovitis arising from her job duties as a housekeeper in 2012. The employer denied the case and provided no benefits and relied upon medical opinions of Dr. Brown and Dr. Dysarz. Claimant had worked for the employer for about a year and reports she used her hands 90% of the time.
She underwent a right carpal tunnel release in 2012. She treated with injection or left deQuervains. She disputed the medical history in records documenting chronic symptoms with both hands. She had a prior settlement in both wrists on the basis of earlier claims of carpal tunnel syndrome. The ALJ found her credibility was "diminished" based on such inconsistencies.
Claimant's treating physician, Dr. Dysarz, concluded that the work duties were not the prevailing factor in her carpal tunnel or deQuervain's based on her history and that he personally observed her job duties. He noted her job description identified "frequent" lifting, carrying and pushing and pulling.
Dr. Schlafly noted in an earlier exam in 2006 that she had carpal tunnel syndrome and would probably require surgery. At the time of his 2014 exam he recommended surgery he recommended left carpal tunnel release and left deQuervain's release.
Dr. Brown concurred with the diagnosis of carpal tunnel syndrome and deQuervain's, but did not find the current employment to be the prevailing factor because the carpal tunnel was previously diagnosed in the earlier records.
The ALJ found the defense based on statute of limitations was moot because he found the conditions were not compensable.
The Commission found the work as a housekeeper exposed claimant to the risk of DeQuervain's, it accepted her testimony and the job description that her activities were "frequent" physical requirements of the job, and gave little weight to Dr. Dyserz's opinions about his own personal observations. The Commission further accepted Dr. Schlafly's conclusions that there was a recognized link between hand motions in the job and the development of DeQuervain's, a conclusion that Dr. Dysarz indicated was controversial. The commission gave little weight to Dr. Brown's "normal" exam of the wrist, when other doctors found the wrist with positive findings and Dr. Brown did not address "whether it is possible to rule out the continued existence of a left deQuervain's tenosynovitis based on a one-time negative clinical presentation."
The Commission further addressed the statute of limitations issue that was not addressed by the ALJ and concluded that it was reasonably discoverable that an injury had been sustained.
The Commission did not disturb the denial of allegations of bilateral carpal tunnel syndrome.
