Opinion
NO. 2012-CA-000047-WC
04-19-2013
MONUMENTAL LIFE INSURANCE COMPANY APPELLANT v. RALPH CAUDILL, HON. EDWARD D. HAYS, ADMINSTRATIVE LAW JUDGE, and WORKERS' COMPENSATION BOARD APPELLEES
BRIEF FOR APPELLANT: Crystal L. Moore Lexington, Kentucky BRIEF FOR APPELLEE: John Earl Hunt Stanville, Kentucky
NOT TO BE PUBLISHED
PETITION FOR REVIEW OF A DECISION
OF THE WORKERS' COMPENSATION BOARD
ACTION NO. WC-09-73799
OPINION
AFFIRMING
BEFORE: MOORE, STUMBO, AND VANMETER, JUDGES. STUMBO, JUDGE: Monumental Life Insurance Co. appeals from a decision of the Workers' Compensation Board affirming an award of permanent total disability benefits in favor of Ralph Caudill. Monumental argues that all the evidence of medical restrictions indicated that Caudill could return to work and that there was no substantial evidence to support the finding that Caudill's cervical injury was work-related. We affirm.
Caudill worked as an insurance sales field agent for Monumental. On November 3, 2009, Caudill was injured after falling down a flight of stairs leading into the home of a client. Caudill was treated by Dr. Debra Hall, Dr. Scott Akers, Dr. Norman Mayer, and Dr. Brendan Coughtry. Caudill filed a workers' compensation claim on May 20, 2010. Dr. Henry Tutt performed an independent medical evaluation. Following a hearing, the Administrative Law Judge (ALJ) awarded Caudill benefits based upon a finding of permanent total disability. The ALJ made additional findings of fact in an order denying Monumental's petition for reconsideration. The Board affirmed. This appeal followed.
Monumental first argues that all evidence of medical restrictions indicated that Caudill could return to work and, therefore, the finding of permanent total disability was not supported by substantial evidence.
The standard of review of a decision of the Board "is to correct the Board only where the Court perceives the Board has overlooked or misconstrued controlling statutes or precedent, or committed an error in assessing evidence so flagrant as to cause great injustice." Western Baptist Hosp. v. Kelly, 827 S.W.2d 685, 687-88 (Ky. 1992). KRS 342.0011(11)(c) defines "permanent total disability" as "the condition of an employee who, due to an injury, has a permanent disability rating and has a complete and permanent inability to perform any type of work as a result of an injury[.]" In Ira A. Watson Dept. Store v. Hamilton, 34 S.W.3d 48, 51-52 (Ky. 2000), our Supreme Court stated:
An analysis of the factors set forth in KRS 342.0011(11)(b), (11)(c), and (34) clearly requires an individualized determination of what the worker is and is not able to do after recovering from the work injury. Consistent with Osborne v. Johnson, supra, it necessarily includes a consideration of factors such as the worker's post-injury physical, emotional, intellectual, and vocational status and how those factors interact. It also includes a consideration of the likelihood that the particular worker would be able to find work consistently under normal employment conditions. A worker's ability to do so is affected by factors such as whether the individual will be able to work dependably and whether the worker's physical restrictions will interfere with vocational capabilities. The definition of "work" clearly contemplates that a worker is not required to be homebound in order to be found to be totally occupationally disabled.(Internal citations omitted).
Although the Act underwent extensive revision in 1996, the ALJ remains in the role of the fact-finder. KRS 342.285(1). It is among the functions of the ALJ to translate the lay and medical evidence into a finding of occupational disability. Although the ALJ must necessarily consider the worker's medical condition when determining the extent of his occupational disability at a particular point in time, the ALJ is not required to rely upon the vocational opinions of either the medical experts or the vocational experts. A worker's testimony is competent evidence of his physical condition and of his ability to perform various activities both before and after being injured.
The ALJ determined that Caudill was totally disabled based upon the 24% impairment rating assigned by Dr. Eric Johnson. Dr. Hall also provided ample evidence that Caudill was totally disabled as a result of the work-related injuries. The Board properly applied the controlling law. While Monumental points out evidence contrary to the findings of the ALJ, such evidence does not compel a different result. Magic Coal Co. v. Fox, 19 S.W.3d 88, 96 (Ky. 2000).
Monumental next argues that the Board erred by concluding that the injury to Caudill's cervical spine was work-related and that causation may be inferred from the evidence. There is no requirement that a finding of causation must be based solely on a physician's opinion. Dravo Lime Co., Inc. v. Eakins, 156 S.W.3d 283, 289 (Ky. 2005). An ALJ has the authority "to infer causation from properly admitted evidence." Id.
The ALJ found that the cervical spine injury was work-related based upon the medical report of Dr. Mayer. In the report, Dr. Mayer stated that Caudill's neck pain was "worsened post trauma" and that the injury was "aggravated on trauma based on history." Caudill also testified that his neck pain began with the work accident. While a medical expert did not explicitly state that the neck injury was caused by the work accident, we agree with the Board that there was sufficient evidence of record for the ALJ to infer causation.
Accordingly, the decision of the Workers' Compensation Board is affirmed.
ALL CONCUR. BRIEF FOR APPELLANT: Crystal L. Moore
Lexington, Kentucky
BRIEF FOR APPELLEE: John Earl Hunt
Stanville, Kentucky