Opinion
W.C. No. 4-721-655.
September 25, 2008.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Stuber (ALJ) dated April 14, 2008, that denied and dismissed his claim after finding that the claimant did not sustain a compensable injury. We affirm.
Several of the ALJ's findings of fact are summarized as follows. The claimant sustained a work-related injury to his low back on April 20, 2007. The claimant returned to modified duty, with physical restrictions, on April 25, 2007. The claimant felt increasing low back pain and spasm as he worked. After returning from lunch, the claimant removed a 20 to 30 pound roll of wire and dragged it to another work station. He lost consciousness, fell, and struck his head on the concrete floor.
The claimant went to the emergency room that day. He told one owner of the employer that he was unsure what caused his fall and advised another owner that he had passed out and could not remember anything that happened when he fell. Two days later, the claimant reported to an examining physician that his legs gave out, which led to his fall. About two weeks after his fall, the claimant advised a co-worker that he was not sure what caused his fall.
The claimant received injections to control cluster headaches that he has suffered since childhood. Two days after his fall, a physician diagnosed a closed head injury, cervical and thoracic strain, and bilateral upper extremity weakness. Later diagnoses included postconcussive syndrome and traumatic brain injury.
Dr. Orent conducted an independent medical examination for the respondents. He diagnosed a drop attack, which is a sudden loss of blood profusion to the brain. Dr. Orent suspected a cardiac or vascular event or a seizure. He considered the claimant's smoking history to be a major risk factor for vascular disease. Dr. Hall conducted an independent medical examination for the claimant. He concluded that the most likely cause of the claimant's fall was low back and leg pain. Both Dr. Hall and Dr. Orent testified in this matter. Dr. Hall disagreed with Dr. Orent, but agreed that if the claimant's history of low back pain was not accurate the fall would be idiopathic. Dr. Orent testified that the claimant would likely be able to remember if his fall was caused by low back pain and, also, that the claimant would have an oncoming sense of fainting if he had fainted.
The claimant denied to three people from work that severe low back pain caused his fall. Upon consideration of the claimant's statements and his explanations of his medical history to various physicians and the medical evidence, the ALJ found that the claimant sustained an unexplained fall as indicated by his "sudden loss of consciousness with no oncoming sense of syncope and no memory of the events." Findings of Fact, Conclusions of Law, and Order at 4, ¶ 22. The ALJ also found that the claimant's injuries were not due to any special hazard of employment.
The claimant challenges the ALJ's determination that the claimant's fall was unexplained and, therefore, not compensable. The claimant asserts that his previous work-related injury was sufficiently related to his latest fall to support a finding of compensability for his subsequent injuries. See, e.g., Vanadium Corp. of America v. Sargent, 134 Colo. 555, 307 P.2d 454 (1957) (upholding compensability of claim based on aggravation of preexisting congenital back condition). A compensable injury may be the result of an industrial aggravation of a pre-existing condition as long as the aggravation is the proximate cause of the disability or need for treatment. H H Warehouse v. Vicory, 805 P.2d 1167, 1169 (Colo.App. 1990). To prove a compensable injury, the claimant must establish that the injury arose out of and in the course of employment. Section 8-41-301(1)(b), C.R.S. 2008; Madden v. Mountain West Fabricators, 977 P.2d 861 (Colo. 1999). Moreover, whether there is a sufficient nexus or causal relationship between the claimant's employment and the injury is one of fact, which the ALJ must determine based on the totality of the circumstances. In Re Question Submitted by the United States Court of Appeals, 759 P.2d 17 (Colo. 1988).
Therefore, the question of whether the claimant met his burden to prove a compensable injury is one of fact for determination by the ALJ. Wal-Mart Stores, Inc. v. Industrial Claim Appeals Office, 989 P.2d 251 (Colo.App. 1999). We must uphold the ALJ's factual findings that are supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. 2008. This standard of review requires that we consider the evidence in a light most favorable to the prevailing party, and defer to the ALJ's credibility determinations, resolution of conflicts in the evidence and plausible inferences drawn from the record. Wilson v. Industrial Claim Appeals Office, 81 P.3d 1117 (Colo.App. 2003).
In support of his contention, the claimant refers to his description of events leading up to his fall. The claimant described his pain getting worse "all day long" on the day of his fall, and claimed he had "all sorts of spasms" in his back and leg. Tr. at 19. The claimant provided the following explanation of what happened after he started dragging wire: "I started to turn and torque my body, I had a real big flash of pain come across my low back and down my left leg and down I went." Tr. at 19. The claimant then indicated that he woke up with someone standing over him. Tr. at 19. As noted by the claimant in his brief, Dr. Hall indicated that the likely cause of the claimant's fall was his low back and leg pain. Dr. Hall issued a report dated August 8, 2007, in which he opines that the claimant's symptoms are causally related to his fall at work. Dr. Hall stated that "[t]he most likely cause of the fall was the work-related problems that he was having with his low back and leg pain." Exhibit 2 at 3-4. Dr. Hall also testified to the effect that he concluded the claimant's fall was due to severe pain and potential weakness in the claimant's leg. Tr. at 42. However, the ALJ credited other evidence, including the conclusions of Dr. Orent.
Dr. Orent issued a report on his findings after examining the claimant on August 1, 2007, in which he stated that the claimant "did not experience any sudden, severe back pain that might have caused him to have a vasovagal episode, he simply had a loss of consciousness." Exhibit A at 5. Dr. Orent testified that the claimant told him that he did not recall anything about the event. Orent Depo. at 5-6. The ALJ made a corresponding finding that the claimant denied a specific history, such as low back pain, to Dr. Orent. Dr. Orent noted in his report that the claimant appears to have had "a syncopal episode or drop attack unrelated to a particular event at work." Exhibit A at 5. He further testified that the claimant "would remember severe, searing pain in the back that basically made him feel lightheaded and that would have possibly led to a fainting spell" if his snycopal episode had been caused by pain. Orent Depo. at 14-15. Instead, Dr. Orent stated that the claimant had a "classic symptom complex for a drop attack." Orent Depo. at 15. The ALJ found Dr. Orent's opinions to be persuasive and made corresponding findings of fact.
Thus, it appears from the examples of evidence in the record recited above that there was conflicting evidence regarding the cause of the claimant's fall. The ALJ found that the claimant sustained an unexplained fall. Under the circumstances, we find no basis upon which to disturb the ALJ's determination that the claimant did not establish a compensable injury. See Rice v. Dayton Hudson Corp., W.C. No. 4-386-678 (July 29, 1999) (claimant's failure to establish that employment played causative role in fall or elevated risk of fall or extent of injuries results in "truly `unexplained fall'").
IT IS THEREFORE ORDERED that the ALJ's order dated April 14, 2008, is affirmed.
INDUSTRIAL CLAIM APPEALS PANEL
____________________________________ John D. Baird
____________________________________ Thomas Schrant
JAMES N GRAY, 707 JACKSON, PUEBLO, CO, 81004 (Claimant).
BOUGHTON'S PRECAST, INC., Attn: MS DEBBIE WARD, 1724 ASPEN CIRCLE, PUEBLO, CO, 81006 (Employer).
PINNACOL ASSURANCE, Attn: HARVEY D FLEWELLING, ESQ., 7501 E LOWRY BLVD, DENVER, CO, 80230-7006 (Insurer).
STEVEN U MULLENS, PC, Attn: JAMES A MAY, ESQ, 1401 COURT STREET, PUEBLO, CO, 81003 (For Claimant).
PINNACOL ASSURANCE, Attn: MS SUMMER WORSHAM, 7501 E LOWRY BLVD, DENVER, CO, 80230-7006 (Other Party).