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IN THE MTR. OF RAHMAN v. SAVA SENIOR CARE, W.C. No

Industrial Claim Appeals Office
May 17, 2011
W.C. No. 4-811-471 (Colo. Ind. App. May. 17, 2011)

Opinion

W.C. No. 4-811-471.

May 17, 2011.


FINAL ORDER

The respondents seek review of a corrected order of Administrative Law Judge Friend (ALJ) dated January 4, 2011, that found the claimant sustained a compensable injury and ordered them to pay for certain medical care. We affirm.

Several of the ALJ's findings of fact are summarized as follows with references to the record in support of them. On October 11, 2009 the claimant grabbed a large patient in an attempt to keep the patient from falling. Exhibit 1. The patient, but not the claimant, ended up on the floor. Exhibit 1. Dr. Winslow diagnosed the claimant as having lumbar and knee strains and related them to the October 11 incident. Exhibit 1. Dr. Winslow released the claimant to return to work and restricted her to lifting no more than 25 pounds. Exhibit 1. Dr. Striplin examined the claimant, but was not able to establish the mechanism or nature of her injuries. Exhibit A at 5. He testified that trying to stop an obese woman from falling could strain the low back and knee, but such injuries were more likely if the claimant had fallen. Tr. at 28. Dr. Striplin further testified that the claimant's shoulder complaints were not related to the work incident. Tr. at 35-36. The claimant had undergone surgery on her left shoulder in the past. Exhibit 4 at 3-4. Dr. Goldman examined the claimant and stated that the claimant suffers from pre-existing, but "symptomatically exacerbated versus aggravated right knee pain, left shoulder pain, and low back pain as a result of October 11, 2009 work related injury." Exhibit 4 at 12. The ALJ was persuaded that the claimant sustained a lumbar strain and a knee strain and that her treatment at Concentra was reasonably needed to cure and relieve the claimant from the effects of her injury.

The respondents review the claimant's past medical history of back pain and related medications, as well as the opinions of Dr. Striplin and Dr. Goldman, and assert that the ALJ erred in finding that the claimant sustained compensable lumbar and knee strains. The respondents argue that the ALJ erred in crediting Dr. Goldman's opinions because Dr. Goldman erroneously relied on the assumption that the claimant fell and an obese patient fell on top of her, whereas the ALJ specifically found that the claimant did not fall. As we read Dr. Goldman's report, the claimant told him she went to assist with a client and that both she and the client fell, but the claimant was able to get up and complete her day. Exhibit 4 at 3. Dr. Goldman's opinions are not without qualification. For example, he recognized the difficulty in providing specific diagnoses for the claimant's back, shoulder, and knee and stated that "[i]t is not at all inconceivable that the patient could have re-injured her right knee, left shoulder and low back during the events of October 11, 2009." Exhibit 4 at 16. Similarly, the respondents refer to Dr. Striplin's testimony to the effect that because of inconsistencies in the claimant's account of the incident Dr. Striplin could not reasonably opine that the incident injured the claimant's back. Instead, Dr. Striplin thought it was merely possible that the claimant could have injured herself without a fall. However, matters such as the extent to which Dr. Goldman's and Dr. Striplin's opinions relied on the claimant's description of the events leading to her claim go to the weight to be given those opinions. To the extent a medical opinion is predicated on an incomplete or inaccurate history, it is for the ALJ to assess the weight of the opinion in light of those circumstances. See Industrial Commission v. Albo, 167 Colo. 467, 447 P.2d 1006 (1968).

Furthermore, the ALJ's determination that the claimant sustained compensable injuries is supported by the opinions of Dr. Winslow. As noted above the ALJ expressly credited Dr. Winslow's opinion that the claimant's lumbar and knee strains "were a result of the activities described at work." Exhibit 1. Dr. Winslow provides the following description of the incident by the claimant: "The patient reports that on this date she was attempting to keep a patient from falling . . . and she strained her right knee back and groin. She twisted while trying to catch this patient around the waist." Exhibit 1. It does not appear that Dr. Winslow relied on any representation that the claimant actually sustained a fall during the incident. In any event, the determination of whether an injury is compensable presents a question of fact for resolution by the ALJ based on the preponderance of evidence standard.

We must uphold the ALJ's determination if supported by substantial evidence in the record. Section 8-43-301(8), C.R.S. The standard of review is whether the ALJ's findings of fact are supported by substantial evidence in the record. Section 8-43-301(8), C.R.S; Metro Moving Storage Co. v. Gussert, 914 P.2d 411 (Colo. App. 1995). "Substantial evidence is that quantum of probative evidence which a rational fact finder would accept as adequate to support a conclusion, without regard to the existence of conflicting evidence. Metro Moving Storage Co. at 414. This standard of review is deferential and the scope of our review is "exceedingly narrow." Id. at 415.

Moreover, we may not substitute our judgment by reweighing the evidence in an attempt to reach inferences different from those the ALJ drew from the evidence. See Sullivan v. Industrial Claim Appeals Office, 796 P.2d 31, 32-33 (Colo. App. 1990) (reviewing court is bound by resolution of conflicting evidence, regardless of the existence of evidence which may have supported a contrary result); Rockwell Int'l v. Turnbull, 802 P.2d 1182, 1183 (Colo. App. 1990) (ALJ, as fact-finder, is charged with resolving conflicts in expert testimony). The ALJ may accept all, part, or none of the testimony of a medical expert. Colorado Springs Motors, Ltd. v. Industrial Commission, 165 Colo. 504, 441 P.2d 21 (1968). See also, Dow Chemical Co. v. Industrial Claim Appeals Office, 843 P.2d 122 (Colo. App. 1992) (ALJ may credit one medical opinion to the exclusion of a contrary medical opinion). Given the ALJ's consideration of the evidence we find no basis for disturbing his determination that the claimant sustained a compensable injury.

IT IS THEREFORE ORDERED that the ALJ's order dated January 4, 2011 is affirmed.

INDUSTRIAL CLAIM APPEALS PANEL

______________________________ John D. Baird

______________________________ Curt Kriksciun

ACE AMERICAN INSURANCE, Attn: EVELYN BONHAM, C/O: GALLAGHER BASSETT SERVICES, INC., ENGLEWOOD, CO, (Insurer).

FOGEL KEATING WAGNER POLIDORI SHAFNER, Attn: LAURENCE J. FREE, ESQ., DENVER, CO, (For Claimant).

CLIFTON, MUELLER BOVARNICK, PC, Attn: RICHARD A. BOVARNICK, ESQ., DENVER, CO, (For Respondents).


Summaries of

IN THE MTR. OF RAHMAN v. SAVA SENIOR CARE, W.C. No

Industrial Claim Appeals Office
May 17, 2011
W.C. No. 4-811-471 (Colo. Ind. App. May. 17, 2011)
Case details for

IN THE MTR. OF RAHMAN v. SAVA SENIOR CARE, W.C. No

Case Details

Full title:IN THE MATTER OF THE CLAIM OF HASSONI RAHMAN, Claimant, v. SAVA SENIOR…

Court:Industrial Claim Appeals Office

Date published: May 17, 2011

Citations

W.C. No. 4-811-471 (Colo. Ind. App. May. 17, 2011)