Employer Ordered to Pay for Cervical Myelopathy

The worker, a short haul freight driver, hit his head while in the employ of the defendant when moving out from underneath a trailer.  He was dazed and suffered a cut to his head but completed his route that day.  He continued to work his regular shifts, “without incident” until he began experiencing symptoms in his lower extremities a number of days later.  Then while at the bank preparing for vacation, he described upper extremity symptoms.  His arms felt heavy and weak.  His hands were numb and unresponsive.  On his vacation, the claimant traveled via motorcycle to South Dakota.  While in South Dakota, his symptoms worsened, his balance was off, he could not walk well and he was unable to return on his motorcycle.  A neurosurgeon at Fletcher Allen Health Care diagnosed him with a disc herniation that was pressing on the spinal cord rather than a nerve root (cervical spondylotic myelopathy) and performed a disc excision and fusion.  He opined the claimant suffered a disc herniation when he hit his head on the underside of the trailer and over the subsequent three weeks he developed the progressive cervical myelopathy.  The employer denied the surgery utilizing a medical opinion that the disc herniation was the result of a natural degenerative process in the claimant’s cervical spine.  The employer’s expert relied on the radiographs of the claimant’s cervical spine taken on the date of the injury which showed an advanced degenerative process, in support of his position.  He also opined that the motorcycle trip was a more likely cause of an aggravation of the pre-existing condition due to the relationship between the trip and the worsening of symptoms. Cain v. New Penn Motor Express, Inc., Op. No. 12-13WC (2013).

The Department of Labor concluded that the treating doctor’s opinion was more credible than the employer’s expert, relying heavily on the “clarity, thoroughness and objective support underlying the opinion.” See Geiger v. Hawk Mountain Inn, Op. No. 37-03 (2003) (citing the five-part test for assessing physician credibility: (1) the nature of the treatment and the length of time there has been a patient-provider relationship; (2) whether the expert examined all the pertinent medical records; (3) the clarity, thoroughness and objective support underlying the opinion; (4) the comprehensiveness of the evaluation; and (5) the expert’s qualifications). The claimant’s doctor adequately explained how the progression of symptoms, though intermittent, explained the worsening of the myelopathy subsequent to the injury.  The defendant’s expert did not adequately address how the motorcycle trip was the cause of the injury when the symptoms began prior to the trip and could not explain what specific elements of the trip were responsible for the causal relationship.  Cain v. New Penn Motor Express, Inc., Op. No. 12-13WC (2013).