Workers’
Compensation Board
OPINION
ENTERED: September 30, 2016
CLAIM NO. 201594472
FORD MOTOR COMPANY (LAP) PETITIONER
VS. APPEAL FROM HON. STEVEN
G. BOLTON,
ADMINISTRATIVE LAW JUDGE
LAVERN FRANK DEEDS and
HON. STEVEN G. BOLTON,
ADMINISTRATIVE LAW JUDGE RESPONDENTS
OPINION
AFFIRMING
*
* * * * *
BEFORE: ALVEY, Chairman, STIVERS and RECHTER, Members.
ALVEY,
Chairman. Ford Motor Company (LAP) (“Ford”)
appeals from the Opinion, Award and Order rendered April 18, 2016 by Hon.
Steven G. Bolton, Administrative Law Judge (“ALJ”) awarding Lavern Frank Deeds
(“Deeds”) temporary total disability (“TTD”) benefits, permanent partial
disability (“PPD”) benefits, and medical benefits for bilateral carpal tunnel
syndrome. The ALJ dismissed Deeds’
cubital tunnel syndrome claim. Ford also
seeks review of the June 14, 2016 order denying its petition for reconsideration. On appeal, Ford argues Dr. Jeffery Fadel’s
opinion regarding causation does not constitute substantial evidence supporting
the ALJ’s determination. We disagree and
affirm.
Deeds
filed a Form 101 alleging he developed symptoms in both arms and hands due to
the repetitive nature of his job duties with Ford. Deeds listed the date of injury as October
14, 2014. Deeds began working for Ford
on January 6, 2014. Prior to that, Deeds
had previously worked in the banking industry beginning in 1984.
Deeds
testified at the final hearing held February 17, 2016. Deeds, who is fifty-four years old, worked as
a driver and front door panel installer for Ford. Deeds stated he retrieved a door panel from a
bin, and while holding it with his left hand, he connected it to the door frame
with his right hand. He then pushed in
eight to ten pins using the palms of his hands as hammers. Some of these pins required approximately
forty-five to fifty-five pounds of pressure to push in. Deeds’ position was considered an ergonomic
job and he was supposed to alternate the door job with two other
employees. Deeds stated he was required
to work continuously for thirty minutes, followed by an hour break. Deeds estimated he completed forty-five door
panels every thirty minutes and he worked ten hour shifts. Deeds considered his job tasks highly
repetitive. Deeds denied having any
previous injuries to either wrist.
Deeds
began experiencing swelling and pain in his hands in mid-September 2014. He eventually sought treatment at Ford’s
medical facility on October 14, 2014.
Ford referred him to Dr. David Tate, who recommended surgery. Deeds sought a second opinion from Dr. Huey-Yuan
Tien in January 2015, who ultimately performed surgery on his left upper
extremity on May 28, 2015. Deeds
declined surgery on his right upper extremity.
Deeds
continued to work regular duty at Ford until he was assigned restrictions in
mid-January 2015 by Dr. Tate and subsequently by Dr. Tien. For the first week on restricted duty, he
swept the floors. For the next two
weeks, he monitored cords on the line.
He was then sent to another line to close windows, which increased the
symptoms in his hands. The following
day, Deeds was sent home with no work available on February 4, 2015. Deeds attempted to return to work in early
June after his surgery. He was placed on
a job requiring repetitive use of his right arm which he had also injured and
for which he had restrictions. Deeds
could only complete part of two shifts.
He ceased working for Ford on August 5, 2015, and subsequently lost his
health insurance. Ford paid Deeds TTD
benefits from February 4, 2015 through April 28, 2015.
Deeds
worked fifteen to twenty hours a week as a gas station cashier for Kroger
beginning in July 2015 for approximately seven weeks. He also worked as an Uber driver. On December 7, 2015, Deeds began working
full-time for Republic Bank reviewing mortgage loans, earning fifteen dollars
an hour. He continues to drive for Uber
on a limited basis. Despite his
post-injury employment, Deeds has not earned the same or greater wages he
earned while employed at Ford.
Deeds
continues to experience symptoms in both hands, but more so on the right. Based on his restrictions and limitations,
Deeds does not believe he can return to his pre-injury job with Ford. Deeds acknowledged his family physician, Dr.
Robert Palmer-Ball, currently prescribes Synthroid for his thyroid condition
which he believes is stable.
Both
parties submitted records from Ford Motor Company OHSIM. On October 21, 2014, Deeds
reported he had experienced bilateral hand pain, swelling and numbness for two
or three weeks. Pamela Thomas, RN, noted
Deeds was required to push pins into door frames with fifty to ninety pounds of
pressure using the palms of his hands.
Deeds was diagnosed with sprains/strains to the hands and returned to
work without restrictions. On January
16, 2015, Dr. Ring Tsai noted Deeds had recently treated with Dr. Tate. On June 9, 2015, Deeds was restricted from
using his left hand through July 14, 2015 and was advised to not repetitively
use his right hand.
Ford
filed the January 6, 2015 record of Dr. Tate, noting Deeds attributed his
bilateral hand complaints to his work activities with Ford. Dr. Tate assessed numbness and tingling in
both hands. He discussed with Deeds,
“that in fact the cause of nerve entrapment is not known, but rather the
patient had noticed his symptoms at work and reported them to his place of work
and was therefore covered by Workmen’s Compensation.” He temporarily restricted Deeds from pushing
and lifting over ten pounds with his hands.
Dr. Tate did not believe Deeds was a candidate for surgery, and
recommended he obtain a second opinion.
The
May 28, 2015 operative report from Klienert Kutz Surgery Center indicates Deeds
had left carpal tunnel syndrome, and a left carpal tunnel release was performed
by Dr. Tien.
Ford
filed the records of Dr. Palmer-Ball. On
January 2, 2015, Deeds reported swelling, tenderness, decreased range of motion
in both hands, as well as numbness and tingling in his fingertips. Dr. Palmer-Ball indicated Deeds probably does
in fact have carpal tunnel syndrome, “which may be somewhat related to his
job. There may be additional factors
which have been overlooked. Patient has
not had labs in quite some time.” Deeds
returned on January 5, 2015. Dr.
Palmer-Ball noted Deeds “has marked edema in his eyes face neck extra lower
extremities. Patient had lab work
done. Patient was found to have acute
renal insufficiency. Patient was also
found to have hypothyroidism with a TSH of 95.”
Dr. Palmer-Ball primarily diagnosed hypothyroidism, as well as acute
renal insufficiency, goiter, edema, and hypertension. He prescribed Synthroid to treat Deeds’
hypothyroidism and restricted him from work.
Deeds followed up with Dr. Palmer-Ball for hypothyroidism on February 2,
2015, March 2, 2015, May 7, 2015 and July 14, 2015, who continued to prescribe
Synthroid.
Ford
filed the April 7, 2015 report of Dr. Richard DuBou, who examined Deeds at its
request. Dr. DuBou reviewed Deeds’ job
tasks with Ford. He noted the results of
an EMG/NCV study revealed severe nerve abnormalities in both major nerves of
both upper extremities. Dr. DuBou noted
when there is more than one nerve involved in the upper extremity, “one very
often looks for systematic causes rather than occupation causing all major nerves
in both upper extremities to show marked abnormalities.” Dr. DuBou also discussed the 2nd
Edition of AMA Guides to the Evaluation of Disease and Injury Causation. Among other causes, it lists high BMI and
thyroid disease as non-occupational risks factors for median nerve entrapment
of the wrist. In this instance, Dr.
DuBou noted Deeds has a BMI of 32.1 and is being treated for hypothyroidism.
Dr.
DuBou noted discrepancies between what Deeds reported concerning his visit with
Dr. Tate and the corresponding treatment record. Dr. DuBou reviewed Deeds’ treatment with Dr.
Tien, who diagnosed bilateral carpal tunnel and cubital tunnel syndrome. Dr. Tien specifically stated hypothyroidism
might aggravate, but does not cause, carpal tunnel pathology or symptoms. Dr. DuBou stated medical literature is at
odds with Dr. Tien’s opinion.
Dr.
DuBou noted Deeds has bilateral cubital tunnel syndrome and carpal tunnel
syndrome, both of which became symptomatic at the same time. Dr. DuBou stated, “[t]hat in and of itself
indicates something other than work may very well be involved.” After performing an examination, Dr. DuBou
opined as follows regarding causation:
With all four nerves in both upper
extremities, both median nerves and both ulnar nerves which are the main nerves
involved in the upper extremities . . . causation would have to be a systematic
condition. There would certainly be a
question if there was only one nerve involved, but with all four involved, I would
have to agree with Dr. Tate rather than Dr. Tien.
Dr.
DuBou opined although surgery on both hands is necessary, the procedures are
not work-related. He anticipated Deeds
would reach maximum medical improvement (“MMI”) twenty weeks following the last
surgery. He also assigned restrictions.
In
a supplemental letter dated April 28, 2015, Dr. DuBou clarified he does not
believe Deeds’ work activities caused his conditions because he has a high BMI
and acute hypothyroidism with documented, marked edema. He also stated there is no association of
work to cubital tunnel syndrome. In
spite of that, Deeds has some abnormality in each of the two major nerves in
both upper extremities. Ford also filed
the literature relied upon by Dr. DuBou on December 4, 2015.
Dr.
DuBou re-examined Deeds on November 27, 2015 subsequent to the May 2015
procedure. He again diagnosed bilateral
carpal tunnel and cubital tunnel syndrome, neither of which he related to
Deeds’ work activities with Ford. Dr.
DuBou noted although automobile assembly line work is one of the three most
common occupational causes of carpal tunnel, Deeds was only in that position at
Ford for ten months. Dr. DuBou
reaffirmed his belief the vast majority, if not all, of Deeds’ carpal tunnel
pathology is due to underlying non-work-related obesity and
hypothyroidism. Regardless of causation,
Dr. DuBou assessed a 2% impairment rating pursuant to the American Medical
Association, Guides to the Evaluation of Permanent Impairment, Fifth
Edition (“AMA Guides”), for the left carpal tunnel release
procedure.
Deeds
filed the September 17, 2015 report of Dr. Fadel. He reviewed Deeds job tasks as a line
operator with Ford and the treatment records.
After performing an examination, Dr. Fadel diagnosed bilateral carpal
and cubital tunnel syndrome caused from hypothyroidism and work. He stated as follows regarding causation:
It is my medical opinion that the cubital
tunnel syndromes at the elbow were not work related and that those problems
were solely caused from the hypothyroidism.
The carpal tunnel and resultant median nerve compression to both wrists
was probably caused by both his work and the hypothyroidism and should be
apportioned, in my view, to a 50/50 ratio.
Dr.
Fadel declined to assess an impairment rating for the left upper extremity since
Deeds had yet to attain MMI from the May 28, 2015 surgery, which he anticipated
would not be reached until one year after the procedure. Dr. Fadel assessed a 13% impairment rating
for the right upper extremity pursuant to the AMA Guides. He apportioned 7% to his work activities with
Ford and 6% to non-work-related hypothyroidism.
Dr. Fadel also imposed restrictions.
Dr.
Fadel re-examined Deeds on February 9, 2016.
He stated Deeds attained MMI from the left carpal release procedure in
January 2016. Dr. Fadel assessed a 6%
impairment rating pursuant to the AMA Guides for the left carpal tunnel
syndrome after surgical intervention, attributing 3% to Deeds’ work
activities. Therefore, Dr. Fadel noted
the 7% impairment rating for the right upper extremity and the 3% impairment
rating for the left upper extremity combined for a total impairment rating of
10% pursuant to the AMA Guides.
In
his April 18, 2016 opinion, the ALJ noted Deeds conceded his bilateral cubital
tunnel syndrome is not work-related. The
ALJ accepted Deeds’ testimony concerning the onset of his carpal tunnel
condition as accurate, as well as his description of his job duties as a front
door installer, his testimony that his symptoms began in mid-September, and the
fact he never had any previous injuries to his wrists. The ALJ made the following analysis regarding
causation/work-relatedness:
I have relied
on the medical opinion of Dr. DuBou in many cases and have the greatest respect
for him and for his professional abilities. However, in this case, I felt that
for unknown reasons, he has given indications in his reports that he felt the
need to advocate for the employer. From his first report letter, it is clear
that he had extensive discussions with the adjuster handling the claim
concerning the alleged facts of the case prior to his initial examination of
Mr. Deeds. As I noted in my summation herein, Dr.
DuBou and Mr. Deeds apparently had a difference of opinion as to whether Deeds
was accurately describing the assignment of work. It is apparent from the
report that the doctor had been fully briefed by the adjuster before he
performed his examination as he confronted Mr. Deeds with information that the
doctor thought had been withheld in Deed’s initial representations. The same
thing is true of the circumstances under which Mr. Deeds left Ford. Dr. DuBou
may think Mr. Deeds was lying, but his apparent attempt at cross-examination
damages his credibility in my mind. I hasten to state that I make no accusation
of ethical impropriety against the doctor, but for me his aggressiveness in
this regard makes me fear that his objectivity may have suffered due to an
evident dislike for the examinee.
At the
request of the Defendant, Dr. Richard Dubou performed an IME on April 7,
2015. As part of his report, Dr. Dubou
specifically notes the findings of Dr. Tien at Kleinert and Kutz: “Dr. Tien
specifically dictated a note that hypothyroidism does not cause carpal tunnel
pathology.” Per Dr. Dubou, “[h]e stated
it [hypothyroidism] might aggravate his symptoms but NOT cause the
symptoms.” Dr. Dubou also quotes Dr.
Tien as stating, “[h]is symptoms he stated are work related.”
Despite the
statements of Dr. Tien, Dr. Dubou nevertheless leans in favor of a
non-work-related diagnosis, stating “with all four nerves in both upper
extremities, both median and both ulnar nerves which are the main nerves
involved in the upper extremities as per the diagram I included in this letter,
causation would have to be a systemic condition.” Dr. Dubou questioned Dr. Fadel’s opinion
because there was no accounting for the fact that the carpal tunnel syndrome
(that could be work related) and the cubital tunnel syndrome (that could not be
work related) seemed to appear simultaneously. We don’t know the answer to that
question unless we posit that neither condition was related to the work. But
that approach does not reconcile how the assembly line work that the Plaintiff
was performing which is known to cause carpal tunnel, did not play a role in
the Plaintiff’s diagnosis.
Dr. Jeffrey
Fadel, an orthopedic surgeon, performed an IME dated April 7, 2015, and a
follow-up exam on February 9, 2016. Dr.
Fadel noted a detailed history of the Plaintiff’s job duties. Dr. Fadel determined that the Plaintiff’s
bi-lateral carpal tunnel injuries are work-related. However, Dr. Fadel did not ignore the fact
that the Plaintiff was diagnosed with hypothyroidism which can be a
contributing factor for carpal tunnel.
Taking into consideration both the extreme repetitive nature of the
Plaintiff’s assembly line position, and the underlying disease, Dr. Fadel
determined that a causation apportionment between the two is most
appropriate. As such, Dr. Fadel
apportioned his impairments 50/50.
This is a
very close case. I respect Dr. DuBou’s opinion, but I believe that the weight
of the lay and medical evidence supports a finding of work-relatedness. The only opinion of record that contains a
specific finding of non-work-relatedness is the IME Report of Dr. DuBou.
In his
report, Dr. Dubou, who freely acknowledges the universal acceptance in the
medical community that automobile assembly line work can cause carpal tunnel
syndrome, offers no substantial rationale as to how in this case the Plaintiff’s
work was not a causal factor at all.
While many of
the physicians of record recognize hypothyroidism as a potential contributing
factor, Dr. Dubou is the only physician to place the sole blame on the
underlying disease...completely ignoring the highly repetitive assembly
work. Dr. Robert Palmer-Ball, Dr. Henry
Tien, the Ford doctors, and Dr. Jeffrey Fadel, all recognize and opine that
there is an occupational aspect to the development of the Plaintiff’s carpal
tunnel. As pointed out by the plaintiff,
although Dr. David Tate does address the unknown nature of causation in his
medical record, he does not opine
that the condition is unrelated to work.
Based upon
the totality of the lay and medical evidence of record, I feel compelled to
find the Plaintiff’s injuries are the partial result of his strenuous and
repetitive physical work duties as opined by Dr. Fadel, whose medical opinion I
find to be persuasive in this case.
While the hypothyroidism must surely have been a contributing factor
that made the Plaintiff more susceptible to nerve neuropathy, it is known that
highly repetitive assembly line work causes carpal tunnel. However, that
contributory factor was recognized by Dr. Fadel in his opinion and factored
into his considerations in the assignment of a WPI rating. All examining and
treating physicians seem to agree that the hypothyroidism and edema arose
separately and independent of any traumatic injury.
The ALJ relied upon Dr.
Fadel in finding Deeds sustained work-related bilateral injuries to his upper
extremities resulting in carpal tunnel syndrome, and warranting a 10%
impairment rating pursuant to the AMA Guides. The ALJ determined Deeds attained MMI on
July 16, 2015. The ALJ awarded PPD
benefits, TTD benefits, and medical benefits.
Ford filed a petition
for reconsideration requesting a correction of the onset date for the award of
TTD benefits. Ford also challenged the
ALJ’s statement he could find no other substantiation for Dr. DuBou’s statement
Deeds decided not to return to work for Ford.
Ford requested the ALJ reconsider his factual findings in light of the
actual requirements of Deeds’ job as he described them, rather than the
generalized statement his type of work is of the kind medical literature agrees
is a common cause of carpal tunnel syndrome.
Ford additionally took issue with the fact the ALJ did not address Dr.
DuBou’s question of how both the carpal tunnel and cubital tunnel conditions
arose at the same time, but from two different causes. Ford requested the ALJ make additional
findings of fact, taking into account Deeds’ specific work duties, and the
impact this has on his causation analysis.
After correcting the
clerical error pointed out by Ford, the ALJ stated as follows in the June 14,
2016 Order denying the remainder of its petition:
Defendant’s
next allegation of error has to do with my observation about Dr. DuBou’s
11/24/2015 IME report whereby I opined that I could find “no other
substantiation” for Dr. DuBou’s notation to that effect. Of course there is
other substantiation in the record as to Mr. Deeds making that statement. I
myself noted it at page 27 of the Opinion, Award and Order. Counsel has
misapprehended my meaning.
When I used
the term “no other substantiation,” the substantiation to which I was referring
was Dr. DuBou’s reason for making that point in his medical report. Whether the
comment was elicited by the examiner or simply volunteered by Mr. Deeds, it had
nothing to do with a diagnosis and I could not understand why the examining
physician thought it relevant. It will be recalled that my concern was that Dr.
DuBou was seemingly partisan in his comments concerning the claimant, which to
my understanding is not the role of an independent examiner. I would have made
the same observation (and have on several occasions) if I thought I detected a
similar attitude on the part of an examiner for a claimant.
As to
Defendant’s other arguments, they [sic] incorrectly state the role of the ALJ
in the fact-finding process. While it is true that the ALJ is frequently called
upon to decide issues of work-relatedness/causation, Defendant goes through a
lengthy exercise of describing the various work activities of the claimant,
then suggesting that I ignored the scope of his activities in making an
over-generous assignment of disability. While I am flattered by the scope of
knowledge imputed to me, that is not within the scope of my powers.
Sometimes the
review of work relatedness/causation issues goes to the simple fact of whether
the claimant was on the job and performing same when his alleged injury was
suffered. However, in this case, there is no issue as to his presence and work.
It is whether the work, by its very nature is, within the realm of reasonable
medical probability, the proximate cause of Plaintiff’s injury.
I am not a
physician. Every human organism has similarities, but also differences.
Sufficient cumulative trauma to cause injury in one person could be harmless to
another person. I am not qualified to say which is which. That is why we rely
on expert medical testimony.
I have
reviewed carefully all of the medical testimony herein. I have written what I
hope is a thorough discussion of my reasons for believing certain parts of that
testimony over others. I did not find the medical testimony of Dr. DuBou to be
persuasive. I did find the medical testimony and opinion of Dr. Fadel to be
persuasive. Any “inferences” I relied upon were described in my analysis of the
medical evidence. Perhaps a closer perusal of it will be instructive. Defendant
Employer’s allegation of error patently appearing on the face of the Opinion,
Award & Order is a disagreement with my interpretation of the medical
evidence in the record, which is not within the scope of my review under the
provisions of KRS 342.281. Francis v.
Glenmore Distilleries, 718 S.W.2d 953 (Ky.App. 1986).
Consequently,
with the exception of the technical correction made herein above, I find no
error patently appearing on the face of the Opinion, Award and Order of April
18, 2016. KRS 342.281.
On appeal, Ford argues
Dr. Fadel’s opinion regarding causation cannot constitute substantial
evidence. It states Dr. Fadel opined
hypothyroidism played a partial role in causing Deeds’ carpal tunnel syndrome,
but solely caused his cubital tunnel syndrome.
However, all of Deeds’ complaints began at the same time. Ford also states the ALJ incorrectly stated
he felt Dr. DuBou ignored Deeds’ job as a cause, arguing Dr. DuBou simply ruled
out his job as a cause after considering his short employment. Ford asserts Dr. DuBou could not reconcile
Deeds’ job caused one condition and not the other when both appeared at the
same time. Dr. Fadel concluded the
cubital tunnel syndrome is solely due to an unrelated conditions and the carpal
tunnel syndrome is 50% work-related despite the fact it consists of the same
symptoms. Ford insists this defies
logic, and Dr. Fadel offered no explanation for his 50/50 apportionment.
As the claimant in a
workers’ compensation proceeding, Deeds had the burden of proving each of the
essential elements of his cause of action, including
work-relatedness/causation. See KRS 342.0011(1); Snawder v. Stice,
576 S.W.2d 276 (Ky. App. 1979). Since
Deeds was successful in his burden, the question on appeal is whether
substantial evidence supports the ALJ’s decision. Wolf Creek Collieries v. Crum, 673
S.W.2d 735 (Ky. App. 1984). “Substantial evidence” is defined as evidence
of relevant consequence having the fitness to induce conviction in the minds of
reasonable persons. Smyzer v. B. F.
Goodrich Chemical Co., 474 S.W.2d 367 (Ky. 1971).
Causation is a factual issue to be
determined within the sound discretion of the ALJ as fact-finder. Union Underwear Co. v. Scearce, 896
S.W.2d 7 (Ky. 1995); Hudson v. Owens, 439 S.W.2d 565 (Ky. 1969). An ALJ is vested with broad authority to
decide questions involving causation. Dravo Lime Co. v. Eakins, 156 S.W.3d
283 (Ky. 2003). Where the evidence is
conflicting, the ALJ, as fact-finder, has the discretion to pick and choose
whom and what to believe. Caudill v.
Maloney’s Discount Stores, 560 S.W.2d 15 (Ky. 1977). The Board, as an appellate tribunal, may not
usurp the ALJ’s role as fact-finder by superimposing its own appraisals as to
the weight and credibility to be afforded the evidence or by noting reasonable inferences which otherwise
could have been drawn from the record. Whittaker v. Rowland, 998
S.W.2d 479, 481 (Ky. 1999). So long as
the ALJ’s ruling with regard to an issue is supported by substantial evidence,
it may not be disturbed on appeal. Special Fund v. Francis,
708 S.W.2d 641, 643 (Ky. 1986).
In this
instance, both Drs. Fadel and DuBou agreed, and Deeds conceded, the bilateral
cubital tunnel syndrome is wholly unrelated to his work activities with
Ford. However, Drs. Fadel and DuBou
offered differing medical opinions addressing the cause of Deeds’ bilateral carpal
tunnel syndrome. Dr. Fadel’s opinion
constitutes substantial evidence supporting the ALJ’s determination Deeds’ carpal tunnel
syndrome is partially casually related to his work activities at Ford. Dr. Fadel reviewed the medical records,
including those of Dr. Palmer-Ball who began treating Deeds’ hypothyroidism in
January 2015. Dr. Fadel diagnosed bilateral carpal and cubital tunnel syndrome
caused from hypothyroidism and work. He
opined the cubital tunnel syndromes were solely due to the unrelated
hypothyroidism. However, he opined the carpal
tunnel condition was caused by both his work and the hypothyroidism, and
apportioned 50% of his occupational disability to his work activities.
After considering
the opinion in its entirety, it is clear the ALJ believed, from the evidence,
Deeds’ carpal tunnel syndrome was partially caused by his repetitive work
activities with Ford. As noted by the
ALJ, Dr.
Palmer-Ball, Dr. Tien, the Ford doctors, and Dr. Fadel, all opined there is an
occupational aspect to the development of Deeds’ condition. This, in conjunction with the opinion of Dr.
Fadel, constitutes substantial evidence supporting
the ALJ’s determination. The ALJ correctly understood the evidence
before him regarding causation, weighed that evidence, and
determined Deeds met his burden of proof on the issue of causation. The ALJ, as fact-finder, has full discretion
to determine the physician or physicians upon whom he relies. If “the physicians in a case genuinely
express medically sound, but differing opinions as to the severity of a
claimant's injury, the ALJ has the discretion to choose which physician's
opinion to believe.” Jones v. Brasch-Barry General Contractors, 189
S.W.3d 149, 153 (Ky. App. 2006).
Accordingly, the April 18, 2016 Opinion, Award and
Order and the June 14, 2016 order on petition for reconsideration by Hon.
Steven G. Bolton, Administrative Law Judge, are hereby AFFIRMED.
ALL
CONCUR.
COUNSEL
FOR PETITIONER:
HON JOHANNA F ELLISON
300 WEST VINE ST, STE 600
LEXINGTON, KY 40507
COUNSEL
FOR RESPONDENT:
HON NICHOLAS MURPHY
401 WEST MAIN ST, STE 1910
LOUISVILLE, KY 40202
CHIEF
ADMINISTRATIVE LAW JUDGE:
HON ROBERT L SWISHER
657 CHAMBERLIN AVENUE
FRANKFORT, KY 40601