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Autozone, Inc. v. Mesa

Court of Appeals of Georgia, Second Division

September 8, 2017


          MILLER, P. J., DOYLE and REESE, JJ.

          REESE, JUDGE.

         The Appellant, Autozone, Inc., seeks review of a judgment of the Superior Court of Columbia County that reversed a ruling of the State Board of Workers' Compensation ("Board"), which denied certain benefits to the Appellee, Eulalia Mesa.[1] The Appellant contends that the superior court misapplied the "any evidence" standard when reviewing the Board's ruling and erred in finding that the Administrative Law Judge ("ALJ"), who initially denied the Appellee's claim, acted "contrary to law." For the reasons set forth, infra, we reverse.

         Viewed in the light most favorable to the Appellant, as the party who prevailed before the Board, [2] the record reveals the following, undisputed facts.[3] In November 2010, while the Appellee was working for the Appellant as a clerk and delivery driver, the truck the Appellee was driving was "rear-ended" by another car, and the accident injured her back and neck. She was treated in an emergency room, followed by outpatient treatment, during which several physicians diagnosed her with neck and lower back pain. Shortly after the accident, the Appellee returned to fully paid, full-time work for the Appellant in a light-duty status, performing only clerical duties because her medication made her too dizzy to drive a delivery truck. In January 2011, a treating physician cleared her to drive the delivery truck, and she resumed her delivery duties for the Appellant.

         The Appellee continued to receive physical therapy for lower back pain and, in February 2011, received a lumbar magnetic resonance imaging ("MRI") scan. After reviewing the lumbar scan, one of the Appellee's physicians, Dr. John Rumbaugh, opined that the scan was "normal." In June 2011, the Appellee was referred to Dr. Allen Goodrich, who determined that her lumbar MRI scan showed a "completely normal disk and spinal canal, " opined that she had reached her maximum medical improvement, and released her to full work duties. Dr. Goodrich's records from August 2011 stated that, in his opinion, the Appellee had no conditions that required surgical intervention.

         In September 2011, the Appellee underwent another lumbar MRI scan. Dr. Amar Rajadhyaksha opined that the scan showed no gross disc herniations, spinal stenosis, or nerve root impingement, nor did it indicate any conditions that could be actively treated. His physical examination of the Appellee showed no focal sacroiliac joint tenderness, and the results of his clinical tests were negative. Based on these findings, he placed the Appellee at maximum medical improvement with no work restrictions and issued a zero percent impairment rating.

         The same month, the Appellee was evaluated by a physical therapist, who opined that, in order to address the Appellee's lower back pain, she needed "skilled rehabilitative therapy in conjunction with a home exercise program, " with visits to the therapist three times a week for four weeks. According to the therapist, the Appellee's "[o]verall rehabilitation potential is good." Despite the recommended frequency of visits, however, the record does not show that the Appellee attended more than one other physical therapy session, which was conducted a week after the first.

         In October 2011, the Appellee saw Dr. Tamar Ference, who ordered MRIs and x-rays of the Appellee's cervical and lumbar spine. The Appellee's cervical spine MRI showed "no significant abnormality." Dr. Ference recommended that the Appellee get physical therapy and that she not work until her condition improved.

         In January 2012, the Appellee was examined by Dr. Jonathan Hyde, who ordered a lateral lumbosacral x-ray that, upon review, he considered to be "normal." He also reviewed two separate MRIs performed in 2011 by prior physicians and found no disc herniations or significant desiccation. Dr. Hyde recommended an electromyogram ("EMG") with nerve conduction study, the results of which were determined to be "unremarkable." Dr. Hyde also performed a diagnostic right sacroiliac joint injection using fluoroscopy, and the Appellee reported that the procedure provided one to two days of significant pain relief. Dr. Hyde opined that the injection was diagnostically positive for sacroiliac dysfunctional pain. Dr. Hyde recommended a surgical fusion of the Appellee's right sacroiliac joint, also known as arthrodesis, and classified her as "off work status." The Appellee declined to undergo the surgery and continued to work for the Appellant until March 2012, when she stopped working, reportedly due to back pain. Dr. Hyde then restricted the Appellee to light-duty work, and she received total temporary disability benefits until April 2012.

         The Appellee had three appointments with Dr. Hyde over the next two and a half years to address her complaints of ongoing back pain. Following the Appellee's visit in May 2012, Dr. Hyde noted that "[t]his patient is fully capable of working within the restrictions given. There is no change in restrictions. The only question is, does she want to go back to work?" During the Appellee's visit in September 2013, Dr. Hyde ordered a lateral lumbosacral x-ray, and he concluded that the image showed no changes from previous images of the same area that were considered "normal." During an appointment with the Appellee over a year later, in December 2014, Dr. Hyde did not conduct any additional tests, although he again noted that the Appellee's lumber MRIs from 2011 were "normal." However, he recommended a surgical sacroiliac joint fusion to address her right-side sacroiliac dysfunction pain. The Appellee decided to have the surgery and sought approval for it under workers' compensation.

         In April 2015, the Appellant sent the Appellee for an independent medical evaluation ("IME") with Dr. Peter Millheiser, who performed a physical examination of the Appellee and reviewed her medical records from other treating physicians, including Dr. Hyde, as well as all of the x-rays, MRIs, and test results. Dr. Millheiser diagnosed the Appellee with a right sacroiliac joint sprain, a cervical sprain, and a lumbar sprain. Still, he found no evidence of sacroiliac dysfunction or permanent impairment. He opined that the Appellee was able to do regular daily activities and regular work without restrictions, and concluded that she was at an "endpoint" in treatment. The Appellee had no other medical appointments or treatment related to her work injury after her examination by Dr. Millheiser in April 2015.

         In addition to these facts, it is undisputed that, although the Appellee was unemployed for two years after leaving her job with the Appellant in March 2012, she became a nanny for a family with a six-year-old boy in March 2014, working six to seven hours per day, five days per week caring for the boy and performing household chores. It follows that the Appellee was employed as a full-time nanny at the time she saw Dr. Hyde in December 2014 and Dr. Millheiser in April 2015, and was still employed there in April 2016, after she filed the instant workers' compensation claim.

         The Appellant denied responsibility for the Appellee's sacroiliac joint fusion surgery, and the parties agreed to have the ALJ resolve the matter on the submission of briefs and documentary evidence alone, without a hearing, as the only issue to be decided by the ALJ was whether the sacroiliac joint fusion surgery was reasonable and necessary. After reviewing the evidence and the briefs, the ALJ denied the Appellee's request for benefits, finding that the surgery was not reasonable or necessary. The ALJ based his finding "particularly" on Dr. Millheiser's opinion that the Appellee had no sacroiliac joint dysfunction as of April 2015. The ALJ explained that he was not persuaded by Dr. Hyde's opinion because Dr. Millheiser's April 2015 opinion was supported by numerous earlier medical opinions finding no joint dysfunction.

         The Appellee appealed to the Board, which adopted the ALJ's decision, finding that the ALJ was in the best position to determine the credibility and weight of evidence in the record. The Board adopted the ALJ's findings of fact on the basis they were supported by a preponderance of competent and ...

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