W.C. No. 4-782-006.Industrial Claim Appeals Office.
May 25, 2011.
FINAL ORDER
The claimant seeks review of an order of Administrative Law Judge Cannici (ALJ) dated August 30, 2010 that denied and dismissed her claim for benefits. We affirm the ALJ’s dismissal of the claim for temporary total disability benefits and his determination that the claimant’s neck condition is not compensable, but set aside the denial of the claim for medical benefits based on the claimant’s carpal tunnel syndrome. We therefore remand this matter for additional findings and a new determination of the claimant’s entitlement to medical benefits related to her carpal tunnel syndrome.
This matter proceeded to hearing to determine whether the claimant sustained a compensable occupational disease and whether she was entitled to temporary total disability benefits and medical treatment. Several of the ALJ’s findings of fact are summarized as follows. The claimant started working for the employer in 2006 as a medical transcriptionist. She began experiencing pain in her elbow, wrist, shoulder, and arm in July 2007. Dr. Vandenhoven evaluated the claimant on July 19, 2007 and diagnosed mild carpal tunnel syndrome in both arms and degenerative disk disease in the cervical area of the claimant’s spine. The claimant obtained medical treatment through personal physicians even after reporting to her employer on September 24, 2008 that she had arm and neck pain. The employer referred the claimant to Dr. Caton who saw the claimant on October 9, 2009. Dr. Caton opined that the claimant’s neck and upper back pain were attributable to her degenerative cervical disease, but Dr. Caton determined that the claimant’s elbow and wrist pain were caused or aggravated by her work activities. The claimant did not follow up with Dr. Caton, but obtained additional medical treatment from her personal physicians. The insurer did not authorize medical treatment with the
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claimant’s personal physicians. The claimant explained that on November 16, 2009 she stopped working for the employer because of neck pain. Dr. Hughes indicated that the claimant’s cervical spine pain was not related to her work, but remarked that the claimant had reached maximum medical improvement for her occupational diseases in the nature of bilateral epicondylitis, bilateral wrist tendonitis, and bilateral carpal tunnel syndrome. Dr. Hughes recommended medical maintenance treatment. Dr. Abston explained that the claimant’s neck and arm pain were not caused by her work, but that the claimant’s work exacerbated her problems. However, Dr. Abston noted that the claimant was not disabled.
The ALJ was persuaded that the claimant’s degenerative cervical condition was not caused by her job duties. However, the ALJ found as follows regarding the claimant’s arm symptoms and the claimant’s disability:
Although doctors have associated Claimant’s bilateral [carpal tunnel syndrome] and arm symptoms with her job duties, the preceding conditions did not cause a disability. Claimant suffered from a mild, benign [carpal tunnel syndrome] and had reached [maximum medical impairment] for her bilateral arm symptoms. Notably, none of the claimant’s physicians have imposed any work restrictions or prohibited her from working. Finally, based on Claimant’s testimony, her non-work-related cervical symptoms constituted the basis for her reduction in hours and ultimate decision to cease working for Employer. Claimant’s non-work-related cervical condition thus caused her disability.
Findings of Fact at 4, ¶ 13. Thus, the ALJ found that the claimant’s carpal tunnel syndrome was work-related, but he denied the claimant any relief because he found the claimant’s disability was caused by her cervical condition, which he found to be unrelated to the claimant’s work. The ALJ therefore denied and dismissed the claim.
The claimant argues that she is entitled to medical benefits based on her carpal tunnel syndrome found by the ALJ to be work-related See § 8-40-201(14), C.R.S. (defining “occupational disease”). We conclude that the ALJ must consider the claimant’s request for medical benefits based on his factual findings to the effect that the claimant sustained an occupational disease in the nature of carpal tunnel syndrome. The ALJ denied the claimant relief regarding her carpal tunnel syndrome on the ground that the condition was not disabling. However, “a claimant suffering from an occupational disease is entitled to reasonably necessary medical benefits, even if the disease has not yet become disabling.” Wal-Mart Stores, Inc. v. Industrial Claim Appeals Office, 989 P.2d 251, 953 (Colo. App. 1999).
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It is unclear to what extent the claimant may be entitled to medical benefits, especially in light of the ALJ’s finding that the claimant reached maximum medical improvement for her carpal tunnel syndrome in accordance with Dr. Hughes’ opinion. We therefore remand this matter to the ALJ to determine what medical benefits, if any, that the claimant is entitled to receive for her carpal tunnel syndrome.
IT IS THEREFORE ORDERED that the ALJ’s order dated August 30, 2010 is affirmed to the extent it denied benefits based on the claimant’s cervical spine condition, but we set aside the denial of medical benefits related to the claimant’s carpal tunnel syndrome and remand this matter to the ALJ, accordingly.
INDUSTRIAL CLAIM APPEALS PANEL
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John D. Baird
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Curt Kriksrum
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CERTIFICATE OF MAILING
SHARON MOSS, 4325 WAPITI WAY, EVANS, CO, (Claimant).
CBAY SYSTEMS HOLDINGS LIMITED, Attn: LINDA SHAW, MT. LAUREL, NJ, (Employer).
NEW HAMPSHIRE INSURANCE COMPANY, Attn: ELLEN SAPP, C/O: CHARTIS, P O BOX 25971, SHAWNEE MISSION, KS, (Insurer).
LAW OFFICES OF REGINA M. WALSH ADAMS, Attn: REGINA M. WALSH ADAMS, ESQ., BUILDING G-1, GREELEY, CO, (For Claimant).
TREECE, ALFREY, MUSAT BOSWORTH, Attn: CHRISTOPHER P. AHMANN, ESQ., DENVER, CO, (For Respondents).
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