Pulliam v. Mississippi State Hudspeth Regional Center
Docket: No. 2013-WC-00409-COA
Court: Court of Appeals of Mississippi; May 20, 2014; Mississippi; State Appellate Court
On January 23, 2007, Sara Pulliam filed a petition with the Mississippi Workers’ Compensation Commission, claiming compensable injuries to her back, right shoulder, and overall body sustained on March 26, 2006, while working as a direct care worker at the Mississippi State Hudspeth Regional Center. Hudspeth acknowledged the back and shoulder injuries but contested their severity and disputed the connection of Pulliam’s Chiari malformation and cervical spine issues to her work injury. An administrative judge (AJ) determined that Pulliam reached maximum medical improvement (MMI) on July 1, 2006, found she did not demonstrate permanent disability from her injuries, assessed her average weekly wage at $296.01, and ruled that her cervical spine and Chiari conditions were not work-related. Additionally, some of her claims were dismissed due to the statute of limitations, though Hudspeth was deemed responsible for medical expenses related to her right shoulder and lumbar injuries.
Pulliam appealed the Commission’s affirmation of the AJ’s decision, arguing errors concerning the admission of a medical report, lack of substantial evidence for the Commission's findings, and the statute of limitations on her claims, as well as Hudspeth's responsibility for certain medical expenses. Upon review, the court upheld the Commission’s finding regarding the non-causal relationship of Pulliam’s Chiari symptoms and cervical spine issues to her work injury, affirming Hudspeth’s limited responsibility for medical expenses. However, it identified an error in the AJ's consideration of unauthenticated medical evidence, which significantly impacted findings on MMI and permanent disability benefits. Consequently, the court reversed these specific findings and remanded the case to the Commission for further proceedings.
Pulliam had been employed at Hudspeth since 2004, previously working in other roles prior to her injury on March 26, 2006, while assisting coworkers with a patient. Following the incident, she reported pain, was diagnosed with a lumbar strain, and re-injured herself shortly after. During the AJ hearing, Pulliam described her job duties, emphasizing the physical demands of lifting, walking, and bending, and insisted she performed her duties unaided before the injury.
Pulliam experienced an injury that led her to miss work and receive workers’ compensation benefits for about a month. Upon returning, she was assigned to an earlier shift at Hudspeth, which involved increased physical demands, including more lifting and walking, aggravating her injury and pain, ultimately resulting in her termination after she exhausted leave time. Following her termination, Pulliam attempted to find employment, contacting around forty potential employers, but only completed five applications due to employers not accepting applications. She continues to suffer from persistent pain in her shoulder and back, limiting her ability to sit or stand for extended periods and finding no relief from medication.
Glover, Pulliam’s supervisor, confirmed that Pulliam had no performance issues before her injury, noting the demanding physical nature of the direct care worker (DCW) position. Dr. Ozborn, Pulliam's long-time physician, diagnosed her with lumbosacral strain after her injury and later noted an exacerbation of her condition following her return to work. By November 2006, Pulliam reported radicular pain, leading to an MRI that revealed a disc protrusion and a Chiari malformation. Dr. Ozborn indicated that the disc protrusion could be responsible for her leg pain and designated Pulliam as at maximum medical improvement (MMI) in September 2007, concluding with reasonable medical certainty that she was totally disabled from any work activity.
On April 2, 2008, Pulliam underwent an employer medical examination conducted by Dr. John Davis at Hudspeth’s request. Dr. Davis concluded that Pulliam’s Chiari malformation and cervical spine issues were unrelated to any work injury, while her ongoing thoracic and lumbar pain, along with left leg discomfort, were linked to her work injury. He deferred questions regarding work restrictions and impairment to a treating physician.
Despite Pulliam's objections, the AJ considered a report from Dr. David Collipp, who performed a second independent medical examination on November 21, 2008. Dr. Collipp diagnosed Pulliam with a lumbar strain and some thoracic involvement but found no aggravation of her pre-existing conditions. He stated that her injury likely reached maximum medical improvement (MMI) around July 1, 2006, although she continued to experience pain. Collipp assigned her a permanent-partial impairment rating of two percent due to persistent pain but determined that she did not have permanent restrictions from the lumbar or thoracic strain. He assessed that Pulliam could perform light to medium work, lifting up to 35 pounds, unrelated to her previous surgeries or complaints. Pulliam objected to Dr. Collipp's report's admission due to lack of authentication.
The standard of review for workers’ compensation cases is established: the court checks if the Commission's decision was backed by substantial evidence, was arbitrary, exceeded agency authority, or violated rights. The Commission is regarded as the ultimate fact-finder. Pulliam argued that the AJ erred by admitting Dr. Collipp's report without proper authentication, while Hudspeth maintained that the report was valid as it was attached to Dr. Davis's report accompanied by an affidavit from his medical-records custodian.
Mississippi Code Annotated section 71-3-61 grants the Commission authority to establish and enforce rules necessary for effectively managing its responsibilities. The Commission can also expand the record scope and relax discovery rules in hearings, as highlighted in case law. However, due process requires the Commission to adhere to its procedural principles in handling workers’ compensation claims.
Procedural Rule 9 allows medical records from physicians to be introduced as evidence instead of direct testimony under specific conditions: (1) written notice must be provided to opposing parties and the Commission at least 30 days before the hearing, which can be fulfilled via a prehearing statement; (2) the medical records must accompany this notice; (3) a sworn statement from the physician or their records custodian confirming the records' authenticity is required; and (4) the content of the records is subject to the same objections regarding relevance and competency as if the physician were present to testify.
In this case, Hudspeth informed Pulliam of its intent to introduce Dr. Collipp’s report, but failed to attach the necessary affidavit or report to the notice. The notice was included in Hudspeth’s pre-hearing statement. At the hearing, Hudspeth submitted an exhibit containing reports from both Dr. Davis and Dr. Collipp, but only Dr. Davis’s records custodian's affidavit was included, lacking any from Dr. Collipp. The record does not clarify how Dr. Collipp’s report was included with Dr. Davis’s, nor does it establish that Dr. Davis referred Pulliam to Dr. Collipp for treatment. Instead, Dr. Davis recommended that Pulliam seek treatment from a specialist in physical or rehab medicine. Following a Commission order, Pulliam visited Dr. Collipp, who then sent his report to Hudspeth’s attorney, who compiled the exhibit.
Pulliam objected to the use of an affidavit from Dr. Davis’s medical-records custodian to authenticate Dr. Collipp’s report. Hudspeth argued that since Dr. Davis and Dr. Collipp work at the same clinic, the affidavit should be considered valid for both reports. Additionally, Hudspeth claimed Pulliam waived her objection by not raising it within fifteen days of notice. However, the affidavit only authenticates Dr. Davis’s report, and there is no evidence that Dr. Collipp’s report was shared with Dr. Davis or that the same medical-records custodian served both doctors. Consequently, Hudspeth failed to authenticate Dr. Collipp’s report properly.
Regarding the waiver argument, it was established that Pulliam was unaware of Hudspeth’s intention to use the affidavit until the hearing, meaning her objection was timely as the fifteen-day period had not elapsed. The Administrative Judge (AJ) erred by admitting Dr. Collipp’s report without proper authentication. The dissent's assertion that Pulliam waived her right to object is unsupported by the record. The AJ's reliance on Dr. Collipp’s report in determining Pulliam's entitlement to disability benefits led to the Commission's decision being reversed, and the case is remanded for reevaluation of Pulliam's disability benefits using properly authenticated evidence.
Additionally, Pulliam argues that the AJ incorrectly determined she did not prove permanent disability, had not reached maximum medical improvement (MMI), and that her injuries, with the exception of a lumbar strain, thoracic strain, and right shoulder injury, were not related to her work injuries.
In workers' compensation claims, claimants are not required to prove with absolute medical certainty that their work-related injuries caused their disabilities; it suffices if medical findings support a causal connection. A claimant can establish this connection through medical testimony. In the case of Pulliam, despite Dr. Collipp’s report being erroneously admitted, the Administrative Judge (AJ) correctly found no causal link between Pulliam's Chiari symptoms and cervical spine issues and her work-related injury, as Pulliam failed to present sufficient medical evidence to support such a connection. Dr. Ozborn indicated that while trauma could have made the Chiari symptomatic, he did not claim it was caused by work-related injuries, whereas Dr. Davis definitively stated that Pulliam's conditions were unrelated to her work. Consequently, the Commission had substantial evidence to determine the lack of a causal relationship.
Regarding Pulliam's Maximum Medical Improvement (MMI), the AJ improperly relied on Dr. Collipp's unauthenticated report to conclude that Pulliam reached MMI on July 1, 2006. In contrast, properly admitted evidence from Dr. Ozborn suggested MMI was reached on September 18, 2007, while Dr. Davis expressed uncertainty about MMI status, deferring to another physician. Therefore, the AJ’s finding was reversed, and the case was remanded for a proper MMI determination.
The Mississippi Supreme Court stipulates that permanent disability benefits are contingent on reaching MMI from compensable injuries. Without a valid MMI determination, Pulliam's entitlement to permanent disability benefits cannot be assessed, necessitating a remand for evaluation once MMI is established.
In terms of the statute of limitations, Pulliam contended the AJ incorrectly found her thoracic injury claim barred. However, records indicate that the AJ deemed her thoracic injury compensable, and the specifics regarding other claims being barred were unclear. Thus, this contention lacked merit.
Pulliam contends that the Administrative Judge (AJ) incorrectly determined that Hudspeth is not liable for medical expenses related to her Chiari I malformation, disc herniation at T6-7, and cervical spine issues. The court emphasizes that employers must cover reasonable and necessary medical treatments stemming from work-related injuries, as established in Wesson v. Fred’s Inc. However, Pulliam did not provide sufficient medical evidence linking her conditions to her work-related injuries. Consequently, the AJ's decision that Hudspeth is not responsible for these medical expenses is upheld. The judgment of the Mississippi Workers' Compensation Commission is partially affirmed and partially reversed, with the case remanded for further proceedings. Costs of the appeal are shared equally between the appellant and appellees. Notably, Dr. Bobo, a neurosurgeon, treated Pulliam’s Chiari malformation, and while the AJ did not formally rule on Pulliam’s objection regarding evidence, reliance was placed on Dr. Collipp's report in the Commission's decisions.
