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Wiljo Interiors, Inc. v. Rials

Court of Appeals of Oklahoma, Division I

November 22, 2016

WILJO INTERIORS, INC., Appellant,
v.
DAVID RIALS, Appellee, and THE OKLAHOMA WORKERS' COMPENSATION COMMISSION, and OLD REPUBLIC GENERAL INS. CORP., Insurance Carrier.

          Mandate Issued: 05/18/2017

         PROCEEDING TO REVIEW AN ORDER OF THE WORKERS' COMPENSATION COMMISSION

          Richard L. Blanchard, THE BLANCHARD LAW FIRM, P.C., Tulsa, Oklahoma, for Appellant,

          Esther M. Sanders, SANDERS AND ASSOCIATES, P.C., Tulsa, Oklahoma, for Appellees.

          BRIAN JACK GOREE, JUDGE

         ¶1 Appellant, Wiljo Interiors, Inc. (Employer), seeks review of an order of the Workers' Compensation Commission awarding surgical treatment to Appellee, David Rials (Claimant), for his right knee. Employer contends the award of surgery was against the clear weight of the evidence and contrary to law because the surgery was to correct degenerative joint disease. We affirm, holding that the Commission's order is neither contrary to law nor clearly erroneous in view of the reliable, material, probative and substantial competent evidence that the recommended surgery was connected to Claimant's acute injury.

         I. Background

         ¶2 Claimant worked for Employer as a framer and drywall hanger. On September 3, 2014, Claimant slipped while cleaning up a job site, striking his right knee. He went to an urgent care clinic that day. X-rays were taken and he was diagnosed with knee sprain.

         ¶3 On October 6, 2014, Claimant was involved in a car accident. The emergency room treatment included a knee x-ray. The radiologist reported finding a "[d]eformity along the medial femoral condyle suggesting osteonecrosis.... No other fracture or dislocation."

         ¶4 Claimant's knee continued to worsen. The urgent care clinic referred Claimant to an orthopedist, Dr. Fox, who opined that Claimant had knee strain due to a "valgus injury" that was work-related. Dr. Fox treated him with injections, immobilization, and physical therapy. After Claimant filed his workers' compensation claim, the Commission appointed another orthopedist, Dr. Mittal, as Claimant's treating doctor. Dr. Mittal found Claimant had degenerative joint disease and recommended partial knee replacement to treat his "medial compartment disease."

         ¶5 Employer objected to Dr. Mittal's recommendation on the grounds Claimant's injury was not compensable under 85A Supp. 2013 §2(9)(b)(5), which excludes from the definition of compensable injury:

any strain, degeneration, damage or harm to, or disease or condition of, the eye or musculoskeletal structure or other body part resulting from the natural results of aging, osteoarthritis, arthritis, or degenerative process including, but not limited to, degenerative joint disease, degenerative disc disease, degenerative spondylosis/spondylolisthesis and spinal stenosis.

         At Employer's request, the Commission appointed an IME. The IME opined that Claimant needed a total knee replacement rather than a partial replacement. At his deposition, the IME said that Claimant's right knee had an osteonecrotic lesion on the medial femoral condyle. He opined that the lesion was an acute injury caused by the fall at work. He said that the total knee replacement was needed to fix that lesion. However, he testified that he had not seen x-rays taken soon after the accident. The IME said that if the osteonecrosis was present in those x-rays, then he would conclude that it was pre-existing and not work-related.

         ¶6 Following the deposition, the attorneys provide the IME with x-rays taken eleven days after the accident. He then submitted a letter stating that the x-rays did not show significant changes from September 2014 to the date of his own examination. He concluded that "the work injury did not cause the underlying findings or degenerative changes found on the x-ray. Therefore, in summary, it is my opinion that the ...


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