Pikeville Medical Center v. Charlotte Baker, 2024-SC-0214

Charlotte Baker, a 65-year-old nurse with 40 years of experience at Pikeville Medical Center, sustained a work-related injury to her left shoulder, hip, and buttocks in December 2020 while transferring a patient.
After initial treatment and a three-month absence, Baker returned to work without restrictions until January 2022, compelled by her husband's healthcare needs, before ultimately leaving the workforce.
Dr. Anthony McEldowney examined Baker, assigned a 5% whole-body impairment rating due to her shoulder injury, and imposed significant physical work restrictions, finding her unable to return to nursing.
Baker filed for workers' compensation, and Pikeville Medical Center did not initially dispute her claim; the Administrative Law Judge (ALJ) found her permanently and totally disabled.
The ALJ’s decision was sequentially affirmed by the Workers’ Compensation Board and the Court of Appeals; Pikeville Medical Center’s appeal to the Supreme Court of Kentucky challenged only the sufficiency of the evidence for permanent total disability (PTD).

Issue	Plaintiff's Argument	Defendant's Argument	Held
Sufficiency of evidence for PTD award	Evidence supports PTD finding: age, restrictions, work history outweigh education/skills	The impairment rating is minimal; Baker’s education and return to work show she could perform some work	Affirmed ALJ: evidence was sufficient, no clear error or abuse of discretion
Use of impairment rating considering prior injury	Dr. McEldowney’s assessment adequate: no active prior impairment	Dr. McEldowney failed to consider a 2017 injury, inflating impairment	ALJ entitled to rely on uncontradicted medical opinion based on Guides
Necessity of direct expert testimony for inability to work	Totality of the evidence allows inference of total disability	No medical testimony stated Baker is unable to work at all	Direct expert testimony not required; inferences from evidence sufficient
Weight of factors (age, education, restrictions) for PTD	ALJ properly considered totality; age/restrictions most significant	Education and prior work could support finding of ability to work	ALJ had discretion to weigh evidence; decision was not unreasonable

Lexington Fayette Urb. Cnty Gov’t v. Gosper, 671 S.W.3d 184 (Ky. 2023) (standard of review for workers’ compensation claims—three-tier review, deference to ALJ on factual findings)
City of Ashland v. Stumbo, 461 S.W.3d 392 (Ky. 2015) (five-part test for determining permanent total disability under KY law)
McNutt Construction/First General Services v. Scott, 40 S.W.3d 854 (Ky. 2001) (requires individualized analysis of claimant’s post-injury work ability)
Plumley v. Kroger, Inc., 557 S.W.3d 905 (Ky. 2017) (ALJ entitled to rely on physician’s impairment rating if consistent with AMA Guides)
Kelly v. W. Baptist Hosp., 827 S.W.2d 685 (Ky. 1992) (scope of Court of Appeals review of Workers’ Compensation Board)