hlASIS Glenwood Regional Medical Center (“Glenwood”) appeals a judgment of the Office of Workers’ Compensation finding that Lisa Hill, a registered nurse, sustained a work-related injury and was entitled to temporary total disability (“TTD”) benefits from the last day she worked and to medical services, including a back surgery. We affirm.
Factual Background
Ms. Hill had been employed by Glen-wood as an RN on the cardiac floor since October 2012, at an average weеkly wage of $1,024.83. She testified that about 5:30 pm on April -30, 2013, she was trying to reposition a large patient from the right to the left side of her bed, when she (Ms. Hill) felt a sudden pain in her neck and back. Aside from the patient, no one else witnessed the incident. Ms. Hill completed her shift, but the' next day, May 1, she reported the incident to her supervisor and then-went'to her family doctor, Dr. Yar-brough, and .was actually seen by a nurse practitioner, Matilda Steрhens.
On the May 1 visit, Nurse Stephens detected some sciatic nerve damage and ordered X-rays which showed bilateral L5 spondylolysis with Grade 1 spondylolisthe-sis; she took Ms, Hill off work, gave her some pain medications and muscle relaxers and ordered an MRI. Glenwood began paying her TTD benefits of $605 a week, effective May 14.
On referral from Dr. Yarbrough’s office, Ms. Hill went, to a neurosurgeon, Dr. Jorge Alvernia, on June 17. She reported a sudden onset of pain from lifting a patient, describing it as “dull and gnawing” but with no radiating effects. The MRI, taken May 16, showed L5/S1 Grade 1 | gspondylolisthesis, for which Dr. Alvernia recommended physical therapy. He also released Ms. Hill to return to light-duty work and ordered a functional capacity evaluation (“FCE”), Ms. Hill testified that she attended therapy for about six weeks and returned to work at Glenwood, in the “chart audits” office and at her normal pаy. She also admitted that after seeing Dr. Alvernia, she called Dr. Yarbrough’s office and tried to get a referral to a different neurosurgeon, but they never gave- her an answer 5
Ms. Hill took the FCE on August 23; the report is not in the record, but Dr, Alvernia testified that it showed she could “tolerate the physical demands of the medical work load.” Despite the spondylolis-thesis at L5/S1 and the appearance of “new symptoms,” he felt she could work. Ms. Hill, however, testified that the exertion of the FCE increased her pain level and caused a new pain, radiating down her right leg. Ms. Hill saw Dr. Alvernia’s colleague, Dr. Baker, three times in October through December, always complaining of this radiating pain, sometimes into the left leg. Dr, Alvernia testified that as of December 18, he could make no objee-
At Glenwood’s request, Ms. Hill submitted to an examination by its choice of neurosurgeon, Dr. Jorge Martinez, on January 2, 2014. Glenwood did not offer Dr. Martinez’s report into evidence or call him as a witness.
Ms. Hill testified that she worked without restrictions for a while, but the pain got worse, radiating all the way down to her left foot and even making her unstable. She kept at the job until January 22, 2014, when she |squit and moved to the Dallas area tо live with her boyfriend.
Once in Dallas she requested, and the OWC approved, treatment with a.new doctor, Dr. Shaad Bidiwala, at. Texas Neurosurgery. ■ Based on’ his examination, a new MRI and the history provided by Ms. Hill, Dr. Bidiwala found an aggravation of spon-dylolisthesis, caused or contributed to by the accident at Glenwood on April 30, 2013. He recommended surgery to correct the problem, took her off work as of February 28, 2014, and projectеd that she could not return to work until post-surgery. , He admitted there was no. published scientific literature stating that trauma can induce spondylolisthesis, but was firm in his opinion that the accident Ms. Hill described aggravated, it and made it symptomatic.
Procedural History
On March 3, 2014, Ms. Hill sent a demand letter to Glenwood for the surgery recommended by Dr. Bidiwala. Glenwood did not respond; Ms. Hill filed the instant contested claim on July 1,2014.,
Glenwood admitted only Ms. Hill’s former employment status, average weekly wage and compensation rate. It denied that any accident occurred, as it was not reported until the next day, and that she was currently disabled, as Dr. Alvernia had twice released her to'return to work. Mostly, however, it alleged that the “incident” of April 30, 2013, neither caused nor contributed to her current medical condition. It produced a sheaf of medical records showing an array of prior complaints of back pain, including (1) a November 1999 visit to West Carroll. Health System for back and body pain, with a diagnosis of bilateral spondylolysis at L5 but , no Insignificant spondylolisthesis; (2) three treatments with Dr. Dan Holt, a chiropractor in Monroe, in April and'May 2012, for a pinched nerve'in her right shoulder and neck, and low back pain; and (3) nine treatments at “The Joint,” a chiropractic clinic in Monroe, from July to September 2012, for essentially thе same complaints. Glenwood also argued that Ms. Hill omitted to mention these prior issues to Drs. Alvernia and Bidiwala; on cross-examination, counsel got Dr. Bidiwala to admit, “I’m not contending that the spondylolis-thesis was caused by her lifting the pa-tientfj”
. At trial, in January 2015, the only live witness was Ms. Hill, who described the accident, her course of medical treatment and her gradually worsening pain. ■ Glen-wood attempted to impeach her with her pretrial deposition, in which she did not recall many details of her prior medical issues. She responded that most of those prior issues were in the neck and shoulder, which she ascribed to picking up babies and carseats in her prior work as a sitter, but said they were never really disabling, like -the current pain. She also showed that she promptly supplemented her deposition to include a- full list of doctors and treatment.
Ms. Hill аlso offered OWC documents relating to her claim, and her amended answers to interrogatories admitting her prior medical treatment.
| ¡¡Roughly four months after trial, the WCJ ruled frоm the bench. After recapping the facts, she stated that she “put great emphasis on this change in condition” in reaching her conclusion, especially that the MRI ordered by Dr. Bidiwala showed “more encroachment on the nerves than what appeared in the earlier MRI.” She accepted Dr. Bidiwala’s opinion that Ms. Hill’s spondylolisthesis probably predated the accident but was not symptomatic until after it. The WCJ сited the prior treatment for neck and shoulder pain, but applied the presumption of causation to find that the accident caused Ms. Hill’s current condition. She therefore awarded TTD of $605 a week, effective February 28, 2014, until Ms. Hill was released to return to work, and ordered Glenwood to provide medical treatment, including the surgery recommended by Dr. Bidiwala. Finally, the court cited Ms. Hill’s numerous prior medical issues and misstatеments in the early phase of the claim, and denied the claim for a penalty and attorney fee.
After the WCJ rendered judgment to this effect, Glenwood took the instant appeal. Later, in November 2015, it filed an exception of prescription. It now raises four assignments of error.
Discussion: Finding of Accident and Causation
By its first assignment of error, Glen-wood urges the WCJ committed manifest error in finding an accident occurred, as the incident was unwitnessed and Ms-. Hill’s testimony was gеnerally not credible. By its second assignment, argued together with the first, Glenwood urges the WCJ committed manifest error in finding disability and causation, as Ms. Hill had significant preexisting spinal problems, gave inaccurate histories, and her [ ¡¡lead physician, Dr. Bidiwala, relied on the bad medical history she provided. Glenwood cites the preexisting injury rule, Peveto v. WHC Contractors, 98-1402 (La.1/14/94),
An employee is entitled to wоrkers’ compensation benefits if she “receives personal injury by accident arising out of and in the course of’ her employment. La. R.S. 23:1031 A. A claimant’s testimony alone may be sufficient to establish an accident provided that “(1) no other evidence discredits or casts serious doubt upon the worker’s version of the incident,
An accident is an “unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently, with or without human fault, and .directly рroducing at the time objective findings of an injury which is more than simply a gradual deterioration or progressive degeneration.” La. R.S. 23:1021(1); Iberia Medical Ctr. v. Ward, 2009-2705 (La.11/30/10),
|sThe claimant is not required to prove the exact cause of her disability, but she must demonstrate by a preponderance of the evidence that the accident has a causal connection with it. Iberia Medical Ctr. v. Ward, supra; Brown v. Offshore Energy Serv., supra. Disability may be presumed to have resulted from an accident if, before the accident, the claimant was in good health, but commencing with the accident, the symptoms of the disabling condition appear and continuously manifest themselves afterward, provided that there is sufficient medical evidence to show a reasonable possibility of a causal relation between the accident аnd disability, or the nature of the accident, combined with the other facts of the case, raises a natural inference of causation. Doucet v. Baker Hughes Prod. Tools, 93-3087 (La.3/11/94), 635 So.2d 166; Brown v. Offshore Energy Serv., supra.
Factual findings in workers’ compensation cases are subject to the manifest error rule. Buxton v. Iowa Police Dept., 2009-0520 (La.10/20/09),
As to the occurrence of an accident, Ms. Hill testified that the only other witness was the patient she was attempting to move. Given the nature of her work, there is nothing suspect about the absence of any сorroborating |flwitnesses. She also testified it happened around 5:30 pm, near the end of her shift, and she did not drop everything and immediately report it. Instead, she did so the next morning, at the top of her shift, and went to her family doctor the same day, describing the incident and her symptoms. This is not an
As for causation, the evidence is somewhat closer. Glenwood has ably shown that Ms. Hill had a significant history of medical treatment, dating back to a 1999 diagnosis of spondylolysis at L5, and chiropractic adjustments in 2012 for a pinched nerve in her shoulder аnd neck, with some pain in the lower back. Glenwood also shows that, at least initially, Ms. Hill failed to mention these prior complaints when she sought treatment for the instant injury, an omission that may have influenced her diagnosis. Finally, Glenwood shows that Ms. Hill’s choice of neurosurgeon, Dr. Bidiwala, admitted that no published scientific literature states that trauma can induce her current condition, spondylolisthe-sis, and he declined to agree thаt it was caused by lifting the patient. This evidence tends to negate a finding of causation.
On the other hand, the record does not show that her prior complaints ever caused her to miss any work, and even though she sought medical attention, she testified they were “just minor things.” She also testified that ImDrs. Alvemia and Bidiwala did not specifically ask her about prior back problems, and the doctors did not refute this in their depositions. She cаndidly admitted that she came to her deposition unprepared to recall details about medical complaints-'and diagnoses dating back 15 years, but as soon as she was reminded of them she supplemented her answers. The omissions "in the histories provided to Ms. Hill’s doctors, and the discrepancies in her deposition, are not unreasonable and do not subvert the WCJ’s finding of causation. Hubbard v. Allied Building Stores, 41,534 (La.App. 2 Cir. 11/1/06),
Finally, we recognize Dr. Bidiwala’s expert opinion that Ms. Hill’s disabling condition, spondylolisthesis, is not a recognized consequence of trauma, and his reluctance to say that moving a patient caused it. As noted, however, the claimant is not required to prove the exact cause of her disability. Iberia Med. Ctr. v. Ward, supra; Brown v. Offshore Energy Serv., supra. She need only make a credible showing that she was in good health before the accident, but suffered symptoms аfter it, in circumstances that raise a natural inference of causation. Doucet v. Baker Hughes Prod. Tools, supra; Brown v. Offshore Energy Serv., supra. Heavy lifting has long been associated-with back injuries. Bruno v. Harbert Int’l Inc., supra; Cutno v. Neeb Kearney & Co.,
Finding of Disability
By its third assignment of error, Glenwood urges the WCJ committed manifest error in awarding any disability benefits, as Dr. Alvernia twice released Ms. Hill, first to light-duty and then to full-duty work, and she performed both for several months. Glenwood submits that in denying the claim for a penalty and attorney fee, the WCJ properly found a lack of candor and credibility (“misrepresentations were made” which “caused this Court
Benefits for TTD are based on “temporary total disability of an employee to engage in any self-employment or occupation for wages, whether or not the same or a similar occupation as that in which the employee was customarily engaged when injured, and whether or not an occupation for which the emрloyee at- the time of injury was particularly fitted by reason of education, training, or experience!/]” La. R.S. 23:1221(l)(a). TTD may not be awarded if the claimant can engage in odd-lot employment, sheltered employment,- or employment while working in any pain. R.S. 23:1221(l)(b). Compensation may be made “only for such injuries as are proven by competent evidence, or for which there are or have been objective cоnditions or. symptoms proven, not within the -physical or mental control of the injured employee himself.” La. R.S. 23:1317 A. The finding of disability, however, is 'a legal rather than a purely medical | ^determination. Harper v. Horseshoe Casino, 41,470 (La.App. 2 Cir. 10/19/06),
The' medical evidence was conflicting: Glenwood correctly shows that Dr. Alver-nia released Ms. Hill to light-duty work in June 2013 and to full-duty work in December 2013, while Dr. Bidiwala took her off all work in February 2014. Although Glenwood assailed Ms. Hill’s credibility, it offered no medical evidence to refute Dr. Bidiwala’s opinion, supported by MRI results, that as of February 2014 her spon-dylolisthesis made her unable to work. We also note that in January 2014, Glen-wood sent Ms; Hill to Dr. Martinez for an evaluation but did not offer his report or deposition". The failure to produce this evidence raises a presumption that it would have beеn adverse to Glenwood’s position. Brock v. Frymasters, 41,561 (La.App. 2 Cir. 11/1/06),
We reiterate that the ‘ assessment of a claimant’s credibility is entirely the province of the factfinder.- Marange v. Custom Metal Fabricators, supra; Galiano v. Lucky Coin Machine Co., 2015-2065 (La.1/8/16),
Prescription
By its final assignment of error, Glenwood urges that Ms. Hill’s claim was prescribed. Under La. R.S; 23:1209,-all claims must be' filed within one year' after the accident or, if any indemnity benefits were paid, within one year after the final indemnity payment, but in no event more thаn three years after the accident. Lebert v. McNeese State Univ.,
A. (1) In case of personal injury, including death resulting therefrom, all claims for paymеnts shall be forever barred unless within one year after the accident or death * * * a formal claim has been filed as provided in Subsection B of this Section and in this Chapter.
(2) Where such payments have been made in any case, the limitation shall not take effect until the expiration of one year from the time of making the last payment, except that in cases of benefits payable [for supplemental eаrnings benefits] this limitation shall not take effect until three years from the time of making the last payment of benefits pursuant to R.S. 23:1221(1), (2), (3), or (4).
(3) When the injury does not result at the time of or develop immediately after the accident, the limitation shall not take effect until expiration of one year from the time the injury develops, but in all such cases the claim for payment shall be 114forever barred unless the proceedings have been begun within three years from the date of the accident.
The courts have liberally construed Subsection A(3)’s term “the time the injury develops” in cases where the claimant attempts to continue working until no longer able to perform her employment duties. Sevin v. Schwegmann Giant Supermarkets Inc., 94-1859 (La.4/10/95),
The instant record shows that this claim was not prescribed. The accident was on April 30, 2013, and Ms. Hill initially missed about six weeks of work, receiving her final TTD payment on June 17; she returned to liBwork at light duty for several months and complained of increasing pain; Dr. Bidiwala finally took her off work on February 28, 2014. Under R.S. 23:1209 A(3), as interpreted in Sevin, the latter date is the time the injury developed. Ms. Hill plainly filed her disputed claim within one year of that date, and within three years of the accident. This assignment of error lacks merit.
Conclusion
For the reasons expressed, the judgment is affirmed. IASIS Glenwood Regional Medical Center is to pay all costs.
AFFIRMED.
APPLICATION FOR REHEARING
Before DREW, MOORE and GARRETT, JJ.
Rehearing denied.