James W. CLARK, Claimant-Appellant,
CRY BABY FOODS, LLC, Employer, Defendant, and Idaho State Insurance Fund, Surety, Defendant-Respondent.
James W. Clark, Vancouver, Washington, pro se appellant.
Anderson Julian & Hull, Boise, for respondent. Alan K. Hull and Rachael O'Bar argued.
This appeal arises from a worker's compensation claim stemming from an accident at an onion processing plant on April 17, 2008. James Clark was injured when his right forearm was caught in a roller machine which resulted in significant soft-tissue damage. The Industrial Commission determined that Clark had suffered a compensable injury and that he was entitled to medical treatment through the date of his hearing and temporary disability benefits from the date of injury until he reached medical stability on April 17, 2009. The Commission also found that Clark had a permanent partial impairment (PPI) of 10% of the whole person and a permanent partial disability rated at 25% of the whole person. Clark appeals, arguing that the Commission committed error by relying on fraudulent evidence. We affirm.
I. FACTUAL AND PROCEDURAL BACKGROUND
On April 17, 2008, James W. Clark had been employed by Cry Baby Foods, LLC, for six days. He worked near a roller machine that stripped onions coming from delivery trucks of leaves, dirt, and outer layers. It was Clark's job to clear clogs from this machine with a stick. Clark's glove caught in the machine, and his hand and arm were trapped between two rollers. Clark was stuck in the machine for around ten minutes before it could be shut off, and it took another ten to fifteen minutes before he could be extricated.
Clark was evaluated by paramedics and transported by Life Flight to St. Alphonsus in Boise. Although repeated x-rays showed no signs of fracture, there was significant soft-tissue damage to Clark's right forearm. Clark was evaluated by Dr. Gross, an orthopedic surgeon, in the emergency room. At that time, Clark's chief complaints were pain and swelling. He was discharged with a prescription for pain medication and an antibiotic and was told to return the next day for a follow-up appointment. At the follow-up appointment, Clark complained that he could not move his thumb, but he had feeling in all of his fingers. The next week, Clark returned for another follow-up with Dr. Gross. He reported that he kept reliving the accident, and he had returned to work so that he could " confront the machine." He complained that he was having difficulty sleeping, and Dr. Gross noted that " [h]e sounds like he is having some PTSD [post-traumatic stress disorder] symptoms." Dr. Gross prescribed some medication to help with sleep and recommended he start physical therapy in Ontario.
Clark began physical therapy on April 22, 2008, and over the course of fifteen visits in April and May reported mild improvement. At another follow-up appointment on May 2, Dr. Gross noted that Clark's arm was healing well and that he would not recommend any surgeries. He referred him to a psychiatrist to address Clark's evident post-traumatic stress issues. A few days later, Clark returned to Dr. Gross desiring a referral for housekeeping and cooking services. The physician's assistant evaluating him declined, noting that " he can perform all of his activities of daily living and thus does not need a housekeeper." On May 29, Dr. Gross signed a work release indicating that Clark was capable of returning to work on a modified or light-duty basis. That form was backdated to May 9, 2008. Clark returned to work on June 5. His employer stated that he worked for a few hours and then left, claiming he had a doctor's appointment. Clark never returned to work.
Following the referral from Dr. Gross, Clark sought treatment from Lifeways Mental Health Services for psychiatric evaluation and treatment. He was diagnosed with PTSD and expressed frustration at " having to arrange all the medical stuff" that he needed in order to heal. This topic, as well as the related litigation, became a source of a great deal of anxiety for Clark. On multiple occasions during his treatment at Lifeways, Clark expressed anxiety about his worker's
compensation claim and related issues. During his treatment with Lifeways, he was referred to Dr. Heriza for a psychological evaluation. Dr. Heriza noted his concern about Clark's history of substance abuse as it related to his prescribed narcotic pain medication. Dr. Heriza considered other possible factors contributing to Clark's mental health condition, including PTSD resulting from the industrial accident, substance-induced mood disorder, seizures or epilepsy, and Cluster B personality disorder.
At a follow-up appointment with Dr. Heriza, Clark indicated that he was taking hydrocodone " less for pain and just to help his mood." Dr. Heriza expressed concern over " significant issues with habituation and addiction." Dr. Heriza ruled out seizures or epilepsy as a contributing factor in Clark's mental state, and attributed his mental health issues to " significant substance related issues" as well as " some mild anxiety/posttraumatic symptoms and prominent cluster B features."
As a result of Clark's ongoing complaints of pain, surgery was performed on his arm on February 19, 2009. This surgery removed scar tissue around Clark's radial nerve, and the nerve was resected in an attempt to relieve the pain he was feeling. By April 17, 2009, his doctor indicated that Clark had reached the point of maximum medical improvement (MMI) and was ready to be evaluated regarding a partial permanent impairment rating (PPI). Clark continued to complain of pain and reduced strength in the hand and arm, but his doctor did not believe this would improve appreciably. His doctor initially assessed a 16% whole person PPI, but upon reassessment, changed that figure to 18%.
Clark was also evaluated by a neuropsychologist at the request of the surety. Dr. Beaver, the neuropsychologist, stated that the " accident was the predominate cause above all other causes of his posttraumatic stress disorder. Unfortunately, his multiple pre-existing psychiatric issues, including recurrent major depression, polysubstance dependency, somatization, and borderline personality disorder also act to exacerbate his psychological difficulties." Dr. Beaver assessed Clark's PPI as " a 10% impairment of the whole person for mental and behavioral impairments. However, only 5% (one half) of this rating ...