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Case # G1292329
Date of Accident: 02/14/2015
District Office: NYC
Employer: NYC Dept of Correction
Carrier: Police, Fire, Sanitation
Carrier ID No.: W846505
Carrier Case No.: W0721581380
Date of Filing of Decision: 03/24/2017
Claimant's Attorney: O’Connor Law Firm
Panel: Kenneth J. Munnelly

MANDATORY FULL BOARD REVIEW
FULL BOARD MEMORANDUM OF DECISION

The Full Board, at its meeting on February 28, 2017, considered the above captioned case for Mandatory Full Board Review of the Board Panel Memorandum of Decision filed October 7, 2016.

ISSUE

The issue presented for Mandatory Full Board Review is whether the claim should be amended to include right carpal tunnel syndrome.

The Workers' Compensation Law Judge (WCLJ) amended the claim to include right carpal tunnel syndrome.

The Board Panel majority reversed the WCLJ decision and disallowed the claim for right carpal tunnel syndrome.

The dissenting Board Panel member would affirm the WCLJ.

The claimant filed an application for Mandatory Full Board Review arguing that the claim should be amended to include right carpal tunnel syndrome based on the opinion of his treating physician, Dr. Katzman.

The self-insured employer (SIE) did not file a rebuttal.

Upon review, the Full Board votes to adopt the following findings and conclusions.

FACTS

In a C-3 (Employee Claim) filed on March 12, 2015, claimant reports an injury occurred on February 14, 2015, when he slipped on loose floor tiles, and injured his right knee, right elbow and fingers on the right hand. In a report filed on April 9, 2015, for an examination on March 16, 2015, Dr. Tolat indicated the claimant injured his right elbow and right knee when he tripped on floor tiles at work and fell. The claimant reported he went to the hospital by ambulance and x-rays were negative for fractures. The claimant reported right elbow pain and tingling in his right hand, as well as pain in the right knee. Dr. Tolat diagnosed right knee strain/sprain, right elbow strain/sprain, and prescribed physical therapy.

A C-4 filed on May 26, 2015, for an examination on April 15, 2015, by Dr. Katzman reported the claimant has right elbow and right knee pain, and had developed numbness and tingling in his right hand which Dr. Katzman opined was carpal tunnel syndrome. Dr. Katzman took x-rays of the right knee and right elbow, which showed no fractures. Dr. Katzman reported positive testing for right carpal tunnel syndrome including Tinel's, carpal compression testing and Phalen's testing. Dr. Katzman diagnosed right elbow strain, right knee strain and posttraumatic right carpal tunnel syndrome. Dr. Katzman ordered MRIs of the right knee and right elbow, as well as an EMG/NCV test for carpal tunnel syndrome, and opined all complaints were causally related to the accident on February 14, 2015.

A C-4 filed on June 12, 2015, for an examination held on April 22, 2015, by Dr. Mansukhani reported the claimant complained of right elbow pain, associated with numbness and tingling in all fingers of the right hand, along with right knee pain which was improving. Dr. Mansukhani reported positive Phalen's and Tinel's tests for the right hand, and also reported sensation was decreased in all fingers of the right hand. Dr. Mansukhani recommended the claimant continue with physical therapy.

In a decision filed October 19, 2015, the WCLJ found the claimant had work-related injuries to his right elbow and right knee, found prima facie medical evidence for right carpal tunnel syndrome, and directed the self-insured employer (SIE) to produce an independent medical examination (IME) by the next hearing. The WCLJ scheduled the following hearing for the testimony of the claimant and summations on mechanism of injury.

At a hearing held on December 14, 2015, the claimant testified that on February 14, 2015, he worked for the New York City Department of Corrections, and while he was working in the control room, he tripped on the floor tile and fell on the floor, injuring his right knee, right arm and right hand. On cross-examination, the claimant acknowledged the C-3 did not indicate an injury to the right hand, but testified that the nurse completed the form, and his right hand was hurting at that time. The claimant acknowledged that he completed a subsequent C-3 that only indicated injuries to his right knee and right elbow but testified he thought he reported an injury to his right hand. The claimant testified that he had not injured his right hand prior to or subsequent to February 14, 2015. He had pain up to the right forearm and down the hand from the date of the accident, and he began treatment for his right hand after the first EMG/NCV test.

At the conclusion of testimony, the WCLJ precluded the SIE from obtaining an IME with respect to carpal tunnel syndrome because the WCLJ had directed the IME to be completed by the date of the hearing, and the SIE had failed to timely file an IME on the issue of causally related carpal tunnel syndrome. The WCLJ directed the deposition of Dr. Katzman.

Dr. Katzman was deposed on January 21, 2016, and testified that when he examined the claimant on April 14, 2015, the claimant presented with elbow and knee pain, and numbness and tingling of the right hand. The claimant had good range of motion but positive provocative measures for carpal tunnel syndrome including Tinel, Phalen and carpal compression test. Dr. Katzman recommended MRIs for the claimant's right elbow, right knee, and a nerve study test.

On cross-examination, Dr. Katzman testified the claimant reported he originally injured his right knee and right elbow, but developed numbness and tingling in his right hand. According to Dr. Katzman, some people do not realize they hurt their wrist during this type of accident. Because the claimant had never experienced numbness and tingling prior to the accident, Dr. Katzman was of the opinion that the numbness and tingling were causally related to the accident.

Dr. Katzman was unsure whether the claimant had any subsequent accidents between the February 14, 2015, accident and the April 15, 2015, examination. Testing revealed a positive Tinel's, Phalen's and carpal compression test, and so he concluded the claimant had carpal tunnel syndrome. Dr. Katzman believed the claimant injured his right wrist in the accident. Dr. Katzman explained that based on the history provided to him, it was most likely that claimant struck his wrist or hand during the fall, which caused his carpal tunnel syndrome.

By a reserved decision filed June 24, 2016, the WCLJ amended the claim to include right carpal tunnel syndrome based on the credible testimony of Dr. Katzman.

The SIE sought administrative review arguing that the WCLJ decision was not supported by substantial evidence because the claimant testified the he injured his right forearm, right hand, right elbow and right knee when he tripped and fell at work on February 14, 2015, but the evidence in the record does not support the claimant's testimony. Neither C-3 reports an injury to the right hand or right wrist, Dr. Tolat's report dated March 15, 2015, only indicates injuries to the right elbow and right knee, and Dr. Katzman testified that the claimant could have only developed carpal tunnel syndrome if he had injured his hand on the date of the accident, but the claimant never reported such an injury to Dr. Katzman. The claimant did not submit a rebuttal.

LEGAL ANALYSIS

"It [i]s claimant's burden to establish a causal relationship between his employment and his disability by competent medical evidence (see Matter of Sale v Helmsley-Spear, Inc., 6 AD3d 999 [2004]; Matter of Keeley v Jamestown City School Dist., 295 AD2d 876 [2002]). To this end, a medical opinion on the issue of causation must signify 'a probability as to the underlying cause' of the claimant's injury which is supported by a rational basis (Matter of Paradise v Goulds Pump, 13 AD3d 764 [2004]; see Matter of Van Patten v Quandt's Wholesale Distribs., 198 AD2d 539 [1993]). '[M]ere surmise, or general expressions of possibility, are not enough to support a finding of causal relationship' (Matter of Ayala v DRE Maintenance Corp., 238 AD2d 674 [1997], affd 90 NY2d 914 [1997]; see Matter of Zehr v Jefferson Rehab. Ctr., 17 AD3d 811 [2005])" (Matter of Mayette v Village of Massena Fire Dept., 49 AD3d 920 [2008]).

Here, the initial C-3 reports injuries to the right elbow, right knee and right fingers. At the initial examination held on March 16, 2015, the claimant reported tingling to his right hand. On April 22, 2015, Dr. Mansukhani also noted the claimant reported right elbow pain with tingling and numbness in the right fingers. On May 26, 2015, Dr. Katzman noted the claimant reported tingling in his right hand, and upon diagnostic testing, Dr. Katzman diagnosed right carpal tunnel syndrome causally related to the accident. Dr. Katzman credibly testified that it was most likely that claimant struck his wrist or hand during the fall, which caused his carpal tunnel syndrome.

Therefore, the Full Board finds that the preponderance of the evidence in the record supports a finding that the claimant's right carpal tunnel syndrome was causally related to his accident.

CONCLUSION

ACCORDINGLY, the WCLJ reserved decision filed June 24, 2016, is AFFIRMED. No further action is planned by the Board at this time.