Siegel v. AT & T Communications

• Decision Date: 14 January 1993
• Docket Number: No. 91-2446,91-2446
• Citation: 611 So.2d 1345
• Parties: 18 Fla. L. Week. D324 Teddy SIEGEL, Appellant, v. AT & T COMMUNICATIONS and Gates McDonald, Appellees.
• Court: Florida District Court of Appeals

Page 1345

611 So.2d 1345

18 Fla. L. Week. D324

Teddy SIEGEL, Appellant, v. AT & T COMMUNICATIONS and Gates McDonald, Appellees.

No. 91-2446.

District Court of Appeal of Florida First District.

Jan. 14, 1993.

Thomas G. Morton, Jr., Pensacola, for appellant.

Alfred J. Hilado, of Zimmerman, Shuffield, Kiser & Sutcliffe, P.A., Orlando, for appellees.

WIGGINTON, Judge.

Claimant brings this appeal from the order of the judge of compensation claims awarding temporary total disability benefits from May 1, 1990, through September 18, 1990, but denying all claims for medical benefits. For the following reasons, we affirm in part and reverse in part.

Claimant is a 46-year-old female who was employed by AT & T Communications when she sustained her industrial injury. At that time, she was participating in AT & T's executive loan program with the United Way and was responsible for conducting presentations at various businesses. In doing so, she utilized a projector, which she carried herself.

In December 1988, claimant experienced pain in her left shoulder after reaching to open a car lock while in the process of going to another meeting. She subsequently related the pain in her left shoulder to carrying the projector. Consequently, it was arranged that claimant would no longer carry the projector or participate in the executive loan program; instead, she worked in a staff capacity as a quality consultant from January 1989 through March 1989. This position did not require any manual labor and was within claimant's physical capabilities.

Nevertheless, claimant continued to experience difficulties with her left shoulder. She was examined in February 1989 by the company physician who thereafter referred her to Dr. Shea, an orthopedic surgeon.

Claimant was initially treated by Dr. Shea on March 1, 1989, for the pain in her left shoulder; no complaint of any pain was registered in regards to her right arm or shoulder. Dr. Shea determined that claimant suffered from adhesive capsulitis of the left shoulder. This diagnosis was based largely upon the history provided by her and her limited range of motion. Dr. Shea later described the condition as being caused by prolonged immobilization due to pain, resulting in a stiff shoulder.

Since physical therapy did not appear to improve claimant's range of motion, Dr. Shea performed a manipulation of her left shoulder on April 25, 1989, in order to break the adhesions. Claimant was discharged on April 28 and prescribed intensive physical therapy. She progressed in therapy with noted marked improvement of the left shoulder. In Dr. Shea's opinion, claimant reached maximum medical improvement with regard to her left shoulder on July 13, 1989, with a permanent impairment of two percent of the body as a whole, and restrictions against throwing activities and activities resulting in an extreme or repeated range of motion of the shoulder. As recommended, claimant returned to work at AT & T. She eventually moved into a managerial position and was under the direct supervision of Ms. Paula Beavers. This position did not require manual labor and claimant was physically capable of performing the job. Ms. Beavers indicated that she was pleased with claimant's job performance and reflected this opinion in her performance appraisal.

However, on October 26, 1989, claimant was again seen by Dr. Shea for right shoulder pain. Claimant did not relate this condition to any particular incident; rather, she indicated her right shoulder began hurting her and feeling stiff during the preceding week. Dr. Shea examined claimant and determined she exhibited early signs of adhesive capsulitis of the right shoulder. However, he opined that he did not believe claimant's right shoulder condition was related to the industrial accident to which claimant had attributed her left shoulder injury. Furthermore, Dr. Shea specifically noted that claimant had no history of an injury to her right shoulder. Dr. Shea treated claimant's right shoulder with physical therapy.

Claimant eventually elected to accept early retirement in January 1990, an option offered by AT & T to all eligible employees. However, in the meantime, she continued to experience problems with both of her shoulders and eventually desired alternative orthopedic care. In turn, AT & T provided such care through Dr. White, an orthopedic surgeon, who initially treated claimant on December 21, 1989. He provided conservative treatment and prescribed therapy. Dr. White believed that claimant suffered from subacromial bursitis of both shoulders, but could not determine the exact cause of this condition. Instead, he deferred his opinion regarding the etiology of claimant's shoulder conditions to Dr. Shea. A second opinion rendered from Dr. Csencsitz in January 1990 resulted in that doctor's concurring in the opinions of Doctors White and Shea. Surgery was not indicated at that time.

Nonetheless, on February 14, 1990, Dr. White performed arthroscopic surgery on claimant's right shoulder. This was followed by arthroscopic surgery on her left shoulder on May 1. Dr. White also prescribed a TENS unit for claimant for relief of pain. He believed claimant reached MMI for both shoulders on September 19, 1990, with a permanent impairment to both. In addition, he placed permanent restrictions on claimant.

Thereafter, mid-September 1990, claimant began to experience heart palpitations. She indicated these problems developed on a Sunday night and contacted Dr. White the following Monday morning, who, in turn, advised her to reduce her intake of Flexeril. Claimant continued, however, to experience heart problems and contacted her pharmacy the following day for medication. On Wednesday, she called Dr. White who reminded her that he was an orthopedic surgeon and suggested she see her regular doctor. Instead, claimant contacted her attorney and informed him she intended to go to the emergency room. At no point did claimant attempt to contact the E/C; rather, on September 14, 1990, claimant received treatment from Dr. Leiva, an internist, who admitted claimant to Sand Lake Hospital for testing.

In addition, upon admission to the hospital and due to her deep state of depression, claimant received psychiatric care by Dr. Saavedra. Dr. Saavedra made no attempt to obtain prior authorization and admitted that claimant did not present an emergency situation at the time of her initial evaluation. However, Dr. Saavedra continued to provide psychiatric care following claimant's discharge from the hospital.

Due to continued pain, claimant sought unauthorized treatment at the Cleveland Clinic in Fort Lauderdale in January 1991. She was also referred by Dr. Leiva to Dr. Freeman, a rheumatologist, who initially treated claimant on February 27, 1991. Again, no prior authorization was sought for this treatment. Dr. Freeman deferred her opinion regarding the causation of the adhesive capsulitis to Dr. Shea, but ultimately diagnosed claimant's condition as fibromyalgia--a generalized pain syndrome. Dr. Freeman opined that based on the temporal sequence of the pain evolution as described to her by claimant, she would relate the fibromyalgia to claimant's initial accident, although she could not give a definite opinion as to what degree either shoulder presently contributed to the fibromyalgia. She did opine that claimant was capable of performing some work, but cautioned that due to her pain and emotional concerns, she doubted that claimant would be able to concentrate to any appropriate degree.

In addition to the above-referenced treatment, claimant was also seen on May 24, 1991, by Dr. Erlich, a psychiatrist, for an independent medical evaluation. He opined claimant had a transient depressive disorder, but was unable to state within a reasonable degree of medical probability the cause of this disorder, other than to suggest simply that claimant may have possessed a tendency toward depression or that it could have been caused by stress. In the converse, Dr. Erlich was unable to state within a reasonable degree of medical probability whether claimant's disorder was the direct and immediate...