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Igawa v. Koa House Restaurant2/2/2001
ry" owing to Igawa's continuing blackouts, memory problems, mathematical difficulties and emotional behavior impairments -- for forgetfulness and difficulty with numbers, he rated a 2% impairment; for mild emotional behavior limitation, he rated a 2% impairment; for risk or limitation of daily activities due to blackouts, he rated a 7% impairment; for a combined total of 11% impairment.
Dr. Sakoda further opined that Igawa suffers a problem of the cervical spine. He stated,
Under the DRE Category, he would really fall into Category II and that would be 5% impairment of the whole person. However, there are no x-rays, no EMG studies and nothing to assess whether he might be placed in a higher category because of some other criteria. Thus, he may not qualify for the DRE categories. Using the Range of Motion Model, he has 4% impairment of the whole person for the injury that is still symptomatic. He has limitation of movement.
Cervical flexion is 31 degrees or 2% impairment of the whole person. Cervical extension is 40 degrees or 2% impairment of the whole person. Cervical right lateral flexion is 30 degrees or 1% impairment of the whole person. Cervical left lateral flexion is 43 degrees of 1% impairment of the whole person. Cervical right rotation is 62 degrees or 1% impairment of the whole person. Cervical left rotation is 68 degrees or 1% impairment of the whole person.
The combined value is 8% impairment of the whole person for limitation of movement of the cervical spine. The combined value for the neck injury would then be 8% + 4% or 12% impairment of the whole person based on the Range of Motion Model.
In his February 26, 1996 report on his independent psychiatric examination of Igawa, Dr. Ginandes evaluated Igawa for permanent psychiatric injury. He rated Igawa's overall level of psychiatric impairment as being "moderate - 35%." Of that figure, Dr. Ginandes explained that "5% is due to his prior head injury and prior history, and 30% is due to his industrial injury of October 1 , 1991." Dr. Ginandes noted that he saw no evidence of any malingering or conscious exaggeration of symptoms in his examination of Igawa.
The record also contains a June 28, 1992 report by Dr. James F. Pierce, one of the insurer's independent medical examiners. In it, Dr. Pierce noted that there does appear to have been a dramatic increase in Igawa's headaches after the work injury, and that
I do not think his headaches are related to his temporal lobe seizures nor to his head injury of 1975. There are scattered notes throughout his record of headaches. The headaches he describes took a rather dramatic change since his accident of October. I think the accident combined with the associated stressors are responsible for the majority of his headache problems now.
As summarized by Dr. Ginandes, " here seems to have been considerable controversy among physicians as to what role his earlier head injury played in his neurological disorder, and as to what role other stresses have played in his development of his depression and/or his adjustment disorder." The reports of Drs. Nicholson, Bergmanis and Bussey directly conflict with those of Drs. Sakoda, Ginandes and Pierce, giving rise overall to a reasonable doubt as to the existence of work-connected PPD.
In instances where the testimony of two doctors directly conflict on the issue of an injury's causal connection to the claimant's employment activity, the legislature has mandated that the conflict should be resolved in the claimant's favor. Chung, 63 Haw. at 652, 636 P.2d at 727. The Hawaii Supreme Court has noted that, in Hawaii, the legislature has chosen to
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