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Korsak v. Hawaii Permanente Medical Group11/10/1999
Claimant-Appellant Richard J. Korsak (Korsak) appeals the July 15, 1998 decision and order of the Labor and Industrial Relations Appeals Board (the Board) which denied workers' compensation for his disabling low back condition. We reverse because his employer failed to produce substantial evidence which expressly, directly, and specifically rebutted the presumption of compensability.
FACTS
Korsak worked as a physician for Employer-Appellee Hawaii Permanente Medical Group, Inc. (Kaiser). On November 16, 1992, he sustained a compensable injury to his right knee when he slipped and fell in Kaiser's hospital parking lot.
Following surgery on his right knee, Korsak began a course of physical therapy. He was seen three times in February 1993 by a physical therapist specializing in knee problems. Korsak claims he also attended a physical therapy session in early March, during which he felt sciatic (of, relating to, or situated near the hip) pain. Korsak contends he exacerbated a pre-existing low back condition as a result of this March 1993 physical therapy session.
It is undisputed that Korsak has a significant history of low back problems. He underwent two back surgeries in the 1970's and was involved in an automobile accident in 1989 in which he fractured his back and herniated a disc.
After the alleged March 1993 physical therapy session, Korsak's low back condition made it impossible for him to continue work as a physician. He took an unscheduled retirement on January 14, 1994.
On March 4, 1993, Kaiser filed a WC-1 report for Korsak's knee injury.
On July 30, 1994, Dr. Roy Sam, a former chief of physiatry at Kaiser and Korsak's associate at work, examined Korsak in connection with a Social Security Administration evaluation. Dr. Sam initially noted that Korsak injured his right knee and severely aggravated his low back problem in the 1992 fall.
In 1992 the patient was walking in the Kaiser Moanalua Hospital parking lot, when he slipped on oil and injured his right knee. The patient had a right medical meniscus tear and severely aggravated his back problem. He had a medial meniscectomy in February of 1993 by Dr. Frank Uhr.
Dr. Sam went on to opine, however, that Korsak exacerbated his low back condition during physical therapy.
Postoperatively the patient went to physical therapy and the sports therapist stretched his leg during pulling the right leg over the left. This resulted in a severe strain of the sciatic nerve causing him to have severe pain in the leg. The patient had epidural blocks and morphine blocks by Dr. Robinson, about four blocks in all. The patient was not helped by these injections.
On October 24, 1994, Korsak added a workers' compensation claim for his low back condition, stating that he exacerbated this condition while doing physical therapy for his work-related knee injury. Korsak did not claim that he suffered additional low back injury during the November 16, 1992 fall. The State Special Compensation Fund was made a party to the case pursuant to Hawaii Revised Statutes (HRS) ยง 386-33 (1993).
On October 17, 1995, Dr. Lee Silver performed a records review of Korsak's medical history at the behest of the Director of the Department of Labor and Industrial Relations (the Director).
By decision and order dated December 22, 1995, the Director awarded benefits only for the injury to Korsak's right knee, finding that he did not sustain a compensable back injury during physical therapy for the November 16, 1992 fall.
In a January 4, 1996 letter to the Director, written at Korsak's request, Dr. Sam further opin
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