Case details

Rear-end collision caused need for future surgery: claimant





Result type

Not present

back, cervical, cervical sprain., neck, neck. pain, nerve impingement, nerve root impingement, neurological, radicular pain, radiculitis, sprain, strain
At around 4 p.m. on June 24, 2009, claimant Eric Morehouse, 46, an outside sales employee, was operating his employer’s motor vehicle, a 2006 Toyota Camry, while in the course and scope of his employment. While driving on north Kuehner Drive, he stopped for traffic at the intersection with East Los Angeles Avenue, in Simi Valley, and was rear-ended by a Honda Civic operated by an underinsured motorist, who was not paying attention and unable to stop. Due to the strong impact, Morehouse’s vehicle was pushed forward, causing it to strike a vehicle in front of him. Morehouse brought a claim against the motorist that struck him and a workers’ compensation claim with his employer’s workers’ compensation carrier. The underinsured motorist’s insurer tendered its $15,000 policy limits, which was allegedly insufficient to cover Morehouse’s damages. Thus, Morehouse sought further recovery via the supplementary-underinsured-motorist provision of his own insurance policy, which was administered by the Hartford Co., Morehouse claimed that he suffered a cervical sprain and strain with radiculopathy and a nerve root impingement. After the collision, Morehouse presented to Eastern Ventura Medical Group (doing business as Med Group), in Simi Valley, with complaints of neck pain. He was subsequently evaluated by a physician, whom he visited several times thereafter, and was diagnosed with a cervical sprain and strain with radiculopathy. However, by Sept. 25, 2009, Morehouse was still had the work restriction of no lifting over 10 pounds, and no repetitive stooping and twisting. As a result, he underwent another workers’ compensation evaluation on Oct. 8, 2009, and was again diagnosed with a cervical sprain and strain with radiculopathy. On June 17, 2010, the workers’ compensation evaluator indicated that Morehouse was progressing better and that Morehouse was allowed to return to normal and customary job duties, so long as there are no flare-ups in his condition. On May 26, 2011, Morehouse presented to a physician with complaints of ongoing neck pain that radiated into the left, upper extremity. The physician dispensed medication and requested that updated diagnostic studies. Morehouse subsequently underwent another never conduction study on July 7, 2011, and a cervical MRI on July 20, 2011. The diagnostic studies confirmed Morehouse’s subjective complaints with the objective findings of a nerve root impingement at the C6-7 level. Due to the radiating pain, epidural injections were recommended, which Morehouse received on Nov. 10, 2011, and Nov. 22, 2011. Morehouse later returned to the physician for a follow up visit on Jan. 13, 2012, and complained that he was still symptomatic. The physician subsequently opined that Morehouse was a candidate for a two-level decompression and fusion at the C5-6 and C6-7 levels as a result of the stemming from the collision. Morehouse claimed that he was hesitant about the surgery and decided to try treating his pain with less intrusive means. As a result, he opted for a third epidural injection, which was performed on Sept. 10, 2012. Following the injection, Morehouse reported significant pain relief. He also reported that his left arm pain was almost gone. During his last visit with the physician on Nov. 9, 2012, Morehouse claimed that despite having improvements after the injections, he continued to be symptomatic. Thus, new sets of diagnostic exams were ordered, and the claimant’s expert orthopedic surgeon opined that Morehouse was a candidate for an anterior cervical discectomy and fusion at the C5-6 and C6-7 levels with plating, and an autograft and allograft. However, Morehouse had not yet undergone the surgery. Morehouse claimed that he was asymptomatic prior to the date of the accident, in that he had no prior complaints or prior visits with doctors regarding any issues of neck pain or radiating pain to his upper extremity. However, he claimed that after the collision, he became symptomatic and that all of this medical care was necessitated by the collision. Thus, he claimed that his surgical recommendations were all due to his symptomology, which started after the collision. Morehouse claimed that he has been living with his pain, causing his day-to-day activities to diminish, and that his condition will continue to diminish as he ages. He also claimed that that he is restricted in activities and with medication, which was no choice of his, and that he used to take his boat out to a lake and dive off the boat for pleasure. Morehouse further alleged that he used to play softball for more than 10 years in a league through Simi Valley Parks & Recreations, and would go scuba diving and hiking. However, he claimed that all of his activities were restricted following the collision. In addition, Morehouse claimed that he has had problems with his sleep ever since the accident. The Hartford Co. was already responsible for paying some of Morehouse’s medical care under the workers’ compensation coverage. Thus, Morehouse sought recovery for all additional human harms and losses under the supplemental underinsured-motorist provision of his own insurance policy, which was also administered by the Hartford Co. The parties were in agreement that Morehouse was bound by the contractual policy limit of $1 million, less the underinsured motorist’s third-party settlement. The Hartford’s neurosurgery expert conducted a defense medical examination of Morehouse to provide opinions on past and future care. In his report, the expert opined that there appeared to be no radicular symptoms and that the epidural injections were not necessary. However, during his deposition on Nov. 4, 2016, the expert testified that much of Morehouse’s prior care was reasonable, including the epidural injections, as a second review of the records appeared to indicate possible radiculopathy. The respondent’s expert neurosurgeon also opined that Morehouse had a degenerative condition prior to the crash, but agreed that there was no evidence that Morehouse was symptomatic prior to the accident, as Morehouse had no history of any neck complaints or radiating pain prior to the crash. In regard to Morehouse’s alleged need for future surgery, the respondent’s counsel asserted that there were gaps in Morehouse’s treatments and that there was an extensive delay in seeking possible surgery. The respondent’s expert neurosurgeon subsequently opined that surgery was not appropriately related to the incident based on Morehouse’s statement to him and the extensive lapses of time between treatments since the incident. Thus, the respondent’s counsel asserted that, given the delay, any surgery would not be directly related to the accident.
Judicate West, CA

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