Preview
1 RoB BONTA
Attorney General of California
2 KRISTIN M . DAILY
Supervising Deputy Attorney General
3 JAMES F. CURRAN
Deputy Attorney General
4 State Bar No. 142041
"1300 I Street, Suite 125
5 P.O. Box 944255
Sacramento, CA 94244-2550
6 Telephone: (916)210-6113
Fax: (916)324-5567
7 E-mail: James.Curran@doj.ca.gov
Attorneys for Defendant
8 California Highway Patrol
9 SUPERIOR COURT OF THE STATE OF CALIFORNIA
10 COUNTY OF SACRAMENTO
II
12
13
DAVID RIDGE, Case No. 34-2019-00265393
14
Plaintiff, DECLARATION OF JAMES F. CURRAN
15 IN SUPPORT OF DEFENDANT
v. CALIFORNIA HIGHWAY PATROL'S
16 OPPOSITION TO PLAINTIFF'S
iVJC^^^^ MOTION (PEN. CODE
17 THE CALIFORNIA HIGHWAY PATROL; § 832.7; EVID. CODE § 1043)
and DOES 1-100, inclusive.
18 Date: July 20, 2022
Defendants. Time:! 1:30 p.m.
19 Dept: 53
Judge: Hon. Richard K. Sueyoshi
20 Trial Date: April 3, 2023
Action Filed: September 23, 2019
21
22 I, James F. Curran, am an attorney licensed to practice law in all courts of the State of
23 California. I am a Deputy Attorney General and counsel of record for Defendant California
24 Highway Patrol (CHP) in this case. I have analyzed the pleadings and documents relevant to this
25 lawsuit and have engaged in "meet-and-confer" communications with Plaintiffs counsel, John
26 Briscoe, of Mayall Hurley, PC, concerning two motions to compel that Mr. Briscoefiledon
27 behalf of Plainfiff David Ridge regarding the survey sent out to CHP officers by Officer Erik
28 Mallory. The first motion concerned a notice of Mallory's further deposition and a document
Declaration of James F. Curran in Support of Defendant's Opposition to Pitchess Motion (34-2019-00265393)
1 demand therein. The second motion was a motion to compel further responses by CHP to
2 Plaintiffs Special Interrogatories, Set Three. I also participated in the hearing on the latter
3 motion as CHP's counsel and have reviewed the court's order granting that motion,in part. I have
4 reviewed Plaintiffs Pitchess motion. I therefore have personal knowledge of the matters
5 described below, and could competently testify to their truth if called upon to do so.,
6 1. Attached as Exhibit 1 is a true and correct copy of the August 14, 2019 Agreed Medical
7 Examination report by Orthopedic Surgeon Beth Bathgate, M.D. I am informed and believe that
8 Dr. Bathgate was the agreed medical examiner in one of Plaintiff Ridge's workers' compensation
9 claims.
10 2.1 represented CHP at the first session of the deposition, taken via Zoom by Plaintiffs
11 counsel, John Briscoe, of CHP Officer Erik Mallory on December 15, 2021. Mallory participated
•I
12 from a different location than my location during the Zoom deposition. At this deposition,
13 Mallory testified he had in his possession paper copies of responses to a survey he had
14 disseminated, with the help of a union representative, to a large number of CHP officers. Mallory
15 scanned and emailed to me pdf copies of the survey response forms after the conclusion of the
16 first, and, thus far, only, session of his deposition on December 15,2021. Prior to receiving these
17 pdf copies from Mallory, my office had not received the survey response forms from CHP, and,
18 to the best of my knowledge, our points of contact for this case at CHP did not possess the survey
19 response forms. Copies of the survey response forms are attached as Exhibit 2 to the Declaration
20 of John Briscoe, filed by Plaintiff in support of the present motion. Those copies of the forms
21 have the responding officers' CHP identification (badge) numbers redacted pursuant to agreement
22 between the parties during the meet-and-confer process.
23 3. Attached as Exhibit 2 is a true and correct excerpt from the transcript of the February
24 25, 2021 percipient witness deposition of Captain Matthew Stover, who was Plaintiffs area
25 commander and second-level supervisor during the events giving rise to this case.
26 4. Attached as Exhibit 3 is a true and correct copy, with redactions, of the Disability
27 Retirement Approval Letter issued by CalPERS to Plaintiff on January 3, 2022.
28
Declaration of James F. Curran in Support of Defendant's Opposition to Pitchess Motion (34-2019-00265393)
1 5. Attached as Exhibit 4 is a true and correct copy, with redaictions, of Plaintiffs
2 Application for Reinstatement from Disability Retirement (entitled, "Reinstatement From
3 Disability / Industrial Disability Retirement Application"), signed by Plaintiff on October 30,
4 2021. ' •
5 6. Attached as Exhibit 5 is a true and correct copy of a December 21, 2021, rriemorandum,
6 with redactions, informing the recipient that Plaintiff was to report to CHP's Acaderiiy for a
7 requalification training course on February 14, 2022.75. '
8 7. Attached as Exhibit 6 is a true and correct copy of a June'25, 2014 memorandiam setfing
9 forth the minutes of the Second Quarter 2014 meeting of CHP's Uniform Committee.
10 8. Attached as Exhibit 7 is a true and correct copy of an April 7, 2017 memorandum '
11 setting forth the minutes of the First Quarter 2017 meeting of CHP's Uniform Committee.
12 9. Attached as Exhibit 8 is a true and correct copy of a Jiily' 18, 2017 memorandum setting
13 forth the minutes of the Second Quarter 2017 meeting of CHP's Uniforin Committee. I am
14 informed and believe, after review of the these and several other sets of the Committee's meeting
15 minutes, that the Uniform Committee has not evaluated any other ELBV prototype since Officer
16 Mallory presented his in March 2017.
17 10. I am informed and believe Plaintiff (a) has completed the requalification course, (b) is
18 presently working full duty (not limited or "light duty") as a patrol officer out of CHP's area
19 office in Santa Ana, (c) is performing patrol officer duties while wearing the regular "duty belt,"
20 or Sam Browne belt, and (d) has made no request for reasonable accommodation of his disability
21 since he applied to be reinstated in October 2020 and returned to work with CHP.
22 11. On June 20, 2022, CHP served a verified further response to Plaintiff Ridge's Specially
23 Prepared Interrogatories, Set Three, Interrogatory No. 10, to which CHP attached a spreadsheet
24 with the contact information for all survey respondents still employed by CHP. The text of this
25 further response contained some typographical errors, i.e., it mis-numbered the interrogatory.
26 CHP therefore served, on July 6, 2022, a Revised Further Response to Interrogatory No. 10.
27 A true and correct copy of that Revised Further Response is attached hereto as Exhibit 9.
28
Declaration of James F. Curran in Support of Defendant's Opposition to Pilchess Motion (34-2019-00265393)
1 12. On June 7, 2020, CHP served its responses to Plaintiff s Specially Prepared
2 Interrogatories, Set Four, a true and correct copy of which is attached as Exhibit 10. Set Four
3 included Interrogatory No. 11, which reads as follows: "From July 2, 2018 to the date of the
4 response to this interrogatory, how many officers of DEFENDANT have requested, on one or
5 more occasions, that they be permitted to wear an external load-bearing vest, in lieu of the leather
6 Sam Browne duty belt, as an accommodation for a physical disability?" In response,to
7 Interrogatory No. 11, CHP informed Plaintiff and his counsel that only three officers; including
8 Plaintiff Ridge, have made this request. (See Exhibit 10, at 2:11 -18.)
9 I declare under penalty of perjury under the laws of the State of California that the
10 foregoing is true and correct. Executed on July 7, 2022 at Sacramento, California.
11
12
13
14 SA20I9106238
15
16
17
18
19
20
21
22
23
24
25
26
27
28 „
Declaration of James F. Curran in Support of Defendant's Opposition to Pitchess Motion (34-2019-00265393)
EXHIBIT 1
Beth Bathgate, M.D. Mail Correspondence To:
Orthopedic Surgery 772 Jamacha Road, Suite 415
El Cajon, California 92019
Phone (619)416-9677
Fax (619) 768-2592
E-mail: Dr.Bathgate2019@gmail.corn
Thomas Kurtz, Esquire
Novey Law Group
5800 Standford Ranch, Suite 610
Rocklin, California 95765
Amy Chen, Claims Examiner
State Compensation Insurance Fund
P.O. Box 3171
Suisun City, California 94585-6171
Re: RIDGE, David
DOB: May 21, 1971
Emp: California Highway Patrol
DDI: CT April 21, 2014-April 21,
2015;
CT April 22, 2015 - March 6,
2019
Claim: 06089772
DOE: August 14, 2019
AGREED MEDICAL EVALUATION
Dear Mr. Kurtz & Ms. Chen:
As requested, David Ridge was seen for an Agreed Medical Re-Evaluation in my Sacramento
office on August 14, 2019, regarding his orthopedic injury.
This report is submitted pursuant to 8 Cal. Code Regs. Section 9795(b)&(c) as an ML 101-94,
Agreed Medical Re-Evaluation. Fifty minutes were spent in face-to-face time with the patient^
two hours in review of the medical records and. three hours in preparation of the report.
00034
RE: RIDGE, David-
August 14,2019
Page 2
RECAPITULATION
Mr. Ridge was last evaluated on February 6, 2019. The history and his medical records
included the following.
Mr. Ridge first noted low back pain in about 2007. He also had some numbness in the left leg
related to his work as a Highway Patrol Officer, including wearing a 30-pound duty belt and
prolonged sitting. He also had to accost suspects. He did not report this as an injury and saw
his primary care doctor. An MRI was done and no further treatment recommendations were
given. He states that his back continued to bother him. He reported it as an injury in about
2010 but did not complete the process. He did not have any further treatment for this
although he did continue with pain.
His low back pain gradually increased. He couldn't stand any position without his leg going
numb. If he sat in the patrol car, his back would hurt. He reported the injury on April 21,
2015.
At that timi, he also had right wrist and thumb pain that started on that date.
He received medical treatment from Dr. Fainsztein. An MRI was done of the lumbar spine,
which showed congenital spinal canal narrowing and mild lateral facet arthropathy at L5-S1.
He received physical therapy. Diagnoses from Dr. Fainsztein included chronic right
lumbosacral strain with left thigh intermittent paresthesias and right thumb de Quervain's
syndrome.
An ergonomic workplace evaluation was ordered. Mr. Ridge states thai this was done and it
helped him. He was not given a brace for his wrist or thumb.
Dr. Fainsztein considered him to have reached maximum medical improvement on July 15,
2015.
Medical records were received and included the following.
He was seen by Evelyn Fainsztein, M.D., occupational medicine specialist, on May 7, 2015,.
and a Doctor's First Report of Occupational Injury was completed. Four years of left
thigh/left lower extremity numbness and low back pain. He reported it and was sent to
Marshall Hospital to obtain x-rays. He attempted twice to go to a work comp facility but both
times was told they do not provide work comp services. He attempted to contact Kaiser but
did not hear back. He has never done physical therapy. Two months of pain at the base of the
right thumb. Employed by State of California Highway Patrol Date of injury listed as April
15, 2015. Medical history of hypertension and sleep apnea. Diagnosis: Chronic right
lumbosacral strain with left thigh intermittent paresthesias; Right thumb de Quervain's.
00035
RE: RIDGE, David
August 14,2019
Page 3
Ergonomic workstation evaluation, ice/heat, modalities, thumb/wrist splint, and physical
therapy recommended. Medications provided. Likely, a bulged disc aggravated by the duty
belt. No needfor MRI or specialty referral at this time.
He was seen by Dr. Fainsztein on June 3, 2015. Chronic low back pain with left-sided
paresthesias and right thumb de Quervain's tendinitis, today asymptomatic. Thumb wrist
splint provided. Awaiting ergonomic evaluation. Continue medications and physical therapy.
Dr. Fainsztein issued a supplemental report on June 24, 2015: • Telephone message.
Worsening left lower extremity numbness, now constant. Physical therapy not helping
numbness. Right thumb intermittent worsening. Continued left lower extremity radiculopathy.
MRI ordered. Continue physical therapy, ice and heat.
Lumbar spine MRI was performed on July 6, 2015, and read by John Winn, M.D. Small bony
hemangioma within the L2 vertebral body. Congenital spinal canal narrowing within the
lower lumbar spine secondary to short pedicles and prominent epidural fat. Mild bilateral
facet arthropathy at L5-S1. Impression: Congenital spinal canal narrowing. No significant
degenerative disc disease or acquired central canal stenosis. Mildfacet arthropathy at L5-S1.
On July 15, 2015, he was seen by Dr. Fainsztein. No findings on MRI to warrant continued
treatment. Permanent and stationary for the low back and right thumb. Discharged with no
permanent impairment, no disability, and no future medical care.
Diagnoses at the time of the previous evaluation were chronic low back pain with mild
bilateral facet arthropathy, chronic left lateral femoral cutaneous nerve irritation and right
wrist de Quervain's syndrome. He was not permanent and stationary and further treatment
was indicated.
Mr. Ridge states he has continued to work full time as a California Highway Patrol Officer.
He didn't start being treated following the December 3, 2015, Agreed Medical Evaluation
until July 7, 2016. He then began seeing Dr. Yang. An epidural injection was done in August
of 2016. He states this did not help him.
He had an increase in his right wrist and thumb pain on about August 16, 2016, when he was
wrestling a person in custody to the ground. He was seen at the Emergency Room at Marshall
Medical Center. Diagnosis was exacerbation of de Quervain's tenosynovitis due to injury. He
was advised to ice the injury, wear a thumb spica splint and use medication for pain. Mr.
Ridge continued working without restrictions. He states his thumb and wrist pain were
increasedfor some time but then returned to their baseline level.
00036
RE: RIDGE, David
August 14,2019
Page 4
He has been unable to obtain a special external vest carrier for his gun. This was
recommended by Dr. Yang. He states this was denied by the insurance company. He has not
yet seen an orthopedic surgeon or a neurologist.
Medical records were received and included the following.
He was seen by Michael Yang, M.D., pain management specialist, on July 7, 2016. History of
chronic low back pain for many years. Employed as a highway patrol officer. He first saw a
doctor for low back pain in 2007. Date of injury listed as April 21, 2015, for low back] right
wrist and hand pain. Past medical history positive for hypertension and depression.
Diagnosis: Lumbar spine degenerative arthritis; Lumbar degenerative joint disease; Femoral
nerve injury; Radiculopathy of lumbar region; Right wrist injury. Lumbar epidural steroid
injection requested. Special load bearing vest requested due to his carrying heavy duty
weapons at work. Right wrist femoral nerve injury deferred until this condition is researched
more.
On August 5, 2016, he was seen by Dr. Yang. It appears work comp will not approve the
special vest. Temporary certification to return to work using a normal gun belt. Authorization
requested for AME or QME to help determine whether or not he can continue as an officer
due to the gun belt issue. Follow-up for approved epidural steroid injection.
Left lumbar epidural steroid injection was performed by Dr. Yang on August 15, 2016.
Diagnosis: Lumbar degenerative disc disease; Lumbar radiculitis.
He was seen by Juliet Lamers, M.D. and Nurse Practitioner J. Goodall in the emergency
department at Marshall Medical Center on August 16, 2016, and a Doctor's First Report of
Occupational Injury was completed. Complaints of right wrist and thumb pain. Onset
yesterday after wrestling a person in custody to the ground. Prior diagnosis of de Quervain's
tendinopathy. Employed as a highway patrolman. Assessment: Exacerbation of de Quervain's
tenosynovitis due to injury: Advised to ice injury, wear thumb spica splint, and use medication
for pain.
Dr. Yang saw him on September 6, 2016. Recent lumbar epidural injection did not help with
low back pain. Continued de Quervain's symptoms, and mostly symptoms in the left femoral
nerve distribution. Authorization requested for referral to neurologist regarding femoral
nerve entrapment, chiropractic treatment for severe right paraspinal spasm, and orthopedic
surgeon for evaluation of de Quervain's and possible steroid injection.
Authorization again requested by Dr. Yang for chiropractic treatment, neurological
evaluation for femoral nerve entrapment, and orthopedic surgeon for right wrist steroid
injection on September 27, 2016.
00037
RE: RIDGE, David
August 14,2019
Page 5
Diagnoses at the time of that evaluation were chronic low back pain with mild bilateral facet
arthropathy, chronic left lateral femoral cutaneous nerve irritation and right wrist strain and
tendinitis with deQuervain's syndrome. He was not yet considered to have reached maximum
medical improvement. Further treatment had been recommended. '
Since the last evaluation, Mr. Ridge continued working at his full duties as a California
Highway Patrol Officer. He received further treatment. He saw an orthopedic hand surgeon.
Dr. Slater, on May 15, 2017. Diagnosis was right thumb carpometacarpal joint arthralgia
and lateral subluxation of the metacarpophalangeal joint with early degenerative changes:
He was given an injection and a thumb spica splint. This resulted in some improvement of his
symptoms.
He receivedfurther treatment for his lateral femoral cutaneous nerve irritation:
He received right L4-5 medial branch blocks on September 25, 2017.
He was referred to a neurosurgeon, Dr. Sanden, who saw him on October 4, 2017. A lumbar
spine MRI was done on October 26, 2017. Dr. Sanden recomrnended surgery. When he saw
Mr. Ridge on April 8, 2018, he noted that the MRI documented L4-5 stenosis, ligamentous
facet and disc injury with neurogenic pseudoclaudication, L5-S1 foraminal stenosis from
ligamentous facet hypertrophy contributing to lower extremity radiculopathy, and a mild
kyphotic deformity related to wedging. There was a component of congenital stenosis^
Dr. Sanden did lumbar spine surgery on April 12, 2018, with decompression at L4-5 and L5-
Sl jor stenosis. ,- •
Mr. Ridge states that he last worked on the date of his surgery. He recently was released by
Dr. Sanden to start modified duty, which he has been doing since January 10, 2079.,
Medical records were received and included the following.
He was seen for follow-up by Michael Yang, M.D., pain management specialist, on November .
22, 2016 and January 23i 2017. Continued right de Quervain's symptoms and low back pain.
Diagnosis: Radiculopathy of lumbar region; Lumbar degenerative joint disease; Lumbar
spine degenerative arthritis; Femoral nerve injury; Right wrist injury. No benefit from lumbar
epidural steroid injection. Referredfor orthopedic evaluations. Chiropractic visits approved.
He was seen by Joseph Ambrose, D.C. on February 17, 2017, and a Doctor's First Report of
Occupational Injury was completed. Cumulative stress to lower back during law enforcement
duties. Currently with complaints of low back pain and stiffness and left leg pain and
numbness. Also with right wrist pain. Injury date listed as April 21, 2015. Employed by
California Highway Patrol. Diagnosis: Segmental dysfunction of thoracic, lumbar, sacral and
00038
RE: RIDGE, David
August 14,2019
Page 6
pelvic regions; Sprain of ligaments of thoracic spine, lumbar spine, and sacroiliac; Lower
back strain; Muscle spasm of back. Chiropractic care recommended.
On March 17, 2017, he was seen by Gary Martinovsky, M.D., pain management specialist, on
March 17, 2017. During the course of employment as a police officer for California Highway
Patrol, he sustained cumulative trauma injury to his lower back from wearing a 30-pound
gun belt, right wrist due to repetitive typing and mouse manipulation, and left leg attributed
to the magazine pouch pressed against his left femoral nerve for 20 years. Past work-related
motor vehicle accident in 1997, cumulative stress, and hypertrophy. Medical history of high
blood pressure. Diagnosis: Left meralgia paresthetica; Lumbar facetogenic pain; Lumbago.
Authorization requested for plastic surgery consultation to evaluate for left femoral nerve
decompression. Referred to hand surgeon for right de Quervain's release. Referral requested
for chiropractic physiotherapy for the lower back.
He was seen by Physician Assistant Leonid Pugach for Dr. Martinovsky on April 28, 2017.
Pain in the right wrist, lower back and left leg associated with tingling/numbness in the left
leg and weakness in the right hand. Approved plastic surgery consultation. Pending
scheduling of hand surgery evaluation. Pending request for chiropractic treatment.
He was seen by Robert Slater, M.D., orthopedic hand surgeon, on May 15, 2017. Several year
history of right hand and thumb pain. Impression: Right thumb carpometacarpal (CMC) joint
arthralgia and lateral subluxation of metacarpophalangeal joint with early degenerative
change. Right thumb CMC joint injection provided. Referred to hand therapy for custom
thumb spica splint.
On May 23, 2017, he was seen by PA Pugach for Dr. Martinovsky. Authorization requested
for thumb spica splint. Continue chiropractic therapy.
Dr. Slater saw him on June 22, 2017. Improved right thumb CMC joint arthralgia with
injection. Pursue therapy appointment. Recheck on July 20, 2017. Pending custom thumb
spica splint.
He was seen by Harry Khasigian, M.D., orthopedic surgeon, on July 10, 2017. Pain and
numbness left lateral thigh, aggravated by wearing his gun belt while working as a sheriff.
Impression: Lateral femoral cutaneous nerve injury (meralgia paresthesia) as a result of
obesity and wearing large gun belt. Referred to physical therapy: Medication prescribed.
Consider exploration of lateral femoral cutaneous nerve. Weight reduction, rest and removal
of offending pressure of belt recommended.
On July 14, 2017, he was seen by Fred Samimi, M.D., neurologist. Low back and anterior left
thigh numbing pain and paresthesia. Assessment: Meralgia paresthetica. MRI consistent with
lumbar facet arthropathy. Medications prescribed.
00039
RE: RIDGE, David
August 14, 2019
Page 7
Right L4, L5 medial branch nerve blocks were administered by Dr. Martinovsky on'July 25,
2017. Diagnosis: Lumbar facet arthropathy.
He was seen by Dr. Slater on September 14, 2017. Comp carrier refused to authorize thumb
spica splint. Continue self-purchased thumb spica splint. " . -
He was seen by Roderick Sanden, M.D., neurosurgeon, on October 4, 2017. Employed as a
California Highway Patrol officer. Back and leg pain began in 2010. Injury date listed as
April 21, 2015. Assessment: L2-3 versus L3-4 disc protrusion, traumatic, left lower extremity
radiculopathy; Meralgia paresthetica left lateral femoral cutaneous of the right thigh from
abdominal panniculus; Body mass index of 43; Situational adjustment reaction to young
adulthood; Congenital spinal stenosis; Right wrist de Quervain's. Authorization requested for
gastric bypass, medication, repeat lumbar spine MRI and x-rays,. and EMG/nerve conduction
study. Seen for recheck by Nurse Practitioner Theresa Sanden on November 15, 2017.
Request for gastric bypass surgery denied. Follow-up with Dr. Sanden for review of
diagnostic studies and to discuss surgical options. '
Lumbar spine x-rays with flexion/extension views was taken on October 25, 2017, and read by
Larry Chespak, M.D. Findings/Impression: Anterior wedging of T12 and LI. Disc space
narrowing at Tl 1-12 and T12-L1 levels.
Lumbar spine MRI was performed on October 26, 2017, and read by Dr. Chespak
Findings/Impression: L3-4: Facet and posterior ligamentous hypertrophic changes. Broad
disc protrusion measuring 2-3mm. Bilateral neural foraminal exit zone compromise. L4-5:
Facet and posterior ligamentous hypertrophic changes. Hypertrophy of the posterior inferior
endplate of L4. Disc protrusion measuring l-2mm. Bilateral neural foraminal exit zone
compromise with spinal stenosis. L5-S1: Marked facet and posterior ligamentous
hypertrophic changes. Hypertrophic spurring. Disc protrusion measuring 2-3mm. Moderate
bilateral neural for aminaiexit zone compromise.
Bilateral lower extremity electrodiagnostic testing was performed on November 7, 2017, and
read by Navnit Bhatia, M.D. Interpretation: Normal study with no evidence of bilateral
radiculopathy or compression neuropathy.
He was seen by NP Sanden for Dr. Sanden on December 11, 2017 and January 11, 2018.
Surgery pending authorization. Without surgery, he will ^ove achieved maximum medical
improvement. Seen for follow-up on February 12, 2018 and March 12, 2018. Increased pain
and weakness. Lumbar surgery denied, pending re-request.
00040
RE: RIDGE, David
August 14,2019 "
Page 8
January 11, 2018, U.R. Non-Certification from EK Health. Denied: L4-5 and L5-S1
laminectomy, intraoperative neuromonitoring, and lumbar back brace. Surgery certified on
March 20, 2018. Continued denial of back brace.
On April 8, 2018, he was seen by Dr. Sanden. Back and leg pain beginning in 2010, with
cumulative injury reported on April 15, 2015. Past medical history including hypertension
and obesity. Assessment: MRI documented L4-5 stenosis, ligamentous facet, and disc injury
with neurogenic pseudoclaudication; L5-S1 forarninal stenosis from ligamentous facet
hypertrophy contributing to lower extremity radiculopathy; Mild kyphotic deformity from
collapse wedging Tl 1-T12-L1; body mass index of 43; Left thigh meralgia paresthetica;
Component of congenital stenosis; Right wrist de Quervain's. Surgery discussed, proceed as
planned on April 12, 2018.
He was seen by Wutt Linn, M.D. at Mercy San Juan Medical Center on April 12, 2018. Past
medical history of high blood pressure, depression, and progressively worsening chronic
lower back pain with radiating numbness to the left lower extremity. Admit diagnosis
secondary to lower back pain with left leg numbness. Proceed with planned lumbar spine
surgery.
Lumbar spine surgery was performed by Dr. Sanden on April 12, 2018. This was L4-5
laminectomy, foraminotomy andfacetectomy, L5-S1 bilateral laminectomy, foraminolomy and
medial facetectomy, and manipulation under anesthesia. Postoperative Diagnosis: L4-5
central stenosis from ligamentous facet hypertrophy with broad-based disc osteophyte
complex, neurogenic pseudoclaudication, lower extremity radiculopathy, left greater than
right. L5-S1 moderate to severe foraminal stenosis, foraminal nerve compression,
radiculopathy, ligamentous facet hypertrophy, broad-based. disc osteophyte complex with
lower extremity radiculopathy, left greater than right. L4, L5, SI congenital spinal stenosis.
L4, L5, SI stenosis, contribution from epidural lipomatosis. L4-5 central stenosis greater than
foraminal stenosis with left synovial facet cyst with disc osteophyte complex. L5-S1 bilateral
foraminal greater than central stenosis, medial facet hypertrophy with left greater than right
nerve compression.
He was seen by NP Sanden for Dr. Sanden on April 26, 2018. Doing well following lumbar
spine surgery. Two days ago he walked to his mailbox up and down a hill and now has a
burning and knife stabbing sensation in his left dorsolateral thigh with numbness/tingling,
now intermittent and improved with rest. Postoperative physical therapy requested.
On August 14, 2018, he was seen by NP Sanden for Dr. Sanden. Flare up on June 18 after
.third session of physical therapy, now resolved. He has fallen out of bed three times.
Improved left thigh numbness. Mild weakness through the left foot/ankle with prolonged
walking greater than one mile. Extension of physical therapy requested. Recheck on
00041
RE: RIDGE, David
August 14,2019
Page 9
September 12, 2018. Constant radiating leg pain through the left buttock into the left thigh
with numbness/tingling.
He was seen by NP Sanden for Dr. Sanden on October 23, 2018. Nearly resolved left
foot/ankle weakness, no longer with foot drag. Continue ongoing care and treatment:
He was seen by NP Sanden for Dr. Sanden on December 4, 2018. Six months status post
lumbar spine surgery with intermittent lower back pain and pain into the left buttock and
thigh. Physical therapy helped with strengthening. Proceed with scheduled QME on February
9. Follow-up in four weeks.
INTERVAL HISTORY
Since the last evaluation, Mr. Ridge has been followed by his spine surgeon. Dr. Sanden, Dr.
Nkadi and Dr. Ambrose.
Mr. Ridge states that his lawyer filed a new cumulative trauma case from April 22, 2015, to
March 6, 2019, for the low back. He states that he had been off work from April 12, 2018, the
time of his low back surgery, until January 10, 2019. He was released to modified work,
which he started on Jahuaiy 10, 2019. He did have to wear a gun belt in the office for a few
months around this time, from about February to April 2019. Dr. Nkadi gave him a restriction
of not using a gun belt in about April 2019. He has continued to do office work since that
time.
He continued with low back pain, and in March 2019 went to a chiropractor. Dr. Ambrose,
and his family practice doctor. He had a new MRI done.
Mr. Ridge states that he was released to full duty for a few months in 2019 but he did not
retum to work at patrol, but worked in an office.
He has been depressed related to his injuries.
Medical records were received and included the following.
He was seen for follow-up by Nurse Practitioner Theresa Sanden for Roderick Sanden, M.D.,
neurosurgeon, on January 9, 2019. Status post lumbar spine surgery performed in April 2018
with pain and numbness/tingling radiating into the left buttock and thigh to above the left
knee. Pain in the right buttock began yesterday while walking upstairs. Resolved left
foot/ankle weakness. Assessment: Status post L4-5 and L5-S1 laminectomy/diskectomy; Mild
kyphotic deformity from collapse wedging Tl 1-T12-L1; Body mass index of 43; Left thigh
meralgia paresthetica; Component of congenital stenosis; Right wrist de Quervain's. MRI
00042
RE: RIDGE, David
August 14,2019
Page 10
recommended due to new pain/symptoms on the right. QME scheduled for February 2019.
Recheck on February 12, 2019. Released to full work duties without restrictions.
He was seen by NP Sanden for Dr. Sanden on March 18, 2019. Pain radiating from right
buttock around right hip region and into right groin. Aching, shooting pain and numbness into
left buttock and thigh. Assessment: Status post L4-5 and L5-S1 laminectomy/diskectomy with
previous documented 80 percent improvement in axial low back pain and 60 percent
improvement of left leg pain; Recent five day fiare up of right back/buttock, hip and groin
pain, which he believed is a new industrial injury; Mild kyphotic deformity from collapse
wedging Tl 1-T12-L1 contributing to upper thoracolumbar axial lower back pain; Body mass
index of 43; Left thigh meralgia paresthetica, now possibly bilateral in nature; Nonindustrial
right hip pain with negative right hip x-rays taken by nonindustrial primary care provider;
Ongoing preexisting component of congenital stenosis; Right wrist de Quervain's.
Authorization requested for physical therapy and lumbar spine MRI. Consider right hernia
evaluation and right hip MRI. Likely permanent and stationary if lumbar spine MRI findings
are normal. •; •
Lumbar spine MRI was performed on April 23, 2019, and read by Larry Chespak, M.D,.
Comparison: October 26, 2017. Findings/Impression: Surgical intervention at L5-S1 level
done since prior examination. L3-4: Broad disc protrusion measuring 2-3mm again noted.
Bilateral neural foraminal exit zone compromise without spinal stenosis. No significant
osteoarthritic changes involving the facet joints. Post administration of intravenous contrast
with no abnormal increased or decreased enhancement. L4-5: Disc protrusion measuring 1-
2mm again noted, unchanged when compared to prior examination. No significant
osteoarthritic changes involving the facet joints. Post administration of intravenous contrast
with no abnormal increased or decreased enhancement. L5-S1: Left laminectomy performed
since prior examination. Partial regeneration of lamina. Soft tissue mass adjacent to the
medial aspect of the left facet joint impinging upon the thecal sac, with finding not present
preoperatively and cannot be determined if this represents scar or residual disc. Post
administration of intravenous contrast with no abnormal increased or decreased enhancement.
He was seen by Paul Nkadi, M.D., physiatrist, on May 23, 2019, and a Doctor's First Report
of Occupational Injury was completed. Employed as an officer for California Highway Patrol
for the past 24 years. No specific date of injury. Cumulative trauma from wearing a 30-35
pound gun belt eight hours a day. Date of injury listed as April 21, 2015. Industrial-related
injury. Diagnosis: Chronic lumbar radiculopathy; Meralgia paresthetica; Trochanteric bursitis
of both hips; Osteoarthritis of carpometacarpal joint of thumb; Status post lumbar
laminectomy. Proceed with scheduled TENS unit trial as well as chiropractic therapy for
previous injury. Bilateral iliotibiai band stretching in physical therapy recommended.
00043
RE: RIDGE, David
August 14,2019
Page 11
On May 28, 2019, he was seen by Nurse Practitioner Aminah Al-Saeedi for Dr. Nkadi.
Constant back pain. Sleep disturbed by pain. TENS unit dispensed. Pending approval of
acupuncture and chiropractic therapy. • • .
Dr. Nkadi saw him on June 19, 2019. Worsening back pain due to duty belt. Physical therapy
scheduled to begin next month. Continue TENS unit.' Work clarification requested.
Recommend no wearing duty belt, may wear outer-vest carrier and duty belt suspension
system. ' '
CURRENT TREATMENT
He is followed by Dr. Nkadi. He gets chiropractic treatment and physical therapy once a
week. He uses a TENS unit. - ', . .
MEDICATIONS i ,. :
He takes no medications for his injury. For unrelated reasons, he takes: clonazepam,
Propranolol, lisinopril and citalopram. i
CURRENT COMPLAINTS
He has constant low back pain with numbness and tingling in the left leg. His pain is worse
with sitting and going from a sitting to a standing position. He has pain in the back of the right
leg to the knee. He can't wear a gun belt without pain as it pokes into him when he is sitting
in a patrol car. He has complaints of pain in the buttocks and hips.
His pain is sharp, throbbing, shooting, stabbing, aching and burning and moderate.
He states his pain is worse than it was before surgery. It also increased when he returned to
work. He cannot do hiking or walking for exercise.
His right thumb pain is constant. He has an aching. This has not changed since the last
evaluation.
JOB HISTORY
At the time of his injury, Mr. Ridge worked for the California Highway Patrol as an officer.
He started working there in October 1995. He did all the duties of a Highway Patrol Officer,
including clearing the highways and arresting suspects. He initially drove a patrol car.
00044
RE: RIDGE, David
August 14,2019
Page 12
For the last three years, he has been an officer assigned to a small field office in Placerville.
He states he has lots of different duties. He does clerical work, handles reports, does data
entry. He does some patrol work as well.
As a Highway Patrol Officer, he is required to be able to lift over 100 pounds, sit, walk, walk
on uneven ground, climb and reach overhead. . • , ,
OTHER INJURIES
He has had no new injuries since the last evaluation.
He had a motor vehicle accident related to work when there was a patrol car collision in
1998. He had no injuries or settlements related to this.
He had a cardiac workers' compensation case in 2007, which was settled.
He had a stress claim in 2010, which was settled.
He has had no other work-related injuries, no personal injuries and no motor vehicle
accidents with injuries.
GENERAL MEDICAL HISTORY
He has a heart condition and high blood pressure. He states he is currently being evaluated
regarding an essential tremor and Parkinson's is being considered. Prior surgeries include
tonsillectomy in 2007. He has had no other hospitalizations.
REVIEW OF MEDICAL RECORDS
1. Subpoenaed records from Advanced Neurospinal Care, NMCI Medical Clinic
2. Roderick Sanden, M.D./Theresa Sanden, NP: 01/09/19 - 03/18/19
3. Larry Chespak, M.D.: 04/23/19
4. Joseph Ambrose, D.C: 05/08/19 - 05/29/19 (3 visits; Mid and low back pain, left lower
extremity numbness/tingling)
5. PaulNkadi,M.D./Aminah Al-Saeedi, ANP-C: 05/23/19-06/19/19
00045
RE: RIDGE, David
August 14,2019
Page 13
PHYSICAL EXAMINATION
The examinee is an alert, cooperative, right-handed, 48-year-old male, who appeared
comfortable during the examination. In preparation for performing the examination of Mr.
RidgCj and In accordance with the AMA Guides to the Evaluation of Permanent Impairment. 5"^
Edition, he was provided a "warm-up" period such that he was observed performing range of
motion activities about his spine and extremities. In addition, spinal examinations were
performed, utilizing the single or dual inclinometer where appropriate and extremity
examinations were performed using the goniometer or inclinometer.
Height: 5'10" Weight: 310 lbs.
EXAMINATION OF THE BACK
General Examination
Alignment of the examinee's spine and lower extremities is normal with no scoliosis or
lordosis. The examinee has a normal gait and is able to walk on toes and heels.
A well-healed scar is present over the low back.
There is tenderness and muscle guarding over the low back and paraspinal muscles diffusely.
Range of motion of the back is as follows. An inclinometer was used and the highest of three
measurements is recorded.
Measured Normal ROM
in degrees (3 times) in degrees
Flexion 40° 60°
SF 30°
Extension 25° 25°
Lateral bending, right 20° 25°
Lateral bending, left 20° 25°
Muscle Strength and Range of Motion
Range of motion and muscle testing of the extensor, flexor, invertor and evertor muscles of
the hip, knee, ankle, subtalar and great toe joints are normal bilaterally.
There is no tenderness over the iliac crests.
00046
RE: RIDGE, David
August 14,2019
Page 14
Neurological Testing
Straight leg raising, seated and supine and cross, is normal bilaterally.
Deep tendon reflexes, both patellar and Achilles, are normal and equal bilaterally.
Sensation to pinprick is intact in both lower extremities, except decreased over the left lateral
thigh in an SI distribution to 70% of normal.
Credibility Testing
Difftise Tenderness Appropriate
Nonanatomic Nerve Dysfunction Appropriate
Histrionic Movements Appropriate
Hypersensitivity Appropriate
DIAGNOSIS .
1. Chronic low back pain status post surgery for decompression at L4-5 and L5-S1.
2. Chronic left lateral femoral cutaneous nerve irritation, resolved.
3. Right wrist strain with carpometacarpal arthritis.
CAUSATION
There is no change to my opinion with regard to causation. This is included here for
completeness.
In my opinion, it is medically reasonable that Mr. Ridge had a cumulative trauma injury
involving the back and left leg related to his work as a California Highway Patrol Officer
with a reported date of April 21, 2015. He noted that he had back pain over the years,
starting in 2007. This was related to sitting in a patrol car, wearing a duly belt and also
stopping combative suspects. This gradually increased with time and was reported on April
21,2015.
The cover letter from Amy W. Chen, Senior Claims Representative, indicated that a new
injury to the low back was alleged with a cumulative trauma from April 22, 2015, through
March 6, 2019. She indicated that claim was denied based on Dr. Sanden's March 18, 2019,
report that stated that there was "no new low back cumulative trauma through March 6,
2019."
00047
RE: RIDGE, David
August 14, 2019
Page 15
Based on the available records, in my opinion, there has been a new cumulative trauma
sustained relative to Mr. Ridge's back. While it is noted he was assigned to a small office in
Placerville for the last three years where he did primarily office work, he did occasionally do
patrol as well arid he was required to wear a duty belt. He was receiving treatment for his
injury during this time. On August 5, 2016, he was seen by Dr. Yang. Dr. Yang indicated that
"work comp will not approve the special vest.: temporary certification to retum to work using
a normal gun belt." The patient described increasing pain as a result.
Mr. Ridge indicated he continued to work full time as a California highway patrol officer until
his lumbar spine surgery on April 12, 2018. There was a record indicating he was seen in the
Marshall Emergency Room on August 16, 2016, after he had increased pain in his righti wrist
and thumb when wrestling a person in custody to the ground. This was discussed in the prior
reports and the right wrist and thumb are not being readdressed as they were previously
considered to have reached maximum medical improvement. This information is just given to
support that he was working full time as a highway patrol officer when this incident occurred.
It is noted that from April 12, 2018 through January 10, 2019, he was off work on temporary
total disability following his lumbar spine surgery. He then did modified work and was
required to wear a gun belt for two months. In my medical opinion, there has been a new
cumulative trauma injury sustained to his lumbar spine as claimed.
Mr. Ridge complained of depression related to his injury and not being able to continue as a
California Highway Patrol Officer. Evaluation for this should be allowed for AOE/COE by a
psychologist or psychiatrist.
DISCUSSION/DISABILITY STATUS
He was declared to have reached maximum medical improvement for the right upper
extremity and low back at the time of the February 6, 2019 evaluation. The right wrist has
been stable and will not be readdressed.
Since the last evaluation, Mr. Ridge has seen Dr. Sanden and also Dr. Nkadi. He is currently
receiving chiropractic treatment and physical therapy. He has not returned to his full duties.
Mr. Ridge states that he does not think that he will be able to retum to full duty due to the
heavy job requirements of his position as a California Highway Patrol Officer.
Mr. Ridge received conservative treatment following the December 2016 evaluation. He had
medial branch blocks done in July 2017 and a further MRI of the lumbar spine. He was
referred to a neurosurgeon. Dr. Sanden, on October 4, 2017. Dr. Sanden recommended
surgery, which was done on April 12, 2018, with decompression for central stenosis and
foraminal changes at L4-5 and L5-S1. Following surgery he has received physical therapy.
00048
' liE: RIDGE, .David / ' . i ''|'
Aiigus[t;14,'2019 . ^ \ ' . •. ; ' J.
• Page^i e^ :5,t- • ;• . ••• . • -
Mr. Ridge was' tempora'ri}yvt6tally^disabledv^^^ April42,"V20I8, a(the time,of his surgery, ,
until January/l0,,20r9S He.then worked-at modified duty frorn;^^^^^ he-
.'>did. wear.-:a gun •..belt wh,ile^!dpjng^ office, work.' This exacerbatejd:hi's'^back palini'He 'went to a
chiropractor and his own doctors for treatrrieritv'He had a new .MRI wriich showed a soft tissue
mass adjacehf to ther'rnedial 'aspeptiof ;tlie;Ieft.Tacet joint!impinging -upon, the thecal'sac. It was.
stated::i _- •; • •, . '•! ' j. i : ' , • , .- •.
OBJECTfyE F A G T O R I SUi^PQRTINfa^IM^
1'. Lumbar spine IylRI,->July,,:6, ^2015. Congenital sjfMnaf canal :n^arrowi significant
degenerative •'disc/disease^ central-'canal ^stenosis! Mildrfac'et •arthrppathy. at
Ls-sL^r--/^ • H= ••• • •, '
2. •. Left ^^umb'ar^/^^epidijfaj/^ste injection;*-August -.l^S, 2pj[,6: -'Diagnosis: Lumbar
degeneirative disc disease; Liimbar ira^
3. He has tenderness^;tpi palpation bver^^ has tenderness ,tp
palpation and decreased range of motion oYithel^lurribar spine.iHe has pain over the left
lateral femoral cutaneousrieryeand a'positive-Tiners sign. .
4. Right; L4,''L5. medial (bWch, nerve.block^^^^ 25;|201^. Diagnosis:'Lumbar facet
• artlirdpathy. '' \ .
-5. Lurhbar.spin'e Xrray's.'witli '.flexion/extensioh'"view 25,- 20-17. Anterior Wedging -
•" of Tl 2-and p i Misc space harrowing at Tll-12 -ancivT1'2-Ll .levels.
.6. , .Lumbar 'spine" 'MRI,j>:(9^ctbber, j26j-"'>20,17." L3-4:/^Fac.et. and post'erior,;;'"Iigamentpusr
.• hypertrophic^:.chanjges^^^Broad ;disc, pfoVrusipn;. nieasu^rm
Preview
1 RoB BONTA Attorney General of California 2 KRISTIN M . DAILY Supervising Deputy Attorney General 3 JAMES F. CURRAN Deputy Attorney General 4 State Bar No. 142041 "1300 I Street, Suite 125 5 P.O. Box 944255 Sacramento, CA 94244-2550 6 Telephone: (916)210-6113 Fax: (916)324-5567 7 E-mail: James.Curran@doj.ca.gov Attorneys for Defendant 8 California Highway Patrol 9 SUPERIOR COURT OF THE STATE OF CALIFORNIA 10 COUNTY OF SACRAMENTO II 12 13 DAVID RIDGE, Case No. 34-2019-00265393 14 Plaintiff, DECLARATION OF JAMES F. CURRAN 15 IN SUPPORT OF DEFENDANT v. CALIFORNIA HIGHWAY PATROL'S 16 OPPOSITION TO PLAINTIFF'S iVJC^^^^ MOTION (PEN. CODE 17 THE CALIFORNIA HIGHWAY PATROL; § 832.7; EVID. CODE § 1043) and DOES 1-100, inclusive. 18 Date: July 20, 2022 Defendants. Time:! 1:30 p.m. 19 Dept: 53 Judge: Hon. Richard K. Sueyoshi 20 Trial Date: April 3, 2023 Action Filed: September 23, 2019 21 22 I, James F. Curran, am an attorney licensed to practice law in all courts of the State of 23 California. I am a Deputy Attorney General and counsel of record for Defendant California 24 Highway Patrol (CHP) in this case. I have analyzed the pleadings and documents relevant to this 25 lawsuit and have engaged in "meet-and-confer" communications with Plaintiffs counsel, John 26 Briscoe, of Mayall Hurley, PC, concerning two motions to compel that Mr. Briscoefiledon 27 behalf of Plainfiff David Ridge regarding the survey sent out to CHP officers by Officer Erik 28 Mallory. The first motion concerned a notice of Mallory's further deposition and a document Declaration of James F. Curran in Support of Defendant's Opposition to Pitchess Motion (34-2019-00265393) 1 demand therein. The second motion was a motion to compel further responses by CHP to 2 Plaintiffs Special Interrogatories, Set Three. I also participated in the hearing on the latter 3 motion as CHP's counsel and have reviewed the court's order granting that motion,in part. I have 4 reviewed Plaintiffs Pitchess motion. I therefore have personal knowledge of the matters 5 described below, and could competently testify to their truth if called upon to do so., 6 1. Attached as Exhibit 1 is a true and correct copy of the August 14, 2019 Agreed Medical 7 Examination report by Orthopedic Surgeon Beth Bathgate, M.D. I am informed and believe that 8 Dr. Bathgate was the agreed medical examiner in one of Plaintiff Ridge's workers' compensation 9 claims. 10 2.1 represented CHP at the first session of the deposition, taken via Zoom by Plaintiffs 11 counsel, John Briscoe, of CHP Officer Erik Mallory on December 15, 2021. Mallory participated •I 12 from a different location than my location during the Zoom deposition. At this deposition, 13 Mallory testified he had in his possession paper copies of responses to a survey he had 14 disseminated, with the help of a union representative, to a large number of CHP officers. Mallory 15 scanned and emailed to me pdf copies of the survey response forms after the conclusion of the 16 first, and, thus far, only, session of his deposition on December 15,2021. Prior to receiving these 17 pdf copies from Mallory, my office had not received the survey response forms from CHP, and, 18 to the best of my knowledge, our points of contact for this case at CHP did not possess the survey 19 response forms. Copies of the survey response forms are attached as Exhibit 2 to the Declaration 20 of John Briscoe, filed by Plaintiff in support of the present motion. Those copies of the forms 21 have the responding officers' CHP identification (badge) numbers redacted pursuant to agreement 22 between the parties during the meet-and-confer process. 23 3. Attached as Exhibit 2 is a true and correct excerpt from the transcript of the February 24 25, 2021 percipient witness deposition of Captain Matthew Stover, who was Plaintiffs area 25 commander and second-level supervisor during the events giving rise to this case. 26 4. Attached as Exhibit 3 is a true and correct copy, with redactions, of the Disability 27 Retirement Approval Letter issued by CalPERS to Plaintiff on January 3, 2022. 28 Declaration of James F. Curran in Support of Defendant's Opposition to Pitchess Motion (34-2019-00265393) 1 5. Attached as Exhibit 4 is a true and correct copy, with redaictions, of Plaintiffs 2 Application for Reinstatement from Disability Retirement (entitled, "Reinstatement From 3 Disability / Industrial Disability Retirement Application"), signed by Plaintiff on October 30, 4 2021. ' • 5 6. Attached as Exhibit 5 is a true and correct copy of a December 21, 2021, rriemorandum, 6 with redactions, informing the recipient that Plaintiff was to report to CHP's Acaderiiy for a 7 requalification training course on February 14, 2022.75. ' 8 7. Attached as Exhibit 6 is a true and correct copy of a June'25, 2014 memorandiam setfing 9 forth the minutes of the Second Quarter 2014 meeting of CHP's Uniform Committee. 10 8. Attached as Exhibit 7 is a true and correct copy of an April 7, 2017 memorandum ' 11 setting forth the minutes of the First Quarter 2017 meeting of CHP's Uniform Committee. 12 9. Attached as Exhibit 8 is a true and correct copy of a Jiily' 18, 2017 memorandum setting 13 forth the minutes of the Second Quarter 2017 meeting of CHP's Uniforin Committee. I am 14 informed and believe, after review of the these and several other sets of the Committee's meeting 15 minutes, that the Uniform Committee has not evaluated any other ELBV prototype since Officer 16 Mallory presented his in March 2017. 17 10. I am informed and believe Plaintiff (a) has completed the requalification course, (b) is 18 presently working full duty (not limited or "light duty") as a patrol officer out of CHP's area 19 office in Santa Ana, (c) is performing patrol officer duties while wearing the regular "duty belt," 20 or Sam Browne belt, and (d) has made no request for reasonable accommodation of his disability 21 since he applied to be reinstated in October 2020 and returned to work with CHP. 22 11. On June 20, 2022, CHP served a verified further response to Plaintiff Ridge's Specially 23 Prepared Interrogatories, Set Three, Interrogatory No. 10, to which CHP attached a spreadsheet 24 with the contact information for all survey respondents still employed by CHP. The text of this 25 further response contained some typographical errors, i.e., it mis-numbered the interrogatory. 26 CHP therefore served, on July 6, 2022, a Revised Further Response to Interrogatory No. 10. 27 A true and correct copy of that Revised Further Response is attached hereto as Exhibit 9. 28 Declaration of James F. Curran in Support of Defendant's Opposition to Pilchess Motion (34-2019-00265393) 1 12. On June 7, 2020, CHP served its responses to Plaintiff s Specially Prepared 2 Interrogatories, Set Four, a true and correct copy of which is attached as Exhibit 10. Set Four 3 included Interrogatory No. 11, which reads as follows: "From July 2, 2018 to the date of the 4 response to this interrogatory, how many officers of DEFENDANT have requested, on one or 5 more occasions, that they be permitted to wear an external load-bearing vest, in lieu of the leather 6 Sam Browne duty belt, as an accommodation for a physical disability?" In response,to 7 Interrogatory No. 11, CHP informed Plaintiff and his counsel that only three officers; including 8 Plaintiff Ridge, have made this request. (See Exhibit 10, at 2:11 -18.) 9 I declare under penalty of perjury under the laws of the State of California that the 10 foregoing is true and correct. Executed on July 7, 2022 at Sacramento, California. 11 12 13 14 SA20I9106238 15 16 17 18 19 20 21 22 23 24 25 26 27 28 „ Declaration of James F. Curran in Support of Defendant's Opposition to Pitchess Motion (34-2019-00265393) EXHIBIT 1 Beth Bathgate, M.D. Mail Correspondence To: Orthopedic Surgery 772 Jamacha Road, Suite 415 El Cajon, California 92019 Phone (619)416-9677 Fax (619) 768-2592 E-mail: Dr.Bathgate2019@gmail.corn Thomas Kurtz, Esquire Novey Law Group 5800 Standford Ranch, Suite 610 Rocklin, California 95765 Amy Chen, Claims Examiner State Compensation Insurance Fund P.O. Box 3171 Suisun City, California 94585-6171 Re: RIDGE, David DOB: May 21, 1971 Emp: California Highway Patrol DDI: CT April 21, 2014-April 21, 2015; CT April 22, 2015 - March 6, 2019 Claim: 06089772 DOE: August 14, 2019 AGREED MEDICAL EVALUATION Dear Mr. Kurtz & Ms. Chen: As requested, David Ridge was seen for an Agreed Medical Re-Evaluation in my Sacramento office on August 14, 2019, regarding his orthopedic injury. This report is submitted pursuant to 8 Cal. Code Regs. Section 9795(b)&(c) as an ML 101-94, Agreed Medical Re-Evaluation. Fifty minutes were spent in face-to-face time with the patient^ two hours in review of the medical records and. three hours in preparation of the report. 00034 RE: RIDGE, David- August 14,2019 Page 2 RECAPITULATION Mr. Ridge was last evaluated on February 6, 2019. The history and his medical records included the following. Mr. Ridge first noted low back pain in about 2007. He also had some numbness in the left leg related to his work as a Highway Patrol Officer, including wearing a 30-pound duty belt and prolonged sitting. He also had to accost suspects. He did not report this as an injury and saw his primary care doctor. An MRI was done and no further treatment recommendations were given. He states that his back continued to bother him. He reported it as an injury in about 2010 but did not complete the process. He did not have any further treatment for this although he did continue with pain. His low back pain gradually increased. He couldn't stand any position without his leg going numb. If he sat in the patrol car, his back would hurt. He reported the injury on April 21, 2015. At that timi, he also had right wrist and thumb pain that started on that date. He received medical treatment from Dr. Fainsztein. An MRI was done of the lumbar spine, which showed congenital spinal canal narrowing and mild lateral facet arthropathy at L5-S1. He received physical therapy. Diagnoses from Dr. Fainsztein included chronic right lumbosacral strain with left thigh intermittent paresthesias and right thumb de Quervain's syndrome. An ergonomic workplace evaluation was ordered. Mr. Ridge states thai this was done and it helped him. He was not given a brace for his wrist or thumb. Dr. Fainsztein considered him to have reached maximum medical improvement on July 15, 2015. Medical records were received and included the following. He was seen by Evelyn Fainsztein, M.D., occupational medicine specialist, on May 7, 2015,. and a Doctor's First Report of Occupational Injury was completed. Four years of left thigh/left lower extremity numbness and low back pain. He reported it and was sent to Marshall Hospital to obtain x-rays. He attempted twice to go to a work comp facility but both times was told they do not provide work comp services. He attempted to contact Kaiser but did not hear back. He has never done physical therapy. Two months of pain at the base of the right thumb. Employed by State of California Highway Patrol Date of injury listed as April 15, 2015. Medical history of hypertension and sleep apnea. Diagnosis: Chronic right lumbosacral strain with left thigh intermittent paresthesias; Right thumb de Quervain's. 00035 RE: RIDGE, David August 14,2019 Page 3 Ergonomic workstation evaluation, ice/heat, modalities, thumb/wrist splint, and physical therapy recommended. Medications provided. Likely, a bulged disc aggravated by the duty belt. No needfor MRI or specialty referral at this time. He was seen by Dr. Fainsztein on June 3, 2015. Chronic low back pain with left-sided paresthesias and right thumb de Quervain's tendinitis, today asymptomatic. Thumb wrist splint provided. Awaiting ergonomic evaluation. Continue medications and physical therapy. Dr. Fainsztein issued a supplemental report on June 24, 2015: • Telephone message. Worsening left lower extremity numbness, now constant. Physical therapy not helping numbness. Right thumb intermittent worsening. Continued left lower extremity radiculopathy. MRI ordered. Continue physical therapy, ice and heat. Lumbar spine MRI was performed on July 6, 2015, and read by John Winn, M.D. Small bony hemangioma within the L2 vertebral body. Congenital spinal canal narrowing within the lower lumbar spine secondary to short pedicles and prominent epidural fat. Mild bilateral facet arthropathy at L5-S1. Impression: Congenital spinal canal narrowing. No significant degenerative disc disease or acquired central canal stenosis. Mildfacet arthropathy at L5-S1. On July 15, 2015, he was seen by Dr. Fainsztein. No findings on MRI to warrant continued treatment. Permanent and stationary for the low back and right thumb. Discharged with no permanent impairment, no disability, and no future medical care. Diagnoses at the time of the previous evaluation were chronic low back pain with mild bilateral facet arthropathy, chronic left lateral femoral cutaneous nerve irritation and right wrist de Quervain's syndrome. He was not permanent and stationary and further treatment was indicated. Mr. Ridge states he has continued to work full time as a California Highway Patrol Officer. He didn't start being treated following the December 3, 2015, Agreed Medical Evaluation until July 7, 2016. He then began seeing Dr. Yang. An epidural injection was done in August of 2016. He states this did not help him. He had an increase in his right wrist and thumb pain on about August 16, 2016, when he was wrestling a person in custody to the ground. He was seen at the Emergency Room at Marshall Medical Center. Diagnosis was exacerbation of de Quervain's tenosynovitis due to injury. He was advised to ice the injury, wear a thumb spica splint and use medication for pain. Mr. Ridge continued working without restrictions. He states his thumb and wrist pain were increasedfor some time but then returned to their baseline level. 00036 RE: RIDGE, David August 14,2019 Page 4 He has been unable to obtain a special external vest carrier for his gun. This was recommended by Dr. Yang. He states this was denied by the insurance company. He has not yet seen an orthopedic surgeon or a neurologist. Medical records were received and included the following. He was seen by Michael Yang, M.D., pain management specialist, on July 7, 2016. History of chronic low back pain for many years. Employed as a highway patrol officer. He first saw a doctor for low back pain in 2007. Date of injury listed as April 21, 2015, for low back] right wrist and hand pain. Past medical history positive for hypertension and depression. Diagnosis: Lumbar spine degenerative arthritis; Lumbar degenerative joint disease; Femoral nerve injury; Radiculopathy of lumbar region; Right wrist injury. Lumbar epidural steroid injection requested. Special load bearing vest requested due to his carrying heavy duty weapons at work. Right wrist femoral nerve injury deferred until this condition is researched more. On August 5, 2016, he was seen by Dr. Yang. It appears work comp will not approve the special vest. Temporary certification to return to work using a normal gun belt. Authorization requested for AME or QME to help determine whether or not he can continue as an officer due to the gun belt issue. Follow-up for approved epidural steroid injection. Left lumbar epidural steroid injection was performed by Dr. Yang on August 15, 2016. Diagnosis: Lumbar degenerative disc disease; Lumbar radiculitis. He was seen by Juliet Lamers, M.D. and Nurse Practitioner J. Goodall in the emergency department at Marshall Medical Center on August 16, 2016, and a Doctor's First Report of Occupational Injury was completed. Complaints of right wrist and thumb pain. Onset yesterday after wrestling a person in custody to the ground. Prior diagnosis of de Quervain's tendinopathy. Employed as a highway patrolman. Assessment: Exacerbation of de Quervain's tenosynovitis due to injury: Advised to ice injury, wear thumb spica splint, and use medication for pain. Dr. Yang saw him on September 6, 2016. Recent lumbar epidural injection did not help with low back pain. Continued de Quervain's symptoms, and mostly symptoms in the left femoral nerve distribution. Authorization requested for referral to neurologist regarding femoral nerve entrapment, chiropractic treatment for severe right paraspinal spasm, and orthopedic surgeon for evaluation of de Quervain's and possible steroid injection. Authorization again requested by Dr. Yang for chiropractic treatment, neurological evaluation for femoral nerve entrapment, and orthopedic surgeon for right wrist steroid injection on September 27, 2016. 00037 RE: RIDGE, David August 14,2019 Page 5 Diagnoses at the time of that evaluation were chronic low back pain with mild bilateral facet arthropathy, chronic left lateral femoral cutaneous nerve irritation and right wrist strain and tendinitis with deQuervain's syndrome. He was not yet considered to have reached maximum medical improvement. Further treatment had been recommended. ' Since the last evaluation, Mr. Ridge continued working at his full duties as a California Highway Patrol Officer. He received further treatment. He saw an orthopedic hand surgeon. Dr. Slater, on May 15, 2017. Diagnosis was right thumb carpometacarpal joint arthralgia and lateral subluxation of the metacarpophalangeal joint with early degenerative changes: He was given an injection and a thumb spica splint. This resulted in some improvement of his symptoms. He receivedfurther treatment for his lateral femoral cutaneous nerve irritation: He received right L4-5 medial branch blocks on September 25, 2017. He was referred to a neurosurgeon, Dr. Sanden, who saw him on October 4, 2017. A lumbar spine MRI was done on October 26, 2017. Dr. Sanden recomrnended surgery. When he saw Mr. Ridge on April 8, 2018, he noted that the MRI documented L4-5 stenosis, ligamentous facet and disc injury with neurogenic pseudoclaudication, L5-S1 foraminal stenosis from ligamentous facet hypertrophy contributing to lower extremity radiculopathy, and a mild kyphotic deformity related to wedging. There was a component of congenital stenosis^ Dr. Sanden did lumbar spine surgery on April 12, 2018, with decompression at L4-5 and L5- Sl jor stenosis. ,- • Mr. Ridge states that he last worked on the date of his surgery. He recently was released by Dr. Sanden to start modified duty, which he has been doing since January 10, 2079., Medical records were received and included the following. He was seen for follow-up by Michael Yang, M.D., pain management specialist, on November . 22, 2016 and January 23i 2017. Continued right de Quervain's symptoms and low back pain. Diagnosis: Radiculopathy of lumbar region; Lumbar degenerative joint disease; Lumbar spine degenerative arthritis; Femoral nerve injury; Right wrist injury. No benefit from lumbar epidural steroid injection. Referredfor orthopedic evaluations. Chiropractic visits approved. He was seen by Joseph Ambrose, D.C. on February 17, 2017, and a Doctor's First Report of Occupational Injury was completed. Cumulative stress to lower back during law enforcement duties. Currently with complaints of low back pain and stiffness and left leg pain and numbness. Also with right wrist pain. Injury date listed as April 21, 2015. Employed by California Highway Patrol. Diagnosis: Segmental dysfunction of thoracic, lumbar, sacral and 00038 RE: RIDGE, David August 14,2019 Page 6 pelvic regions; Sprain of ligaments of thoracic spine, lumbar spine, and sacroiliac; Lower back strain; Muscle spasm of back. Chiropractic care recommended. On March 17, 2017, he was seen by Gary Martinovsky, M.D., pain management specialist, on March 17, 2017. During the course of employment as a police officer for California Highway Patrol, he sustained cumulative trauma injury to his lower back from wearing a 30-pound gun belt, right wrist due to repetitive typing and mouse manipulation, and left leg attributed to the magazine pouch pressed against his left femoral nerve for 20 years. Past work-related motor vehicle accident in 1997, cumulative stress, and hypertrophy. Medical history of high blood pressure. Diagnosis: Left meralgia paresthetica; Lumbar facetogenic pain; Lumbago. Authorization requested for plastic surgery consultation to evaluate for left femoral nerve decompression. Referred to hand surgeon for right de Quervain's release. Referral requested for chiropractic physiotherapy for the lower back. He was seen by Physician Assistant Leonid Pugach for Dr. Martinovsky on April 28, 2017. Pain in the right wrist, lower back and left leg associated with tingling/numbness in the left leg and weakness in the right hand. Approved plastic surgery consultation. Pending scheduling of hand surgery evaluation. Pending request for chiropractic treatment. He was seen by Robert Slater, M.D., orthopedic hand surgeon, on May 15, 2017. Several year history of right hand and thumb pain. Impression: Right thumb carpometacarpal (CMC) joint arthralgia and lateral subluxation of metacarpophalangeal joint with early degenerative change. Right thumb CMC joint injection provided. Referred to hand therapy for custom thumb spica splint. On May 23, 2017, he was seen by PA Pugach for Dr. Martinovsky. Authorization requested for thumb spica splint. Continue chiropractic therapy. Dr. Slater saw him on June 22, 2017. Improved right thumb CMC joint arthralgia with injection. Pursue therapy appointment. Recheck on July 20, 2017. Pending custom thumb spica splint. He was seen by Harry Khasigian, M.D., orthopedic surgeon, on July 10, 2017. Pain and numbness left lateral thigh, aggravated by wearing his gun belt while working as a sheriff. Impression: Lateral femoral cutaneous nerve injury (meralgia paresthesia) as a result of obesity and wearing large gun belt. Referred to physical therapy: Medication prescribed. Consider exploration of lateral femoral cutaneous nerve. Weight reduction, rest and removal of offending pressure of belt recommended. On July 14, 2017, he was seen by Fred Samimi, M.D., neurologist. Low back and anterior left thigh numbing pain and paresthesia. Assessment: Meralgia paresthetica. MRI consistent with lumbar facet arthropathy. Medications prescribed. 00039 RE: RIDGE, David August 14, 2019 Page 7 Right L4, L5 medial branch nerve blocks were administered by Dr. Martinovsky on'July 25, 2017. Diagnosis: Lumbar facet arthropathy. He was seen by Dr. Slater on September 14, 2017. Comp carrier refused to authorize thumb spica splint. Continue self-purchased thumb spica splint. " . - He was seen by Roderick Sanden, M.D., neurosurgeon, on October 4, 2017. Employed as a California Highway Patrol officer. Back and leg pain began in 2010. Injury date listed as April 21, 2015. Assessment: L2-3 versus L3-4 disc protrusion, traumatic, left lower extremity radiculopathy; Meralgia paresthetica left lateral femoral cutaneous of the right thigh from abdominal panniculus; Body mass index of 43; Situational adjustment reaction to young adulthood; Congenital spinal stenosis; Right wrist de Quervain's. Authorization requested for gastric bypass, medication, repeat lumbar spine MRI and x-rays,. and EMG/nerve conduction study. Seen for recheck by Nurse Practitioner Theresa Sanden on November 15, 2017. Request for gastric bypass surgery denied. Follow-up with Dr. Sanden for review of diagnostic studies and to discuss surgical options. ' Lumbar spine x-rays with flexion/extension views was taken on October 25, 2017, and read by Larry Chespak, M.D. Findings/Impression: Anterior wedging of T12 and LI. Disc space narrowing at Tl 1-12 and T12-L1 levels. Lumbar spine MRI was performed on October 26, 2017, and read by Dr. Chespak Findings/Impression: L3-4: Facet and posterior ligamentous hypertrophic changes. Broad disc protrusion measuring 2-3mm. Bilateral neural foraminal exit zone compromise. L4-5: Facet and posterior ligamentous hypertrophic changes. Hypertrophy of the posterior inferior endplate of L4. Disc protrusion measuring l-2mm. Bilateral neural foraminal exit zone compromise with spinal stenosis. L5-S1: Marked facet and posterior ligamentous hypertrophic changes. Hypertrophic spurring. Disc protrusion measuring 2-3mm. Moderate bilateral neural for aminaiexit zone compromise. Bilateral lower extremity electrodiagnostic testing was performed on November 7, 2017, and read by Navnit Bhatia, M.D. Interpretation: Normal study with no evidence of bilateral radiculopathy or compression neuropathy. He was seen by NP Sanden for Dr. Sanden on December 11, 2017 and January 11, 2018. Surgery pending authorization. Without surgery, he will ^ove achieved maximum medical improvement. Seen for follow-up on February 12, 2018 and March 12, 2018. Increased pain and weakness. Lumbar surgery denied, pending re-request. 00040 RE: RIDGE, David August 14,2019 " Page 8 January 11, 2018, U.R. Non-Certification from EK Health. Denied: L4-5 and L5-S1 laminectomy, intraoperative neuromonitoring, and lumbar back brace. Surgery certified on March 20, 2018. Continued denial of back brace. On April 8, 2018, he was seen by Dr. Sanden. Back and leg pain beginning in 2010, with cumulative injury reported on April 15, 2015. Past medical history including hypertension and obesity. Assessment: MRI documented L4-5 stenosis, ligamentous facet, and disc injury with neurogenic pseudoclaudication; L5-S1 forarninal stenosis from ligamentous facet hypertrophy contributing to lower extremity radiculopathy; Mild kyphotic deformity from collapse wedging Tl 1-T12-L1; body mass index of 43; Left thigh meralgia paresthetica; Component of congenital stenosis; Right wrist de Quervain's. Surgery discussed, proceed as planned on April 12, 2018. He was seen by Wutt Linn, M.D. at Mercy San Juan Medical Center on April 12, 2018. Past medical history of high blood pressure, depression, and progressively worsening chronic lower back pain with radiating numbness to the left lower extremity. Admit diagnosis secondary to lower back pain with left leg numbness. Proceed with planned lumbar spine surgery. Lumbar spine surgery was performed by Dr. Sanden on April 12, 2018. This was L4-5 laminectomy, foraminotomy andfacetectomy, L5-S1 bilateral laminectomy, foraminolomy and medial facetectomy, and manipulation under anesthesia. Postoperative Diagnosis: L4-5 central stenosis from ligamentous facet hypertrophy with broad-based disc osteophyte complex, neurogenic pseudoclaudication, lower extremity radiculopathy, left greater than right. L5-S1 moderate to severe foraminal stenosis, foraminal nerve compression, radiculopathy, ligamentous facet hypertrophy, broad-based. disc osteophyte complex with lower extremity radiculopathy, left greater than right. L4, L5, SI congenital spinal stenosis. L4, L5, SI stenosis, contribution from epidural lipomatosis. L4-5 central stenosis greater than foraminal stenosis with left synovial facet cyst with disc osteophyte complex. L5-S1 bilateral foraminal greater than central stenosis, medial facet hypertrophy with left greater than right nerve compression. He was seen by NP Sanden for Dr. Sanden on April 26, 2018. Doing well following lumbar spine surgery. Two days ago he walked to his mailbox up and down a hill and now has a burning and knife stabbing sensation in his left dorsolateral thigh with numbness/tingling, now intermittent and improved with rest. Postoperative physical therapy requested. On August 14, 2018, he was seen by NP Sanden for Dr. Sanden. Flare up on June 18 after .third session of physical therapy, now resolved. He has fallen out of bed three times. Improved left thigh numbness. Mild weakness through the left foot/ankle with prolonged walking greater than one mile. Extension of physical therapy requested. Recheck on 00041 RE: RIDGE, David August 14,2019 Page 9 September 12, 2018. Constant radiating leg pain through the left buttock into the left thigh with numbness/tingling. He was seen by NP Sanden for Dr. Sanden on October 23, 2018. Nearly resolved left foot/ankle weakness, no longer with foot drag. Continue ongoing care and treatment: He was seen by NP Sanden for Dr. Sanden on December 4, 2018. Six months status post lumbar spine surgery with intermittent lower back pain and pain into the left buttock and thigh. Physical therapy helped with strengthening. Proceed with scheduled QME on February 9. Follow-up in four weeks. INTERVAL HISTORY Since the last evaluation, Mr. Ridge has been followed by his spine surgeon. Dr. Sanden, Dr. Nkadi and Dr. Ambrose. Mr. Ridge states that his lawyer filed a new cumulative trauma case from April 22, 2015, to March 6, 2019, for the low back. He states that he had been off work from April 12, 2018, the time of his low back surgery, until January 10, 2019. He was released to modified work, which he started on Jahuaiy 10, 2019. He did have to wear a gun belt in the office for a few months around this time, from about February to April 2019. Dr. Nkadi gave him a restriction of not using a gun belt in about April 2019. He has continued to do office work since that time. He continued with low back pain, and in March 2019 went to a chiropractor. Dr. Ambrose, and his family practice doctor. He had a new MRI done. Mr. Ridge states that he was released to full duty for a few months in 2019 but he did not retum to work at patrol, but worked in an office. He has been depressed related to his injuries. Medical records were received and included the following. He was seen for follow-up by Nurse Practitioner Theresa Sanden for Roderick Sanden, M.D., neurosurgeon, on January 9, 2019. Status post lumbar spine surgery performed in April 2018 with pain and numbness/tingling radiating into the left buttock and thigh to above the left knee. Pain in the right buttock began yesterday while walking upstairs. Resolved left foot/ankle weakness. Assessment: Status post L4-5 and L5-S1 laminectomy/diskectomy; Mild kyphotic deformity from collapse wedging Tl 1-T12-L1; Body mass index of 43; Left thigh meralgia paresthetica; Component of congenital stenosis; Right wrist de Quervain's. MRI 00042 RE: RIDGE, David August 14,2019 Page 10 recommended due to new pain/symptoms on the right. QME scheduled for February 2019. Recheck on February 12, 2019. Released to full work duties without restrictions. He was seen by NP Sanden for Dr. Sanden on March 18, 2019. Pain radiating from right buttock around right hip region and into right groin. Aching, shooting pain and numbness into left buttock and thigh. Assessment: Status post L4-5 and L5-S1 laminectomy/diskectomy with previous documented 80 percent improvement in axial low back pain and 60 percent improvement of left leg pain; Recent five day fiare up of right back/buttock, hip and groin pain, which he believed is a new industrial injury; Mild kyphotic deformity from collapse wedging Tl 1-T12-L1 contributing to upper thoracolumbar axial lower back pain; Body mass index of 43; Left thigh meralgia paresthetica, now possibly bilateral in nature; Nonindustrial right hip pain with negative right hip x-rays taken by nonindustrial primary care provider; Ongoing preexisting component of congenital stenosis; Right wrist de Quervain's. Authorization requested for physical therapy and lumbar spine MRI. Consider right hernia evaluation and right hip MRI. Likely permanent and stationary if lumbar spine MRI findings are normal. •; • Lumbar spine MRI was performed on April 23, 2019, and read by Larry Chespak, M.D,. Comparison: October 26, 2017. Findings/Impression: Surgical intervention at L5-S1 level done since prior examination. L3-4: Broad disc protrusion measuring 2-3mm again noted. Bilateral neural foraminal exit zone compromise without spinal stenosis. No significant osteoarthritic changes involving the facet joints. Post administration of intravenous contrast with no abnormal increased or decreased enhancement. L4-5: Disc protrusion measuring 1- 2mm again noted, unchanged when compared to prior examination. No significant osteoarthritic changes involving the facet joints. Post administration of intravenous contrast with no abnormal increased or decreased enhancement. L5-S1: Left laminectomy performed since prior examination. Partial regeneration of lamina. Soft tissue mass adjacent to the medial aspect of the left facet joint impinging upon the thecal sac, with finding not present preoperatively and cannot be determined if this represents scar or residual disc. Post administration of intravenous contrast with no abnormal increased or decreased enhancement. He was seen by Paul Nkadi, M.D., physiatrist, on May 23, 2019, and a Doctor's First Report of Occupational Injury was completed. Employed as an officer for California Highway Patrol for the past 24 years. No specific date of injury. Cumulative trauma from wearing a 30-35 pound gun belt eight hours a day. Date of injury listed as April 21, 2015. Industrial-related injury. Diagnosis: Chronic lumbar radiculopathy; Meralgia paresthetica; Trochanteric bursitis of both hips; Osteoarthritis of carpometacarpal joint of thumb; Status post lumbar laminectomy. Proceed with scheduled TENS unit trial as well as chiropractic therapy for previous injury. Bilateral iliotibiai band stretching in physical therapy recommended. 00043 RE: RIDGE, David August 14,2019 Page 11 On May 28, 2019, he was seen by Nurse Practitioner Aminah Al-Saeedi for Dr. Nkadi. Constant back pain. Sleep disturbed by pain. TENS unit dispensed. Pending approval of acupuncture and chiropractic therapy. • • . Dr. Nkadi saw him on June 19, 2019. Worsening back pain due to duty belt. Physical therapy scheduled to begin next month. Continue TENS unit.' Work clarification requested. Recommend no wearing duty belt, may wear outer-vest carrier and duty belt suspension system. ' ' CURRENT TREATMENT He is followed by Dr. Nkadi. He gets chiropractic treatment and physical therapy once a week. He uses a TENS unit. - ', . . MEDICATIONS i ,. : He takes no medications for his injury. For unrelated reasons, he takes: clonazepam, Propranolol, lisinopril and citalopram. i CURRENT COMPLAINTS He has constant low back pain with numbness and tingling in the left leg. His pain is worse with sitting and going from a sitting to a standing position. He has pain in the back of the right leg to the knee. He can't wear a gun belt without pain as it pokes into him when he is sitting in a patrol car. He has complaints of pain in the buttocks and hips. His pain is sharp, throbbing, shooting, stabbing, aching and burning and moderate. He states his pain is worse than it was before surgery. It also increased when he returned to work. He cannot do hiking or walking for exercise. His right thumb pain is constant. He has an aching. This has not changed since the last evaluation. JOB HISTORY At the time of his injury, Mr. Ridge worked for the California Highway Patrol as an officer. He started working there in October 1995. He did all the duties of a Highway Patrol Officer, including clearing the highways and arresting suspects. He initially drove a patrol car. 00044 RE: RIDGE, David August 14,2019 Page 12 For the last three years, he has been an officer assigned to a small field office in Placerville. He states he has lots of different duties. He does clerical work, handles reports, does data entry. He does some patrol work as well. As a Highway Patrol Officer, he is required to be able to lift over 100 pounds, sit, walk, walk on uneven ground, climb and reach overhead. . • , , OTHER INJURIES He has had no new injuries since the last evaluation. He had a motor vehicle accident related to work when there was a patrol car collision in 1998. He had no injuries or settlements related to this. He had a cardiac workers' compensation case in 2007, which was settled. He had a stress claim in 2010, which was settled. He has had no other work-related injuries, no personal injuries and no motor vehicle accidents with injuries. GENERAL MEDICAL HISTORY He has a heart condition and high blood pressure. He states he is currently being evaluated regarding an essential tremor and Parkinson's is being considered. Prior surgeries include tonsillectomy in 2007. He has had no other hospitalizations. REVIEW OF MEDICAL RECORDS 1. Subpoenaed records from Advanced Neurospinal Care, NMCI Medical Clinic 2. Roderick Sanden, M.D./Theresa Sanden, NP: 01/09/19 - 03/18/19 3. Larry Chespak, M.D.: 04/23/19 4. Joseph Ambrose, D.C: 05/08/19 - 05/29/19 (3 visits; Mid and low back pain, left lower extremity numbness/tingling) 5. PaulNkadi,M.D./Aminah Al-Saeedi, ANP-C: 05/23/19-06/19/19 00045 RE: RIDGE, David August 14,2019 Page 13 PHYSICAL EXAMINATION The examinee is an alert, cooperative, right-handed, 48-year-old male, who appeared comfortable during the examination. In preparation for performing the examination of Mr. RidgCj and In accordance with the AMA Guides to the Evaluation of Permanent Impairment. 5"^ Edition, he was provided a "warm-up" period such that he was observed performing range of motion activities about his spine and extremities. In addition, spinal examinations were performed, utilizing the single or dual inclinometer where appropriate and extremity examinations were performed using the goniometer or inclinometer. Height: 5'10" Weight: 310 lbs. EXAMINATION OF THE BACK General Examination Alignment of the examinee's spine and lower extremities is normal with no scoliosis or lordosis. The examinee has a normal gait and is able to walk on toes and heels. A well-healed scar is present over the low back. There is tenderness and muscle guarding over the low back and paraspinal muscles diffusely. Range of motion of the back is as follows. An inclinometer was used and the highest of three measurements is recorded. Measured Normal ROM in degrees (3 times) in degrees Flexion 40° 60° SF 30° Extension 25° 25° Lateral bending, right 20° 25° Lateral bending, left 20° 25° Muscle Strength and Range of Motion Range of motion and muscle testing of the extensor, flexor, invertor and evertor muscles of the hip, knee, ankle, subtalar and great toe joints are normal bilaterally. There is no tenderness over the iliac crests. 00046 RE: RIDGE, David August 14,2019 Page 14 Neurological Testing Straight leg raising, seated and supine and cross, is normal bilaterally. Deep tendon reflexes, both patellar and Achilles, are normal and equal bilaterally. Sensation to pinprick is intact in both lower extremities, except decreased over the left lateral thigh in an SI distribution to 70% of normal. Credibility Testing Difftise Tenderness Appropriate Nonanatomic Nerve Dysfunction Appropriate Histrionic Movements Appropriate Hypersensitivity Appropriate DIAGNOSIS . 1. Chronic low back pain status post surgery for decompression at L4-5 and L5-S1. 2. Chronic left lateral femoral cutaneous nerve irritation, resolved. 3. Right wrist strain with carpometacarpal arthritis. CAUSATION There is no change to my opinion with regard to causation. This is included here for completeness. In my opinion, it is medically reasonable that Mr. Ridge had a cumulative trauma injury involving the back and left leg related to his work as a California Highway Patrol Officer with a reported date of April 21, 2015. He noted that he had back pain over the years, starting in 2007. This was related to sitting in a patrol car, wearing a duly belt and also stopping combative suspects. This gradually increased with time and was reported on April 21,2015. The cover letter from Amy W. Chen, Senior Claims Representative, indicated that a new injury to the low back was alleged with a cumulative trauma from April 22, 2015, through March 6, 2019. She indicated that claim was denied based on Dr. Sanden's March 18, 2019, report that stated that there was "no new low back cumulative trauma through March 6, 2019." 00047 RE: RIDGE, David August 14, 2019 Page 15 Based on the available records, in my opinion, there has been a new cumulative trauma sustained relative to Mr. Ridge's back. While it is noted he was assigned to a small office in Placerville for the last three years where he did primarily office work, he did occasionally do patrol as well arid he was required to wear a duty belt. He was receiving treatment for his injury during this time. On August 5, 2016, he was seen by Dr. Yang. Dr. Yang indicated that "work comp will not approve the special vest.: temporary certification to retum to work using a normal gun belt." The patient described increasing pain as a result. Mr. Ridge indicated he continued to work full time as a California highway patrol officer until his lumbar spine surgery on April 12, 2018. There was a record indicating he was seen in the Marshall Emergency Room on August 16, 2016, after he had increased pain in his righti wrist and thumb when wrestling a person in custody to the ground. This was discussed in the prior reports and the right wrist and thumb are not being readdressed as they were previously considered to have reached maximum medical improvement. This information is just given to support that he was working full time as a highway patrol officer when this incident occurred. It is noted that from April 12, 2018 through January 10, 2019, he was off work on temporary total disability following his lumbar spine surgery. He then did modified work and was required to wear a gun belt for two months. In my medical opinion, there has been a new cumulative trauma injury sustained to his lumbar spine as claimed. Mr. Ridge complained of depression related to his injury and not being able to continue as a California Highway Patrol Officer. Evaluation for this should be allowed for AOE/COE by a psychologist or psychiatrist. DISCUSSION/DISABILITY STATUS He was declared to have reached maximum medical improvement for the right upper extremity and low back at the time of the February 6, 2019 evaluation. The right wrist has been stable and will not be readdressed. Since the last evaluation, Mr. Ridge has seen Dr. Sanden and also Dr. Nkadi. He is currently receiving chiropractic treatment and physical therapy. He has not returned to his full duties. Mr. Ridge states that he does not think that he will be able to retum to full duty due to the heavy job requirements of his position as a California Highway Patrol Officer. Mr. Ridge received conservative treatment following the December 2016 evaluation. He had medial branch blocks done in July 2017 and a further MRI of the lumbar spine. He was referred to a neurosurgeon. Dr. Sanden, on October 4, 2017. Dr. Sanden recommended surgery, which was done on April 12, 2018, with decompression for central stenosis and foraminal changes at L4-5 and L5-S1. Following surgery he has received physical therapy. 00048 ' liE: RIDGE, .David / ' . i ''|' Aiigus[t;14,'2019 . ^ \ ' . •. ; ' J. • Page^i e^ :5,t- • ;• . ••• . • - Mr. Ridge was' tempora'ri}yvt6tally^disabledv^^^ April42,"V20I8, a(the time,of his surgery, , until January/l0,,20r9S He.then worked-at modified duty frorn;^^^^^ he- .'>did. wear.-:a gun •..belt wh,ile^!dpjng^ office, work.' This exacerbatejd:hi's'^back palini'He 'went to a chiropractor and his own doctors for treatrrieritv'He had a new .MRI wriich showed a soft tissue mass adjacehf to ther'rnedial 'aspeptiof ;tlie;Ieft.Tacet joint!impinging -upon, the thecal'sac. It was. stated::i _- •; • •, . '•! ' j. i : ' , • , .- •. OBJECTfyE F A G T O R I SUi^PQRTINfa^IM^ 1'. Lumbar spine IylRI,->July,,:6, ^2015. Congenital sjfMnaf canal :n^arrowi significant degenerative •'disc/disease^ central-'canal ^stenosis! Mildrfac'et •arthrppathy. at Ls-sL^r--/^ • H= ••• • •, ' 2. •. Left ^^umb'ar^/^^epidijfaj/^ste injection;*-August -.l^S, 2pj[,6: -'Diagnosis: Lumbar degeneirative disc disease; Liimbar ira^ 3. He has tenderness^;tpi palpation bver^^ has tenderness ,tp palpation and decreased range of motion oYithel^lurribar spine.iHe has pain over the left lateral femoral cutaneousrieryeand a'positive-Tiners sign. . 4. Right; L4,''L5. medial (bWch, nerve.block^^^^ 25;|201^. Diagnosis:'Lumbar facet • artlirdpathy. '' \ . -5. Lurhbar.spin'e Xrray's.'witli '.flexion/extensioh'"view 25,- 20-17. Anterior Wedging - •" of Tl 2-and p i Misc space harrowing at Tll-12 -ancivT1'2-Ll .levels. .6. , .Lumbar 'spine" 'MRI,j>:(9^ctbber, j26j-"'>20,17." L3-4:/^Fac.et. and post'erior,;;'"Iigamentpusr .• hypertrophic^:.chanjges^^^Broad ;disc, pfoVrusipn;. nieasu^rm