NOT TO BE PUBLISHED
OPINION
VANMETER, JUDGE.
Glenda Thompson petitions for the review of an opinion of the Workers' Compensation Board ("Board") affirming an opinion of an Administrative Law Judge ("ALJ") which dismissed a claim of injuries allegedly resulting from two separate falls at Glenda's place of employment, Ridgewood Terrace ("Ridgewood"). For the following reasons, we affirm.
Glenda was hired as a certified nursing assistant by Ridgewood in 1982. In 2001, Glenda slipped and fell at work. She experienced pain in her back and leg, was treated with medication and later returned to work. In December of the same year, Glenda again fell at work and suffered a fractured pelvis. She was able to return to work in January 2002, but was restricted from lifting patients. Ridgewood's workers' compensation insurance carrier paid for Glenda's medical expenses resulting from her falls at work. In 2006, while not at work, Glenda sustained a broken right leg when her ankle gave way. On March 31, 2008, while at work, Glenda's left foot twisted underneath her, causing her to fall and break her left hip. Glenda had a total hip replacement surgery and has not returned to work. Glenda filed a Form 101 — Application for Resolution of Injury Claim, alleging injuries to her low back, pelvis and lower extremities stemming from the December 2001 and March 2008 falls.
Medical records from MultiCare Associates ("MultiCare") establish that Glenda was examined in 1996 for chronic low back pain associated with a back injury in 1994, examined again in May 2000 after Glenda claimed she fell two times earlier in the year, and seen again in June 2001 for continued back spasms causing pain in her legs after she claimed she fell in September 2000. Following Glenda's December 2001 fall, she continued treatment at MultiCare, and records indicate she was diagnosed as having an adductor strain. In March 2002, Glenda's diagnosis changed to pubic ramus fracture and low back pain with degenerative changes and inflammation of the facets. The records also reflect that in July 2003, Glenda was noted to have antalgic gait, described as "pain with walking usually causing a limp caused by something painful to the individual."
At Glenda's request, Dr. Robert Byrd conducted an independent medical examination ("IME") and assessed a 0% impairment rating due to Glenda's December 2001 fall at work. He further assessed a 20% impairment rating due to her antalgic gait derangement, which he attributed to the March 2008 hip fracture. Dr. Byrd was unaware that Glenda suffered from antalgic gait prior to her March 2008 hip fracture. He testified that he did not know why Glenda fell in March 2008.
Dr. Charles Barlow performed an IME of Glenda at the request of Ridgewood and also assessed a 0% impairment rating due to the December 2001 fall. He diagnosed Glenda with degenerative disk disease and facet joint arthropathy in the lumbar spine, in addition to healed pubic rami fractures, nondisplaced. Dr. Barlow concluded that the degeneration is an aging condition and not related to the fall. He stated the pelvic fracture from the December 2001 fall is secondary to her job and did not result in an impairment rating.
Dr. Thomas M. Loeb issued a report after reviewing Glenda's medical records and opined that the mechanism of the March 2008 injury was not readily apparent. He stated that most hip replacement surgeries are due to degenerative arthritis, rather than a fracture. He opined that the combination of degenerative disc problems, combined with arthritis in the right ankle, would cause a weight shift to the left side enhancing limping and creating antalgic gait, and pre-disposing her fall. Glenda's deposition testimony confirmed that she suffered from antalgic gait or limp since 2001.
On appeal, Glenda argues that the ALJ erred by not affording her the "presumption that an unexplained workplace fall arises out of the employment unless the employer presents substantial evidence to show otherwise." Vacuum Depositing, Inc. v. Dever, 285 S.W.3d 730, 733 (Ky. 2009) (citing Workman v. Wesley Manor Methodist Home, 462 S.W.2d 898, 900-02 (Ky. 1971)). We disagree.
Our review of a workers' compensation decision is restricted to "correction of the ALJ when the ALJ has overlooked or misconstrued controlling statutes or precedent, or committed an error in assessing the evidence so flagrant as to cause gross injustice." Bowerman v. Black Equip. Co., 297 S.W.3d 858, 866 (Ky.App. 2009) (citing W. Baptist Hosp. v. Kelly, 827 S.W.2d 685, 687-88 (Ky. 1992)). As the factfinder, the ALJ "has the sole authority to determine the quality, character, and substance of the evidence." Square D Co. v. Tipton, 862 S.W.2d 308, 309 (Ky. 1993) (citation omitted).
Kentucky case law has held that "when an employee during the course of his work suffers a fall by reason of some cause that cannot be determined, there is a natural inference that the work had something to do with it, in the sense that had he not been at work he probably would not have fallen." Workman, 462 S.W.2d at 900. From a procedural standpoint, "in the absence of evidence sufficient to cast substantial doubt in the mind of a reasonable man that the presumption is correct the employee is entitled to its benefit as a matter of law." Id. Although, if the defendant employer can establish by sufficient evidence that the work was not a contributing cause and the fall was a result of a personal or idiopathic cause, "then the rebuttable presumption is reduced to a permissible inference and the board is free either to find or decline to find that it was." Id. Idiopathic or personal factors resulting in harm include pre-existing conditions, physical weaknesses, or personal behavior. Vacuum Depositing, 285 S.W.3d at 733 (citations omitted).
In the case before us, the ALJ found that no impairment existed from the December 2001 fall beyond what was previously compensated for when Glenda missed work from December 2001 — January 2002. Regarding the March 2008 fall, the ALJ stated,
As noted by [Ridgewood, Glenda], prior to March 31, 2008, had four separate falls. These include two falls prior to May 5, 2000 (MultiCare Records), a fall in September 2000 (Multicare Records and a fall prior to March 17, 2006 (Dodds Records) which resulted, on March 17, 2006 in an x-ray which showed a right ankle fracture and arthritis. Dr. Dodds also noted, on July 24, 2003, an antalgic gait. [Glenda] also had another fall, after March 31, 2008, which is not work-related.
Thus, the ALJ determined that Glenda's fall in March 2008 was not work-related, and not an effect of the December 2001 injury, but rather was caused by personal factors such as Glenda's ongoing problems with limping, left leg pain and numbness, and history of falling. Such a determination was supported by the medical records of Drs. Barlow and Loeb, who diagnosed Glenda with antalgic gait, causing her to experience a limp and pain in her foot; degenerative disk disease and facet joint arthropathy; and arthritis. Accordingly, Ridgewood met its burden of establishing that the unexplained March 2008 fall was caused by personal factors, rather than Glenda's employment. The ALJ did not err by dismissing Glenda's claim of a work-related injury from either the December 2001 or March 2008 fall.
The opinion of the Workers' Compensation Board is affirmed.
ALL CONCUR.
