Decision Number: WCAT WCAT WCAT Decision Date: March 01, 2013 Darrell LeHouillier, Vice Chair

Transcription

1 WCAT Decision Number: WCAT WCAT Decision Date: March 01, 2013 Panel: Darrell LeHouillier, Vice Chair Introduction [1] On January 10, 2007, the worker, who was pregnant at the time, slipped on snow and ice in her workplace parking lot and fell. She was injured and filed a claim with the Workers Compensation Board (Board), operating as WorkSafeBC. The Board accepted her claim for right leg contusions and a right hip strain. While the worker reportedly missed time from work, she took that time off as sick leave. She did not receive temporary disability benefits from the Board, but received health care treatment. [2] In July 2011, the worker telephoned the Board and advised that she had ongoing right hip pain since her injury. She was diagnosed with a labrum tear in her right hip and requested additional benefits under her claim, including authorization of surgery as a health care benefit. [3] On October 11, 2011, the Board issued a decision letter stating that the worker s diagnosed labrum tear was not caused by her fall in January 2007 and that her need for surgery to repair her torn labrum was unrelated to her accepted injury. [4] The worker requested a review of the Board s decision, which was confirmed in Review Reference #R The worker appealed the Review Division decision to the (WCAT). The worker s appeal proceeded by oral hearing, with the participation of the employer. Issue(s) [5] The issues under appeal are whether the worker sustained a right labrum tear arising out of and in the course of her employment in her fall on January 10, 2007, and if so, whether surgical repair of that condition should be authorized as a health care benefit under her claim. [6] Other matters were addressed in the decisions leading to this appeal, but I clarified in the oral hearing that neither party disputed those matters. Item #3.3.1 of WCAT s Manual of Rules of Practice and Procedure (MRPP) provides that WCAT will generally consider only the issues raised by the appellant in any given appeal. I see insufficient reason to depart from that usual practice, so will restrict my analysis to the issues as set out above. 1

2 Jurisdiction and Procedure [7] Section 239(1) of the Workers Compensation Act (Act) permits appeals from Review Division decisions to WCAT, subject to the exceptions set out in section 239(2) of the Act. [8] WCAT reviews the record from previous proceedings and can hear new evidence. WCAT has inquiry power and the discretion to seek further evidence, although it is not obliged to do so. WCAT may reweigh the evidence and substitute its decision for the appealed decision or order. WCAT may confirm, vary, or cancel the appealed decision or order. Background and Evidence [9] The worker testified that, before her fall on January 10, 2007, she had no problems with her right hip. She stated that she was physically fit, enjoyed running, and she was in her third trimester of a high-risk pregnancy in January [10] On January 10, 2007, she was clearing snow off her car in the parking lot of her workplace. She reported slipping off a curb that she was standing on at the time, stepping down hard on her right foot, before that foot slipped on some ice, causing her to fall onto her right side. She testified that she experienced a sharp, hot pain in her groin and pelvis, and was fearful because of her pregnancy. She also stated that she experienced a sharp pain in her right hip, along with a sensation of her leg being jammed up into the joint when her right foot slipped off the curb and struck the ground. [11] After the worker s fall, she went home and then went to a hospital immediately. She recalled having a painful bruise on her rear; she was provided instructions related to her pregnancy by the doctor she saw, and was sent home. The hospital records do not indicate any complaints of right hip pain, though the worker testified that the doctor was unable to conduct any examination beyond an external pat down because of her high-risk pregnancy. [12] In the weeks following her fall, the worker missed several days from work, intermittently. [13] The worker sought chiropractic treatment regularly between her fall and February 7, 2007, receiving treatment for her neck and back. There was no mention of right hip symptoms or treatment during that period, and the worker reported significant improvement of her back and neck symptoms to her chiropractor. That said, the worker testified that she remained sore and bruised, with pain in her groin and right hip. [14] Following her discontinuation of chiropractic treatment, the worker saw her regular family physician, Dr. Hartwig, 14 times starting in February 2007, without any right hip symptoms being mentioned in the associated chart notes. 2

3 [15] The worker gave birth on February 24, The birthing process was difficult and lengthy. The worker remained sedentary following the birth. She testified that she continued to experience significant hip pain, worse with sitting. The worker stated that she had difficulty lifting her right leg and lifting objects because of this pain, which she initially related to damage sustained during the delivery of her baby. The worker also reported experiencing tightness in her right hip. [16] The next relevant evidence is from December 19, 2007, when the worker returned to chiropractic treatment for a tune up, in the words of her chiropractor. The right gluteus maximus myofascitis was mentioned, but there was no initial discussion of right hip complaints documented in the associated chart notes. [17] The worker returned to work after maternity leave in March or April [18] In April or May 2008, the worker underwent surgery to repair damage sustained during the delivery of her child in February Following this surgery, the worker was off work again. The worker stated that she experienced increased strength and an ability to engage her core muscles. She stated that pain, tightness, and weakness in her right hip persisted, however. The worker testified that she could not vacuum, rake, or garden as a result. [19] On June 26, 2008, the worker reported to her chiropractor that her right hip had seized up. By June 30, 2008, she reported to her chiropractor that she felt much better. [20] The worker testified that she tried to get back into shape in the summer of 2008, and attended a boot camp; however, she could not handle the weights involved, or do squatting and lunging activities involved in the workouts. She stated that she worked out her abdominal muscles and dropped out after three or four days. Similarly, the worker testified that she tried pilates, but could not handle that activity. She stated that she had difficulty with lunges, squats, lifting her right leg to climb stairs, and walking. She also reported experiencing intermittent catching in her hip and cracking noises while bending forward. [21] The worker stated that she kept some degree of fitness by working out on a stationary bicycle and a treadmill. She reported feeling better after doing physical activity, but stated that she could not go regularly. She could not recall how often she was able to handle going, but stated that she also resumed swimming in the summer of 2008, and on good weeks was able to go three times. She testified that all of this physical activity was undertaken after consultation with Dr. Hartwig. [22] In July 2008, the worker went on holiday. She stated that she experienced considerable pain with walking on stairs and cobblestone streets while on holiday. [23] On August 18, 2008, the worker saw her chiropractor and reported that she felt really good. I asked the worker about this in the oral hearing, and the worker stated that this 3

4 reflected the variability in her symptoms. She stated that she was referring to feeling good on that day only. [24] The worker testified that she attempted to deal with her right hip pain with stretching and yoga. She attributed her pain to nursing her infant, stating that she understood this to affect a woman s joints. [25] The worker returned to work in September [26] On November 25, 2008, the worker saw Dr. Hartwig, complaining of a six-month history of right hip pain, possibly extending back to the postpartum period. The worker testified that Dr. Hartwig related her symptoms to her pregnancy, stating that they stemmed from a piriformis condition. Dr. Hartwig recommended physiotherapy, which the worker pursued, but which she stated made her symptoms worse. She discontinued chiropractic treatment when she started physiotherapy, and maintained the level of physical exercise recommended by her physiotherapist. [27] The worker saw Dr. Hartwig twice in April and May There was no mention of right hip pain in the associated chart notes, although the worker testified that she continued to complain of hip pain, even if it was not the principal reason for each visit. That said, the worker testified that she continued to attempt piriformis treatments, with stretching providing temporary relief from her symptoms; however, she remained unable to run or manage stairs. [28] On November 12, 2009, the worker saw Dr. Hartwig and reported experiencing back pain. Dr. Hartwig s chart notes do not refer to any right hip complaints. In the chart notes from the worker s next ten visits with Dr. Hartwig, there was no mention of her right hip or buttock symptoms; however, the worker testified that she complained of hip pain with each visit. [29] The next evidence is from April 6, 2011, when the worker began seeing Dr. King, a physician specializing in sports medicine. According to Dr. King s report, the worker described having developed right hip pain while pregnant four years previous. The worker testified, however, that she believed she told Dr. King about her fall. She pursued physiotherapy recommended by Dr. King for six to eight weeks, without improvement. As a result, Dr. King requisitioned a magnetic resonance scan (MRI) of the worker s right hip. [30] On June 24, 2011, the worker underwent an MRI. According to the associated MRI report, a limited acetabular labrum tear and an associated 6-millimeter paralabral ganglion were identified. [31] On June 30, 2011, Dr. King noted a possible work-related injury for the first time. 4

5 [32] In July 2011, the worker contacted the Board and advised that she had been having chronic right hip pain since her fall, although she initially related it to a difficult childbirth following her fall. [33] The worker also saw Dr. Hartwig, complaining of a history of episodic right buttock pain and tenderness behind her right groin following her fall at work. Dr. Hartwig stated that the worker was able to perform her pre-injury job duties. [34] On July 20, 2011, the worker was examined by an orthopaedic surgeon, Dr. Gilbart, reporting persistent, dull right hip and buttock pain, which had spread throughout her hip. The worker also described experiencing intermittent episodes of sharp pain giving way in the hip, and occasional locking up, associated with spasm. [35] Subsequently, the worker was noted to be a candidate for right hip arthroscopy. According to Dr. Hartwig, the worker was disabled from her pre-injury job by her right hip pain, before and after that surgery. [36] On September 30, 2011, the worker s claim file was reviewed by a Board medical advisor, Dr. Dray. Dr. Dray stated that labrum tears can be traumatic, usually associated with sporting activities involving rapid hip motion coupled with sudden stopping or turning or with falls, if there was an acute onset of hip pain. Dr. Dray noted that labrum injuries can also be degenerative, after years of repetitive, minor injuries, and are usually associated with hip arthritis. Dr. Dray added that labrum tears are associated with locking, catching, and painful clicking in the hip joint. [37] With respect to the worker s condition, Dr. Dray stated that the gap in medical evidence indicated a lack of continuity of symptoms, which made it difficult to relate the right hip labrum tear to the worker s fall. Dr. Dray added that the worker would have been expected to present with significant and persistent symptoms had she sustained a labrum tear in her fall at work. [38] The worker testified that, in March 2012, she underwent surgical repair of her labrum tear and reduction of bony impingement within the joint. She reported experiencing ongoing soreness in her hip subsequently. [39] On August 4, 2012, Dr. Hartwig wrote a letter, stating that he would defer to Dr. King and Dr. Gilbert on the question of whether the worker sustained a labrum tear in her fall on January 10, That said, Dr. Hartwig stated that he was not aware of any pre-existing hip problem or injuries that she may have sustained after the fall that would cause a problem with her right hip labrum and indicated that her labrum tear could at least in part be caused by the fall in January [40] On October 16, 2012, Dr. Gilbart wrote a letter, stating that he assumed that her symptoms had been present since her fall, following which she remained inactive for over one year. 5

6 [41] Dr. Gilbart stated that the worker s fall likely caused her hip tear because of her lack of any other traumatic incidents, and her subsequent health concerns and resulting inactivity which explained the lack of medical documentation about her right hip pain. He noted that labrum tears tend to be more painful with activity, which correlated to the worker s increased pain complaints while walking more while on vacation, compared to her sedentary activity level following the birth of her child. Submissions [42] The worker stated that her case was unusual, involving a confluence of events that masked the symptoms of the injuries that she sustained in her fall at work and led to the misdiagnosis of the true injury to her right hip. She stated that, for over a year after her injury, she was dealing with a pregnancy, the aftermath of a difficult childbirth, and surgical repair. She stated that she diligently pursued treatment, according to the available diagnoses at the time. [43] The worker added that her testimony was credible, and that the complexity in her case is medical. She referenced Dr. Gilbart s evidence in support of her appeal, stating that it should be preferred to Dr. Dray s opinion because of Dr. Gilbart s relative expertise and his experience, both clinical and surgical, with the worker. [44] The worker added that she explained the apparent gap in her complaints of right hip pain, and referenced a British Columbia Court of Appeal decision, Bancroft-Wilson v. Murphy, 2009 BCCA 1995 (Bancroft-Wilson), in which the court stated that physicians notes are made in haste, not checked for accuracy by the patient, and may not be exhaustive of what occurs during a medical appointment. The court stated that there are frailties inherent in chart notes which must be borne in mind when considering the credibility of a witness who reportedly sought treatment, where the nature of those reported complaints are undocumented. The worker also referred to other cases which provide similar analysis. [45] The worker stated that her physical fitness efforts were not at odds with her diagnosed injury, given that she performed those tasks under the care of physiotherapists but was unable to perform several of the fitness activities that she attempted. [46] The worker argued that her labrum tear should be accepted as a new diagnosis under her claim, resulting from a fall that was more serious due to her pregnancy. She also sought temporary disability benefits and health care benefits. [47] The employer argued that there was no temporal connection between the worker s fall and her right labrum tear. It noted that the documentary evidence does not establish that the worker complained of right hip pain at the hospital just after her fall. The employer stated that the worker first raised the issue of her right hip in 2008, and that Dr. Dray s medical opinion, taking that lack of temporal connection into account, is more persuasive. 6

7 [48] In response to Dr. Gilbart s opinion, the employer argued that Dr. Gilbart did not provide sufficient justification to conclude that the worker s symptoms were caused by a labrum tear, arguing that the same symptoms could be explained by dysplasia, a congenital condition. Furthermore, the employer argued that labrum tears can result from a variety of non-traumatic causes. The employer attached medical information printed out from the Internet to support that contention. [49] The employer added that the worker s level of physical activity in 2008 was more likely to have caused her symptoms, and that it was speculative to relate the worker s labrum tear to her fall in January [50] The employer also referenced a prior WCAT decision, WCAT , which quoted from a Board medical advisor opinion that soft tissue injuries do not have an incubation period and should be felt at the time of injury. Reasons and Findings [51] The issues under appeal are whether the worker sustained a right labrum tear arising out of and in the course of her employment in her fall on January 10, 2007, and if so, whether surgical repair of that condition should be authorized as a health care benefit under her claim. [52] Subject to section 250(4) of the Act, the standard of proof in an appeal is the balance of probabilities. Section 250(4) provides that in a matter involving the compensation of a worker, if the evidence supporting different findings on an issue is evenly weighted, the issue must be resolved in a manner that favours the worker. [53] Section 250(2) of the Act requires WCAT to apply published policy of the board of directors of the Board, subject to the provisions of section 251 of the Act. The Rehabilitation Services and Claims Manual, Volume II (RSCM II) contains the published policy applicable to this appeal. As the worker s injury occurred before July 1, 2010, the RSCM II that existed before that date applies. [54] Section 5(1) of the Act provides that compensation is payable to a worker where an injury arises out of and in the course of employment. [55] Section 5(4) of the Act states that, in cases where a worker s injury is caused by accident, where the accident arose out of the employment, unless the contrary is shown, it must be presumed that it occurred in the course of the employment; and where the accident occurred in the course of the employment, unless the contrary is shown, it must be presumed that it arose out of the employment. [56] Accident is defined in section 1 of the Act as including a wilful and intentional act, not being the act of the worker. 7

8 [57] I am satisfied that the worker s slip and fall in January 2007 amounted to an accident. The worker provided a detailed account of the incident in her testimony, and the Board has accepted her claim in respect of that incident. [58] To be clear, I consider that the worker s foot slipping off a curb, and then slipping on ice to be a fortuitous event occasioned by a physical or natural cause. This satisfies the definition of an accident, as contemplated in section 5(4) of the Act and policy item #14.10 of the RSCM II. I therefore turn to consider whether the worker sustained a labrum tear in that accident. [59] The worker does not have the benefit of a presumption in favour of causation, under section 5(4) of the Act. It is only when an injury is shown to have been caused by an accident that the benefit of the presumption is applied to the circumstances of the accident, in deciding whether the accident (and so, the injury) arose out of and in the course of the worker s employment. [60] Policy item #15.00 of the RSCM II states, for a worker s injury to be accepted, the evidence must establish that there is something in that worker s employment relationship or situation that had causative significance in producing that injury. In such a circumstance, the injury is said to have arisen out of the employment. [61] Before applying the relevant law and policy, I will consider the facts surrounding the worker s case. [62] I accept that the worker experienced pain in her right hip at the time of her fall in January While the documentary evidence from that date and the weeks following her fall do not describe symptoms in her right hip, the worker provided a detailed account of her symptoms which are consistent with the mechanism of injury as she described it. [63] While I am concerned by the lack of documentary evidence related to the worker s right hip pain at the time of her fall and in the weeks that followed, I recognize the limited weight that I can place on medical records, as described in Bancroft-Wilson. In the particular circumstances of this case, the worker s focus was on the fate of her pregnancy after her fall. She focused on the fear she had of losing the child she was carrying, and I have no difficulty in accepting that, despite feeling right hip pain at the time, she may not have focused on her right hip symptoms when seeking medical attention leading up to the birth of her child in February [64] I also recognize that she reported a six-month history of hip pain to Dr. Hartwig in November 2008, but she also reported a possibility that her pain extended back to her post-partum period. I am concerned over this in particular, but recognize that the worker was largely sedentary between her fall and her post-partum period. As a result, I am cautious about relating those symptoms to the worker s fall, but do not consider 8

9 Dr. Hartwig s notes from November 2008 to be sufficient to make any such relationship entirely implausible. [65] As the worker recognized in the oral hearing, her case was complicated by the intervention of other medical conditions and symptoms in her pelvic region. The progression of her right hip symptoms is not easily understood from a lay perspective. Based on the irregular course of her symptoms following her fall, I conclude that there is not a sufficiently strong temporal connection between the worker s accident and the symptoms which ultimately led to her diagnosis of a right hip labrum tear to enable me to connect the two from a lay perspective. [66] I consider that some other form of evidence would be required to connect the worker s right hip symptoms that have been related to a labrum tear to her accident. In this case, there is medical evidence addressing this point, so I turn to consider that evidence. [67] Dr. Hartwig initially indicated that the worker s right hip symptoms related to a piriformis condition stemming from her pregnancy/delivery. Later, Dr. Hartwig advised that it was possible that the worker also had a labrum tear which related, at least in part, to her accident. This does not help me decide the issue under appeal because it does not provide a degree of likelihood as to whether this was the case. In the absence of such information, Dr. Hartwig s opinion amounts to no more than speculation as to a possibility. [68] Dr. King did not provide sufficient evidence to indicate whether the worker s labrum tear occurred in her fall at work in January Dr. King noted a possible connection in his chart notes from June 30, 2011; however, like Dr. Hartwig, Dr. King did not provide any information about the degree of likelihood as to whether the worker s labrum injury resulted from her fall in January Accordingly, Dr. King s evidence is not helpful to me in deciding this appeal. [69] Dr. Gilbart provided an opinion that the worker sustained a labrum tear in her fall in January 2007; however, Dr. Gilbart s analysis is problematic because it states that the worker s labrum tear must have occurred in her fall because of the lack of other trauma. This would amount to a presumption in favour of causation, which I have noted does not apply. [70] Dr. Dray has provided evidence that the worker did not likely sustain a labrum injury in her fall in January Dr. Dray indicated that the mechanism of injury was consistent with a right hip labrum tear, provided the worker experienced acute pain in her right hip at that time. I have found that the worker did experience acute right hip pain at that time and therefore consider Dr. Dray s evidence to support the worker s position on appeal, even though Dr. Dray provided a conclusion to the contrary, based on the understanding that the worker did not experience acute right hip pain at the time of her fall. 9

10 [71] While Dr. Dray added that, commonly, labrum tears are associated with locking, catching, and painful clicking in the hip joint, she did not indicate that this was necessarily the case in each instance. I am concerned about the worker s variable levels of activity following her fall, and about the increasing nature of her right hip symptoms as a function of time. That said, Dr. Dray s evidence establishes that the sorts of locking, catching, and painful clicking that the worker reportedly experienced significantly later, did not need to have been present from the initial phases of any right hip labrum tear. [72] It may be that the worker sustained a right hip labrum tear in her fall in January 2007 and that that tear worsened with subsequent activity, but I do not need to decide that. I note it only as a possible explanation for the worker s concerning progression of symptoms, indicating that I cannot dismiss the possibility that the worker sustained a right hip labrum tear in her fall in January 2007 because of her complicated course subsequently. [73] I recognize Dr. Dray s concern over a perceived lack of continuity in the worker s symptoms and Dr. Hartwig s documentation from November 2008, reflecting inconsistency in the history that the worker provided. The unusual course of her symptoms that followed, however, are insufficient to indicate that the worker did not experience pain when she fell in January 2007 or that the fall and her symptoms at that time were inconsistent with a right labrum tear. [74] After weighing the worker s testimony and the available medical evidence, and after applying policy item #15.00 of the RSCM II, I have concluded that the worker experienced acute right hip pain and a right hip labrum tear in her fall. I do not consider it necessary to explore the possible alternate causes of the worker s symptoms proposed by the employer, having found the evidence sufficient to establish a causal connection between her fall and her right hip labrum tear. I consider those alternate causes proposed by the employer to be speculative and I leave it to the Board to decide what happened to explain the worker s subsequent symptoms after sustaining an initial right hip labrum tear in her fall in January [75] Having decided that the worker sustained a right hip labrum tear in her fall in January 2007, I have determined that an accident which the Board has already concluded arose out of and in the course of her employment was of causative significance in producing that injury. The right hip labrum tear is also accepted under the worker s claim as a result. [76] Section 21 of the Act allows the Board to authorize any health care treatment which is reasonably necessary to cure, relieve, or alleviate from the effects of an accepted injury. Policy item #78.00 from the RSCM II states that health care benefits are subject to the direction, supervision, and control of the Board. 10

11 [77] I have found the worker s right hip labrum tear, for which she underwent surgery, to be related to her injury in January Following examinations of the worker, Dr. Hartwig and Dr. Gilbart indicated that the worker was a candidate for surgery. Even if the worker s symptoms in 2008 and beyond are attributable only in part to the worker s accepted labrum tear, the surgery was proposed and carried out to treat that condition. I consider the expert medical opinion, particularly of Dr. Gilbart, persuasive as to the reasonable necessity of that surgery. I conclude that the worker s surgery should be authorized as a health care benefit under this claim. Expenses [78] The worker requested reimbursement of $ to cover the expenses she incurred in obtaining the evidence of Dr. Hartwig and $1, to cover the expenses she incurred in obtaining the evidence of Dr. Gilbart. [79] Item # of the MRPP states that expenses for evidence will generally be reimbursed where the evidence is useful or helpful to the panel, or where it was reasonable for the party to have sought such evidence in connection with the appeal. [80] The worker s appeal involved consideration of whether she sustained a right labrum tear in her fall on January 10, Dr. Hartwig s evidence and Dr. Gilbart s evidence addressed that issue. As a result, I consider that it was reasonable for the worker to obtain both pieces of evidence. [81] Item # of the MRPP provides that reimbursement of a worker s expenses incurred in obtaining medical evidence will be normally limited to the amount paid by the Board in respect of medical evidence, as set out in a fee schedule between the Board and the British Columbia Medical Association. [82] There are two fee codes associated with medical evidence: #19932 and # Fee code #19932 has the lesser associated maximum amount, and that amount is greater than the expenses associated with the production of Dr. Hartwig s evidence. I therefore consider that the Board should reimburse the worker for the entire expense associated with the production of Dr. Hartwig s evidence. [83] Fee code #19933 applies to an opinion involving the extensive exercise of expert knowledge and judgment. This opinion may be related to the course of events when those events cannot be known for certain. I consider the fee code, which has a maximum associated rate of $1,458.60, to encapsulate the report of Dr. Gilbart. [84] The worker argued that the amount she paid was reasonable, but did not provide sufficient justification to warrant departure from the standard practice as outlined in the MRPP. I therefore consider the appropriate measure of reimbursement of that report to be $1,

12 [85] The worker also asked for reimbursement of $1,725.00, the expenses associated with her obtaining an expedited MRI of her hip, arguing that this was necessary for proper diagnosis and consultation, with the alternative involving years without improvement in her pain and disability. The worker argued that, had her claim been properly adjudicated, she would not have incurred that expense. [86] The worker made it clear that she sought the MRI for the purposes of diagnosis and treatment. Furthermore, she did not submit it as evidence to WCAT; the Board obtained the MRI report before issuing the decision that ultimately led to this appeal. Because the worker did not submit the MRI report to WCAT, section 7(2) of the Workers Compensation Act Appeal Regulation, which provides for WCAT s ability to reimburse parties for expenses related to appeals, does not apply. Furthermore, even without considering that section, I would not exercise my discretion to order reimbursement for an expense associated with a document that was not submitted to WCAT, and was already available to me from the worker s claim file. [87] It may be that the worker can be reimbursed by the Board for the expense she incurred in obtaining that MRI, by having the MRI authorized retrospectively as a health care benefit under her claim. I leave it to the worker to raise that issue with the Board, if she wishes to do so. Conclusion [88] I allow the worker s appeal and vary Review Reference #R [89] I find that the worker sustained a right labrum tear arising out of and in the course of her employment in her fall on January 10, Surgical repair of that condition is authorized as a health care benefit under her claim. [90] I order the Board to reimburse the worker $ in respect of Dr. Hartwig s evidence, and $1, in respect of Dr. Gilbart s evidence. Darrell LeHouillier Vice Chair DL/cv 12