Wednesday, February 19, 2014

Appeals court reverses denial of SIF PTD on post-accident worsening defense

A claimant in a 2001 accident established he was totally disabled after a second round with the court of appeals in Abt v Mississippi Lime Co., ED 99779 (Mo. App. 2-18-2014);

The injured worker sustained multiple injuries from a collision between a locomotive and a truck, but  returned to work for about 4 years after his accident until he states worsening symptoms prevented him from gainful employment.  The ALJ found claimant unemployable due to post-accident worsening but awarded partial benefits against the employer and the SIF, and did not adopt the finding's of claimant's expert that claimant was a SIF total due to a combination. 

The court concluded that no party disputed whether claimant was PTD but only the cause of the condition as post-accident worsening or from a SIF combination.   In the original appeal the court remanded the case and found the Commission erred by disregarding Dr. Poetz' opinion that claimant was totally disabled due to a combination and misread the record that Dr. Poetz' opinion was based on an incomplete medical history.   The determination that claimant's disability flowed from post-accident worsening was not supported by substantial evidence because none of the medical experts supported that conclusion.

The opinion distinguishes between the amount of disability and the cause of disability.  Both parties conceded that claimant was totally disabled but the SIF disputed the cause.  The defense of post-accident worsening in this type of case required expert testimony and the Fund failed to introduce such evidence to support its defense in the primary case or on remand.  As no party disputed that claimant was unemployable, the only issue was the cause the disability. 

The Commission later affirmed a finding of PTD, 2014 MO WCLR Lexis 63 (May 7, 2014).