Wednesday, July 29, 2015


Failure to prove synergy - multiple prior back surgeries

The Commission reversed an award of PTD against the SIF on the basis of prior back impairment combined with a knee contusion.  Claimant's vocational expert changed his opinion and indicated the claimant was totally disabled from pre-existing conditions when provided more complete pre-accident records. 

"Where a medical expert relies upon a demonstrably incomplete and/or incorrect history of an employee's medical treatment in connection with preexisting conditions of ill-being --especially where that treatment involves multiple lumbar spine surgeries and a lengthy period of short-term disability --we simply cannot credit their ultimate opinions with regard to the nature and extent or combination of any disability referable to a claimed work injury versus such preexisting conditions. For this reason, we must find that Dr. Zimmerman's analysis and opinions lack any persuasive value in this case."

Glasco v Citicorp  2016 MO WCLR Lexis 63.

Failure to use term of art "synergy"

The Commission affirmed a SIF based a "close" case whether or not claimant established proof of synergy when claimant's expert did not use the word synergy.  Pentridge v Gayman Construction, 2016 MO WCLR Lexis 22.

The Commission inferred evidence of synergy by claimant's report of prior medical impairment impeding with his recovery from the primary injury, loss of income, and expert opinion that claimant's overall disability was higher. 


The Commission affirms an award of 10% synergy.  Hazelrigg v Gary Gribble's Running Sports, 2016 MO WCLR Lexis 62.


The court of appeals affirmed a denial of PTD fund benefits on a finding that claimant's expert failed to show synergy, rejected the argument that the Commission must accept the medical conclusion when the Fund offered no contrary opinion.  Rasa  v Treasurer of the State of MO,  474 S.W..3D 572 WD 78562  Claimant's own opinion on the issue was regarded as less credible without medical support. 

Claimant failed to establish synergy by lack of expert testimony on the issue of disability on the date of accident.  Claimant's expert provided a disability opinion 4 years after the accident. The ALJ found no explanation of how conditions combined synergistically.  Spratt v US Airways, 2016 MO WCLR Lexis 27.
ALJ Carlisle
Experts:  Musich

"....Stuckmeyer did not explain how the chronic pre-existing conditions were rated or responsible for the overall disability, nor how they combined with the primary injury to create current work restrictions.  .... Stuckmeyer merely offered a conclusory opinion ...."

Atty:  Neuner, Conrad

The court of appeals affirmed a denial of fund benefits based on lack of synergy. Winingear v Treasurer of the State of Mo., 474 S.W.3d 203 (Mo. 2015)

Claimant was choked while working security at Fulton State Hospital and settled the claim against the employer for a neck injury paying new disability on top of a prior settlement for the neck.  Claimant then used the 2 neck cases and prior injuries to pursue SIF benefits.  The commission found Dr. Cohen's conclusions that synergy existed to support Fund liability was not persuasive without any explanation.  The court affirmed the denial and deferred to the commission to assess credibility, even though the commission may have articulated the wrong legal standard in its opinion of clear and convincing evidence.  It does not appear the Fund offered an expert testimony to contest the claim.  The case was decided before reform in 2013 limited such partial claims for Fund benefits.

The commission affirmed a denial of SIF benefits based on lack of synergy.  Reynolds v. Fulton State Hospital, 2015 Mo WCLR Lexis 76.

Claimant settled a case against the employer for 3% and sought SIF benefits for prior medical conditions involving a right knee, a groin injury when the claimant was "grabbed" by a patient and a significant prior 38%t to the same ankle from a ligament reconstruction surgery as a result of a work injury while playing basketball with patients.   The commission found no  basis to award SIF benefits when the record contained no lay or expert opinion about the enhanced disability.  It noted a worker was generally competent to testify about enhanced disability when injuries were bilateral but "here the employee has failed to produce any evidence" except how each prior condition caused separate disability.

ALJ Ruth
Atty:  Keifer,
Experts:  Volarich
Treater: Krause