Wednesday, December 21, 2016

Employer liable for $32,000 bill for kidney stones from heat exhaustion

Brown v Domino's/MBR Mgmt.
December 15, 2016
2016 MOWCLR Lexis     (Inj. No. 12-052588)

A 39 -year old manager at a pizza restaurant in Troy, Missouri worked a week in "excessive heat" and was admitted for heat exhaustion where he underwent a thorough work-up including an endoscopy and colonoscopy.  He was diagnosed with acute renal failure and dehydration.  He was admitted a second time less than 2 weeks later for acute kidney failure.

The parties disputed who was responsible for the medical bills concerning the second hospitalization and whether claimant had any permanent disability when his exam findings were normal.  

"The parties have also essentially agreed that the accidental injury on July 8, 2012 is the prevailing factor in causing the heat exhaustion, dehydration and acute renal failure. Employer, however, disputes that the kidney stones that ultimately necessitated the second hospitalization are medically causally related to the July 8, 2012 work injury, and, further, asserts that the medical bills for that second hospitalization were, therefore, not reasonably required to cure and relieve the effects of the injury."

Claimant reported he had recovered from previous treatment for heat exhaustion and kidney issues.

Dr. Volarich, claimant's expert, concluded that claimant sustained permanent disability as a result of episode of heat exhaustion.  He concluded the heat exhaustion caused the kidney stones and that the second hospitalization related to the initial exposure.   The employer's expert, Dr. Rothstein, indicated claimant did not have a permanent disability.  "He opined that the heat exposure at work on July 8, 2012 was not the prevailing factor in either of these diagnoses. Focusing mostly on the cirrhosis diagnosis, which even Claimant does not try to relate to the work injury...."

Claimant testified that he has increased sensitivity to hot environments that impairs his ability to go to amusement parks, ball games and cut grass.

The ALJ noted the defense expert did not identify his credentials or what records he relied upon and his opinion was submitted by report and not by testimony.  "I find that for Dr. Rothstein, I have no clear understanding of his background or experience, no clear understanding of the basis or foundation of his opinions, no explanation for how he reached the opinions and conclusions he did, and all of this without any physical examination of Claimant or any understanding of what Claimant's testimony might be in the matter."

The ALJ found the totality of Dr. Volarich's testimony supported causation, and the employer over-relied on the expert's use of the word "tipping" to assert his testimony did not establish the evidentiary standard. 

Employer was directed to pay Claimant $ 32,457.90 [the disputed bills for the second hospitalization] for these past medical expenses related to the work accident on July 8, 2012, which includes the work-up for kidney stones. 

The ALJ awarded an additional  "8.75% permanent partial disability of the body as a whole on account of the residual effects of the heat exhaustion."

Claimant testified he had sought relief from his employer from heat exposure.  "Claimant noted that he had asked his boss many times to fix the air conditioning in the store before July 8, 2012, but he was told that it was not a high priority for his boss because there were other stores that did not have any air conditioning at all."

Attorney Andrew Marty represented the employee.  The Commission adopted the 3-0 decision from ALJ Boresi without a separate opinion.