Friday, January 20, 2017

Future medical awarded for degenerative disease defense

Fuller v. Elementis Specialties, Inc., Employer

2017 MO WCLR Lexis 3, 4  (Kohner)

(Jan. 12, 2017)

The commission affirms an award of partial disability to a 59 year old  machine operator with arthritis in both hands.    The case involved a 2011 onset. 
Claimant's expert contends "overuse" from packing duties caused irreversible aggravation of arthritis that required surgery to excise the trapezium.   The ALJ awarded additional disability against the second injury fund for substantial pre-existing disability to the shoulder, elbows and wrists.
 No future medical was awarded.  The award reflects an agreement that the parties agreed to hold claimant harmless if the medical provider sought further reimbursement.   The ALJ affirmed the award without a separate opinion. 
Dean Christianson represented the employee. 
In a second case, claimant slipped and fell in 2013 resulting in injuries to her knee and other body parts.  She subsequent went on to have a total knee replacement.  The ALJ found a partial disability but ordered the employer to pay for the surgery.  Both the claimant and the employer appealed. The employer contests the award for past medical benefits.  The employee claims she should have been awarded total disability.
The surgeon found her meniscus tear caused by the work injury, but that her subsequent total knee replacement and post-operative pain complaints related to degenerative conditions.  The ALJ found the total knee replacement related to the accident but denied future care.  "We find that because employee's left knee joint has been removed and replaced with a prosthetic device, any problems she experiences in the future relating to her left knee joint cannot be considered  causally related to pre-existing degenerative arthritis."
The ALJ found claimant's inability to work flowed from subsequent degeneration of unrelated conditions.  The Commission modified the decision to award total benefits against the second injury fund.