requires use of an expert.
Benefits denied, claimant failed to show a compensable injury from lifting bags, causation or a need for treatment based on a radiology report and his own testimony without something more such as records, reports or expert testimony. The need for surgery is inherently a sophisticated question that requires expert opinion. .
Claimant could establish he had an accident (an undisputed fact), that a foreign object was lodged in his eye, and he required medical treatment to support an award of medical treatment of $23,226 against the Second Injury Fund. “We agree with the Second Injury Fund that certain medical conditions and diagnoses reflected in the medical records, such as conjunctival neoplasm, uveitic cataract, and retrocorneal membrane, are unquestionably beyond the realm of lay understanding.” (citing Silman v. William Montgomery & Assocs., 891 S.W.2d 173, 175-76 (Mo. App. 1995). The commission reversed a finding of PPD and noted the issue was not ripe for determination without a finding of MMI.
Joseph Parr v Bobby Boatright, Frozen Food Express , Oct. 5, 2017 (no Lexis cite) Benefits denied, Record is too deficient to show driving off the road caused need for physical therapy, temporary total disability or permanent disability. The ALJ notes claimant became convinced that he had a traumatic brain injury based on research on the internet.
Julie Zerwig v Verallia/Saint Gobian Inc., 2017 MO WCLR LEXIS 58. A pro se claimant was awarded 2% partial disability following an accident in which her hair was caught in a machine and she reports she was totally bald on part of her head and that her head explodes while it “reattached.” Claimant offered no expert opinion by report or deposition to explain her subsequent and belated spinal symptoms. The Commission affirmed an opinion that hair loss and “contusion” are within the scope of lay testimony. The ALJ concluded but that “no greater amount” than 2% could be awarded without expert opinion.
Claimant asserted she was not given a fair trial and the judge badgered her. The ALJ noted he provided a wide latitude to allow her evidence. The Commission found the ALJ’s cautionary admonition prior to the hearing that claimant would not get what she wanted was reasonable.
.
Martha Satterfield v Carlisle
Power Transmission, 2017 MO WCLR LEXIS
__ (July 7, 2017). The commission found a basis to award a 20% load factor based on lay opinion about synergy. The award based on a finding of synergy was supported
based on a medical conclusion the disability was greater than the simple sum
and did not require further explanation because synergy involving opposite
extremities was within lay understanding and in this case the claimant had an
ankle fracture and the osteoarthritis in both hands of the 72-year old
claimant. See Winingear v. Treasurer, 474 S.W.3d 203 (Mo. App. W.D. 2015).The commission construes the requirements of 287.190.6(2) regarding the burden of proof in disability claims to show disability is “certified” and “demonstrated” and concludes a party must show medical findings that "attest authoritatively," "confirm," "manifest clearly," or "make evident or reveal" the extent of an employee's physical functioning by making findings on examination, rendering diagnoses as to the employee's medical conditions, and identifying restrictions or recommendations as to the employee's physical activities referable to those diagnoses. These medical findings serve to "demonstrate" or "certify" the employee's physical condition; based on such medical findings.
The Commission rejected the “hyper-technical” defense by the second injury fund that medical evidence did not support a finding of PTD when a expert did not indicate he was totally disabled. The commission found the injury nearly deprived the employee the use of his dominant arm. It would have awarded higher PPD against the employer if the issue had been preserved for review.
Benefits can be awarded for adverse consequences of
medications
Lamont Cooper
v Mid Missouri Mental Health Center,
2018 MO WCLR LEXIS (Feb. 23, 2018)Affirms an award of $232,627 in medical, PTD but reverses a safety penalty .
“treatment
for lung/ breathing problems, diabetic retinopathy, fatigue, diabetes and
avascular necrosis of the left hip were found
compensable on the basis that large doses of prednisone on a consistent basis
is a recommended treatment for hypersensitivity pneumonitis. A known side
effect of that treatment are the conditions cited by the ALJ. On that basis,
the ALJ found the occupational disease to be the prevailing factor causing
these conditions.”
Travis Wilkins v Piramal
Glass Co, 2017 MO WCLR LEXIS 34 Appeal was voluntarily
dismissed, ED 105683 (March 1, 2018). ALJ awarded 10% to calf for muscle
tear.
The Commission finds claimant’s staph infection flowed
from a tear of a calf muscle, reversing the denial by the ALJ, and notes the
fact that claimant may have been at higher risk due to diabetes or that
presentation was unusual did not establish was not an affirmative opinion to
show it was not the prevailing factor. Causation found due to aggravation of predisposing conditions.
Leech v Phoenix Home Care, 2017 MO WCLR LEXIS 45 (Oct.
12, 2017)
Total knee is reasonably
related for arthritic knee injured while unplugging a computer.
Myers v Quanta Services,
2017 MO WCLR LEXIS 46Commission awards future medical including a total knee
replacement or a 57-year old with prior knee problems who claims his knee
popped when he unplugged a computer device.
The ALJ asserted claimant denied prior symptoms. Citing Tillotson v St. Joseph Medical Center,
347 S.W.3d 511 (Mo. App. 2011).
Future medical supported award for 62 year old with arthritic knee.
Karon Simpson v Columbia College, 2017 MO WCLR LEXIS __, July 28 2017. (rejecting the contention that the employer unreasonably relied upon medical opinion to contest causation and waived its right to direct future care.)
Jimmy Holifield v Mississippi Lime Co., 2018 MO WCLR LEXIS 6
Surgery not reasonably related to work accident due to prior condition.
Expert apportions new medical condition (DeQuervain) despite prior disability to hand from other medical conditions.
Laverne Shegog v SSM Health, 2017 MO WCLR LEXIS 52
Affirms PTD award against Second Injury Fund with 15% settlement for back.
William Johnson v RBJ Investments , 2018 MO WCLR LEXIS 18
The commission modified an award from PPD to PTD and concluded the 59 year old claimant was unemployable in the open labor market because he was too tired dealing with shoulder pain and no employer would let him take a nap.
Deardorff v State of MO, 2017
MO WCLR LEXIS ___ (June 13 2017)
