Tuesday, April 21, 2015

Res judicata bars second OD claim after denial of accident

Claimant tried a case for a shoulder injury, he was denied benefits, and then filed on a second case involving the same shoulder.   The court of appeals found the Commission exceeded its powers by allowing the worker to re-litigate the claim in a second hearing based on an alternate theory of occupational disease.  Johnson Controls v David Trimmer, WD 77948 (Mo. App. 2015) (April 21, 2015). 

Claimant was a career employee who  tore his shoulder tendon.  His medical histories initially deny any accident and later document a fall.  The case was tried and the ALJ found claimant failed to prove accident.  Claimant appealed and lost.  He then filed a second claim alleging occupational disease.   The ALJ then ordered treatment in a temporary award.  The employer appealed and was ordered by the Commission to provide treatment and paid about $66,000 in benefits.   The claim proceeded to a final hearing which the employer lost both at hearing which was affirmed 2-1, resulting in a further award of partial disability.

The dispute arose whether claimant was precluded from litigating the issue of occupational disease in the second hearing based on the doctrine of res judicata.  The court ultimately found that occupational disease was previously litigated or should have been raised.   The stipulated issue in the first hearing was: "whether or not the claimant sustained an accident or occupational disease" and the denial
implicitly found  that claimant failed to prove occupational disease.  The problem arose because the judge only expressly found that he failed to prove that he "sustained an accidental injury" and made additional comments that he suspected claimant's shoulder condition should have been compensable as an occupational disease.  The attorney took the hint and then filed the second claim.

The court finds that even if the issue of occupational disease was not fully resolved in the first case it should have been brought and was barred by res judicata because the same operative facts give rise to both claims including the same medical and testimonial evidence.   The fact that causes of action arise from two separate statutory provisions did not matter.  It found there was not reason to reach the issue if claimant ever sustained an occupational disease.

Two separate ALJs had found the two cases were separate and distinct causes of action based on two separate provisions.  Trimmer v Johnson Controls, 2001 MO WCLR Lexis 101.  ALJ Allen noted in the original award:  "This is a troublesome case because I suspect that the claimant's injury to his left shoulder was the result of   30 years of hard physical labor performed for the employer. This should have been compensable. However, the claimant has pled an alleged injury from a fall." 2006 MO WCLR Lexis 118. ALJ Miner wrote the final award.   The dissent at the Commission  the proper remedy was to appeal the decision to the court of appeals rather than re-litigating the case in a separate proceeding.