Amie Elsworth v Wayne County Mo (Mo Association of Counties)
No. SD 34919 2018 MO APP LEXIS 421 (April 24, 2018)
The employer appeals an award of PTD and alleges the commission erred when it failed to allow a reduction in benefits due to an alleged safety penalty for speeding and failure to wear a seat belt. The Court affirms. The employer sought a reduction of benefits for an 18-year old involved in a catastrophic truck accident that put him in a permanent vegetative state.
The employer asserted it warned claimant to obey traffic laws and wear a seat belt. The employer argues that claimant did not follow the rules because he was speeding and did not wear a seat belt. The Commission affirmed the award of ALJ Robbins which denied the safety penalty. The employer asserted various negligent acts.
The court noted the employee received on the job training without evidence of the specificity as to what training was provided or received. The commission in the past had considered the efforts of employers to distribute written safety materials, schedule and present training seminars, warning employees with disciplinary actions, testing to be sure that employees understand the rules and if previous violations have gone unpunished. The section does not require a safety rule to be written. The Commission was free to disbelieve the employer concerning the scope of its safety rules and enforcement.
An accident reconstruction expert testified that the employer failed to adequately train the driver. He had obtained a commercial driver's instruction permit only two weeks before his first day n the job.
The case involves a 2007 accident. At the time of the original hearing, the employer had paid more than 2.5 million in past medical benefits.
https://labor.mo.gov/sites/labor/files/decisions_wc/ElsworthDustin.pdf
Friday, April 27, 2018
Wednesday, April 25, 2018
Court drops employer summary judgment on the disputed meaning of "regular"
The court of appeals reversed a summary judgment on behalf of a defendant who tried to argue that claimant was a statutory employee and exclusive remedy was within workers compensation. Barger v. Kansas City Power and Light Company, WD 80778 (April 24, 2018). 2018 MO APP LEXIS 422
GPES/KCP&L contracted with Projectile Tube Cleaning to clean tubes. The work was performed a few times a year as needed. Projectile agreed to provide comp coverage and further agreed its workers were not employees of KCP&L.
Claimant fell, injured his wrist, and pursued comp benefits against Projectile. About two years later the worker sued KCP&L in civil court under a res ipsa theory. The circuit court granted summary judgment and found no material factual issues in dispute. The court of appeals reversed the summary judgment.
The court noted that summary judgment is allowed only if there is no material fact in dispute and the burden is on the party seeking the motion. The court further noted that since McCracken v Wal-mart, 298 S.W.3d 473 (Mo 2009) that the party seeking a summary judgment has the burden as an affirmative defense and that strict construction applied to determine that issue under 287.800. The court notes that cases cited by the parties prior to McCracken now had more limited precedential value.
The court noted disputes of material fact in supporting affidavits based on the assertion that work done periodically "as needed" was not "regular" work to trigger the statutory employment defense. It was disputed if KCP&L had its own tools to perform the services.
The court noted that the agreement that the work was performed under and required by contact did not preclude the need for additional evidentiary hearing.
GPES/KCP&L contracted with Projectile Tube Cleaning to clean tubes. The work was performed a few times a year as needed. Projectile agreed to provide comp coverage and further agreed its workers were not employees of KCP&L.
Claimant fell, injured his wrist, and pursued comp benefits against Projectile. About two years later the worker sued KCP&L in civil court under a res ipsa theory. The circuit court granted summary judgment and found no material factual issues in dispute. The court of appeals reversed the summary judgment.
The court noted that summary judgment is allowed only if there is no material fact in dispute and the burden is on the party seeking the motion. The court further noted that since McCracken v Wal-mart, 298 S.W.3d 473 (Mo 2009) that the party seeking a summary judgment has the burden as an affirmative defense and that strict construction applied to determine that issue under 287.800. The court notes that cases cited by the parties prior to McCracken now had more limited precedential value.
The court noted disputes of material fact in supporting affidavits based on the assertion that work done periodically "as needed" was not "regular" work to trigger the statutory employment defense. It was disputed if KCP&L had its own tools to perform the services.
The court noted that the agreement that the work was performed under and required by contact did not preclude the need for additional evidentiary hearing.
Tuesday, April 24, 2018
Commission cuts 35% PPD award for low back strain
Claimant alleges in 2012 she injured her back and shoulder stacking tool boxes. The expert do not dispute that the accident injured claimant's back but reach different conclusions about the degree of disability.
The ALJ awarded 35% of the back and an additional amount of disability for the shoulder in 2012.
Claimant treated conservatively for her back and states she still experiences 10/10 pain levels which she treats with over the counter mediation. She describes difficulty walking. She has subsequently undergone a total hip replacement for avascular necrosis. The ALJ awarded the 35% claimant's expert, Dr. Zimmerman, rated to the back but did not award additional rated disability at the hip. The ALJ noted claimant's medical expert reached conclusions that were at odds with other medical records and reports.
The employer relies upon the opinion of Dr. Koprivica who assigned 5% disability for a low back strain for axial pain.
The ALJ awarded approximately $57,000 in PPD for the shoulder and back to about $27,000. The Commission affirmed the award denying future medical which was mostly self-help.
The Commission modified the award from 35% of the back to 15% of the back for a strain. It noted claimant's brain treatment may have impacted her ability to remember events.
Claimant was 53-years old and had worked for the employer in Sedalia for 13 years. Claimant qualified for social security disability in 2014 following surgery for sarcoidosis. She believes her brain condition was also work related, a position not supported by any expert.
The Commission noted the parties did not make TTD an issue, and declined to address findings by the ALJ that claimant was not entitled to TTD.
Mary Claxon v Waterloo Industries, 2018 MO WCLR LEXIS __ (4/18/2018)
ALJ Anderson
Atty: Smith, Gary
Experts: Zimmerman, Koprivica
The ALJ awarded 35% of the back and an additional amount of disability for the shoulder in 2012.
Claimant treated conservatively for her back and states she still experiences 10/10 pain levels which she treats with over the counter mediation. She describes difficulty walking. She has subsequently undergone a total hip replacement for avascular necrosis. The ALJ awarded the 35% claimant's expert, Dr. Zimmerman, rated to the back but did not award additional rated disability at the hip. The ALJ noted claimant's medical expert reached conclusions that were at odds with other medical records and reports.
The employer relies upon the opinion of Dr. Koprivica who assigned 5% disability for a low back strain for axial pain.
The ALJ awarded approximately $57,000 in PPD for the shoulder and back to about $27,000. The Commission affirmed the award denying future medical which was mostly self-help.
The Commission modified the award from 35% of the back to 15% of the back for a strain. It noted claimant's brain treatment may have impacted her ability to remember events.
Claimant was 53-years old and had worked for the employer in Sedalia for 13 years. Claimant qualified for social security disability in 2014 following surgery for sarcoidosis. She believes her brain condition was also work related, a position not supported by any expert.
The Commission noted the parties did not make TTD an issue, and declined to address findings by the ALJ that claimant was not entitled to TTD.
Mary Claxon v Waterloo Industries, 2018 MO WCLR LEXIS __ (4/18/2018)
ALJ Anderson
Atty: Smith, Gary
Experts: Zimmerman, Koprivica
Friday, April 20, 2018
Employer waived its right to further cross exam according to Commission
Vitaliano Rodas v the Carter Group Bella Inc.
2018 MO WCLR LEXIS 4-12-2018
The Commission affirms a 30% PPD award for a knee injury and unpaid medical bills for an accident occurring in Kansas by an uninsured employer.
At the time of the accident the 65-year old claimant was performing re-modeling work and repairing a floor. He was a qualified real estate agent.
The employer contends because claimant was a qualified real estate agent he could not pursue benefits based on the exclusion under 287.090.1(2). The commission noted there was no evidence the activities at the time of the accident were related to duties of a qualified real estate agent to invoke the exclusion because claimant was not "fairly" and "clearly" within the terms based on strict construction.
The employer asserted claimant's medical expert was barred because he was not available for cross-examination. The Commission found the employer waived the error by not asserting a timely objection within 10 days of an intent to submit the report, and when the employer had an opportunity to partially cross examine the expert (nothing 36 pages of cross-exam) the deposition was stopped over a dispute over one question that defense counsel was "badgering" the witness by the suggestion the expert was being too much of an advocate. The commission considered the defense counsel had a reasonable opportunity to pursue relief in the eight months between the first attempt at the deposition and the hearing and waived its right for further cross examination.
The Commission affirmed a finding of employment but disavowed additional findings regarding the role as construction industry employers.
The Commission found the rating from claimant's expert uncontroverted because the employer offered no contrary medical opinion.
ALJ Rebman
2018 MO WCLR LEXIS 4-12-2018
The Commission affirms a 30% PPD award for a knee injury and unpaid medical bills for an accident occurring in Kansas by an uninsured employer.
At the time of the accident the 65-year old claimant was performing re-modeling work and repairing a floor. He was a qualified real estate agent.
The employer contends because claimant was a qualified real estate agent he could not pursue benefits based on the exclusion under 287.090.1(2). The commission noted there was no evidence the activities at the time of the accident were related to duties of a qualified real estate agent to invoke the exclusion because claimant was not "fairly" and "clearly" within the terms based on strict construction.
The employer asserted claimant's medical expert was barred because he was not available for cross-examination. The Commission found the employer waived the error by not asserting a timely objection within 10 days of an intent to submit the report, and when the employer had an opportunity to partially cross examine the expert (nothing 36 pages of cross-exam) the deposition was stopped over a dispute over one question that defense counsel was "badgering" the witness by the suggestion the expert was being too much of an advocate. The commission considered the defense counsel had a reasonable opportunity to pursue relief in the eight months between the first attempt at the deposition and the hearing and waived its right for further cross examination.
The Commission affirmed a finding of employment but disavowed additional findings regarding the role as construction industry employers.
The Commission found the rating from claimant's expert uncontroverted because the employer offered no contrary medical opinion.
ALJ Rebman
Tuesday, April 17, 2018
Commission affirms award for off-duty fitness training
An officer in Kansas City injured his knee at the beginning of an obstacle course in December 2015 during off duty hours. The officer signed a form and agreed that use of the obstacle course when he was off-duty would not be covered by workers' compensation. Reiter v Kansas City Police Department, 2018 MO WCLR LEXIS (April 12, 2018)
The ALJ awarded benefits and medical bills for an ACL injury and the Commission affirmed the award in a modified decision.
The employer disputed the accident and asserted it was a recreational activity and did not arise in the course and scope of employment. The claimant asserted no officers ran the course for recreation and fitness provided a benefit for the employer.
The claimant was told by a supervisor to treat on his own because he signed a waiver.
The ALJ found the employer created the hazard and offered the employees benefits for participating. The ALJ found the activities off-duty were regarded in the course of employment because they advanced the employer's interest. The activity could not be considered recreational because it was not performed for diversion but for remuneration.
The Commission affirmed the award but noted the test whether an injury arose of employment depended on medical causation, 287.020.3(2)(a), which was not in dispute, and (2)(b) to define the relative hazard or risk of what caused the risk and not what he was doing. In this case, the commission found the hurdle in claimant's path was the obstacle which caused the knee injury, that the obstacle course was related to employment and claimant would not have been exposed to the similar risk away from work. The Commission applied an equal exposure analysis but concluded it did not regard the test required based on Pile v Lake Regional Health System, 321 S.W.3d 463 (Mo. App. 2010). The commission disavowed reliance on pre-reform cases.
The commission found that 287.390.1 prohibited any waiver of a right to pursue workers' compensation benefits and the claimant's agreement to use the course in exchange for not exercising his rights to be not enforceable.
The award represented 20% PPD for surgically repaired ACL tear represented approximately $48,000 in medical and PPD with open medical for the officer.
ALJ Fowler
Atty Stang, Postlewait
Experts: Stuckmeyer
Treater: Snider
The ALJ awarded benefits and medical bills for an ACL injury and the Commission affirmed the award in a modified decision.
The employer disputed the accident and asserted it was a recreational activity and did not arise in the course and scope of employment. The claimant asserted no officers ran the course for recreation and fitness provided a benefit for the employer.
The claimant was told by a supervisor to treat on his own because he signed a waiver.
The ALJ found the employer created the hazard and offered the employees benefits for participating. The ALJ found the activities off-duty were regarded in the course of employment because they advanced the employer's interest. The activity could not be considered recreational because it was not performed for diversion but for remuneration.
The Commission affirmed the award but noted the test whether an injury arose of employment depended on medical causation, 287.020.3(2)(a), which was not in dispute, and (2)(b) to define the relative hazard or risk of what caused the risk and not what he was doing. In this case, the commission found the hurdle in claimant's path was the obstacle which caused the knee injury, that the obstacle course was related to employment and claimant would not have been exposed to the similar risk away from work. The Commission applied an equal exposure analysis but concluded it did not regard the test required based on Pile v Lake Regional Health System, 321 S.W.3d 463 (Mo. App. 2010). The commission disavowed reliance on pre-reform cases.
The commission found that 287.390.1 prohibited any waiver of a right to pursue workers' compensation benefits and the claimant's agreement to use the course in exchange for not exercising his rights to be not enforceable.
The award represented 20% PPD for surgically repaired ACL tear represented approximately $48,000 in medical and PPD with open medical for the officer.
ALJ Fowler
Atty Stang, Postlewait
Experts: Stuckmeyer
Treater: Snider
Friday, April 13, 2018
Emerging Issues at the Commission concerning medical care
Medical
Causation involving complex matters
requires use of an expert.
Section 287.190.6(2) further provides disability “shall be demonstrated and certified by a physician.”
Henry Chester v Sonoco, 2017 MOWCLR LEXIS 41 appeal dismissed by western district
for failure to pay fee, WD 81174 (11/16/2017)
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. .
Bill Hood v Michael Menech and Vandalia Area Historical Society, 2017 MO WCLR LEXIS 37 (eye)
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.
Dennis
Moss v Mo. Dept. of Corrections, 2018 MO WCLR LEXIS 4. There is no need for strict proof of a certified opinion as PTD can be reasonable inferred. The
commission affirms a PTD award against the fund.
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.
Future medical awards
may not require an expert opinion if the issue is not complex.
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 .
Causation found due to aggravation of predisposing conditions.
A lifting accident while
loading a tub into a car was found to be the cause of claimant’s frozen
shoulder, despite predisposing medical risk factors from diabetes.
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.)
Hearing loss award of $637.36 supported
by proof of audiologist.
Jimmy Holifield v Mississippi Lime Co., 2018 MO WCLR LEXIS 6
Surgery not reasonably related to work accident due to prior condition.
Diane Koch v Aldi, 2018 MO WCLR LEXIS 15. Affirms a 15% partial against employer, total against fund but denies future medical. Claimant had significant wear and tear of a prior hip replacement and testimony was equivocal to show that future medical flowed from the new hip accident when she fell while climbing off of a forklift.
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
Accident aggravated
prior chronic back pain which required use of narcotic medication.
Affirms PTD award against Second Injury Fund with 15% settlement for back.
William Johnson v RBJ Investments , 2018 MO WCLR LEXIS 18
Accident to shoulder caused disturbed sleep to render claimant
unemployable.
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.
Assault
by patient aggravated multiple orthopedic injuries and PTSD.
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)
Friday, April 6, 2018
Total awarded against fund based on "unrebutted" expert opinion.
Hellmann v Prairie Farms Dairy
4/5/2018
ALJ Denigan
Atty Dalton
Experts Volarich, England
The Commission affirmed a PTD award to 56 year old worker against the SIF. The employer had settled for a primary elbow injury. the ALJ notes claimant had an "unusual" number of surgeries for prior orthopedic conditions, and that the opinions of claimant's expert were "unrebutted."
4/5/2018
ALJ Denigan
Atty Dalton
Experts Volarich, England
The Commission affirmed a PTD award to 56 year old worker against the SIF. The employer had settled for a primary elbow injury. the ALJ notes claimant had an "unusual" number of surgeries for prior orthopedic conditions, and that the opinions of claimant's expert were "unrebutted."
Carrier failed to comply with rules to revoke coverage
Sergey Chudnovtsev v BSI Construction, St. Louis Brick
ALJ Boresi
dec. 3/30/2018
Claimant sustained an injury when he fell down some steps resulting in multiple orthopedic injuries. The issue in the case was whether St. Louis Brick, a subcontractor, had effective insurance coverage at the time of the loss.
The ALJ found Travelers failed to establish effective and timely cancellation of coverage. The ALJ found attempts to revoke coverage were equivocal, internally contradictory and conditional and distinguished cases which indicated coverage "would be" canceled and notices that coverage "is" cancelled. The ALJ found the filing of a cancellation of policy notice (form 75) was ministerial in nature and not dispositive.
ALJ Boresi
dec. 3/30/2018
Claimant sustained an injury when he fell down some steps resulting in multiple orthopedic injuries. The issue in the case was whether St. Louis Brick, a subcontractor, had effective insurance coverage at the time of the loss.
The ALJ found Travelers failed to establish effective and timely cancellation of coverage. The ALJ found attempts to revoke coverage were equivocal, internally contradictory and conditional and distinguished cases which indicated coverage "would be" canceled and notices that coverage "is" cancelled. The ALJ found the filing of a cancellation of policy notice (form 75) was ministerial in nature and not dispositive.
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