Commisison awards Total Knee surgery after settlement

The Commission reversed a denial of benefits and allowed claimant to pursue further medical care, including a knee replacement, a month after settling a case. independent of the reactivation provision when the parties agreed to leave medical open for a period of time. Pierce v Bedrock , DOLIR 6-14-2018  (2-1 decision)

Claimant in May 2012 agreed to settle his case with the provision to keep medical open for one year and to allow medical to remain open pursuant to 287.140.8.  In June, the following month, claimant demanded more care.  The employer tendered care, and the doctor indicated claimant's need for total knee replacement was unrelated to the work injury.

The case was appealed and remanded to allow claimant to pursue his claim under the reactivation provision (287.140.8).  The employer objected that claimant failed in his burden to show good cause to trigger a duty to provide care under the reactivation provision. 

The Commission finds "good cause" under 287.140.8 to include any reason that is based on equity or justice or would motivate a reasonable man.  The commission finds the need for total knee replacement to be related, and orders treatment.

The Commission noted the agreement to leave medical open vested jurisdiction with the Commission to determine the scope of an "open" claim, citing State ex rel ISP Minerals, Inc. v Labor and Indus. Rels. Comm'n, 465 S.W.3d 471.  The commission found this agreement vested jurisdiction to provide future medical treatment independent of the re-activation statute.