Wednesday, July 11, 2018

Commission in split decision reverses denial of nursing benefits to spouse for emotional support

Ronald Reynolds v Wilcox Truck Line
July 3, 2018  DOLIR

Claimant sustained an accident in 2007 and alleges post traumatic stress disorder and depression and claims he remains PTD and unable to work in the open labor market.

The ALJ  awards total disability, past TTD of more than $153,000 and denies payment for  nursing services for his spouse. 

The commission modified the award.  It noted the 136 page decision by the ALJ summarized the findings without highlighting the operative facts.  The 2-1 Commission relies upon the causation opinion of Dr. Stanley Butts.  The commission found the defense expert did not demonstrate the symptoms were more likely from dementia or other non-occupational causes.  Claimant also offered vocational evidence that claimant was unemployable.

 Claimant offered an opinion from a life care planner that he required nursing care up to 20 hours a day.  The employer did not appeal the finding that claimant required future medical care.  Claimant argues that he needs someone to manage his medication, doctors appointments, transportation and avoid going into crisis.  Claimant is able to perform many activities of daily living, unlike parties injured with debilitating injuries in other cases.  The Commission found an absence of proof of the ordinary activities of a spouse.  The Commission rejected expert testimony that claimant required round the clock monitoring because symptoms waxed and waned but derived the finding that claimant required 48 hours a week (the basis of this calculation is not documented).   The commission awards $208,896 in past benefits at $16.00 an hour.

The Commission noted it retained jurisdiction to resolve disputes about ongoing obligations if claimant's situation changes and he requires more frequent care.

Clamant sustained additional physical injuries which required debridement.  He is a 62 year old veteran who was hauling mail at the time. 

A dissent noted claimant's fear of driving a truck after his accident did not render him totally disabled.  The dissent notes claimant was trapped after the accident but he was able to work until he witnessed another accident.  The dissent notes statements to a treating psychologist that claimant was able to resume activities working on a farm 12 hours a day. 

Dr. Halfaker rated claimant with a 10% disability. 


 ALJ  Miner
Atty: Powell, Lanham