Wednesday, December 19, 2018

Court suggests different standard of review for denied comp cases

Farmer v Treasurer of the State of MO
2018  Mo App. Lexis ___
SD 35637
December 17, 2018

The Court of Appeals affirms a denial of second injury fund benefits in which the ALJ found claimant lacked credibility and his testimony was not trustworthy of belief.

The court raises on its own  an issue whether to apply the same criteria to evaluate workers' compensation cases in which the Commission award benefits and decisions which deny benefits and concludes the terms to evaluate awards (v non-awards) may warrant consideration of different standards.

"Perhaps because the word "award" appears so prominently (but not exclusively) in section 287.495 as describing final commission decisions, the division and commission typically title their ultimate decision an "award" whether benefits are granted or denied. This ubiquity is unfortunate because it heightens certain logical difficulties ....

In reviewing final decisions adverse to the claimant – the party with the burden of persuasion – the standard of review set forth in Hampton seems, frankly, nonsensical, and we believe it should be reconsidered for the reasons contained in our high court’s more recent decision in White v. Director of Revenue, 321 S.W.3d 298, 305 (Mo. banc 2010) (stating, "When the burden of proof is placed on a party for a claim that is denied, the trier of fact has the right to believe or disbelieve that party’s uncontradicted or uncontroverted evidence. If the trier of fact does not believe the evidence of the party bearing the burden, it properly can find for the other party" (internal citation omitted)). However, both the majority and dissenting opinions in Malam v. State, Dep’t of Corr., 492 S.W.3d 926, 928, 930 (Mo. banc 2016), purported to apply the Hampton standard in their differing analyses of the Commission’s affirmance of a decision denying compensation, so we will attempt to apply it here to the best of our ability. "


Claimant appealed and argued substantial evidence of medical expert opinion supported the award absent what he felt was improper admission of evidence of prior convictions for social security fraud.  The Court found no reversible error as the exhibits were cumulative as claimant had already admitted to the fraud convictions in his testimony.

"Claimant’s argument fails to appreciate that his credibility was crucial in resolving his claim. It is within the sole province of the Commission "to make such [credibility] findings[,] and we defer to such credibility determinations"

Claimant was a 58 year former chief of police for Hayti Heights who alleged  two claims against his employer for a neck injury from breaking up a fight and a stress claim for working long hours.   The opinion describes claimant's multiple claims in the past.  He pled guilty to making a false statement to obtain social security benefits, and concealing earned wages above the income threshold for disability.

Claimant's own expert, Dr. Driver,  reported it was difficult to obtain a consistent story but diagnosed him with a personality disorder. He found the MMPI profile was invalid. 

Claimant objected at trial to the admission of certified records from the federal and state courts concerning the prior convictions.  The ALJ found the admission of prior conviction was equivocal to support the admission of the documents. Claimant contends the admission of the additional records were irrelevant because he freely admitted the convictions.

The ALJ found claimant failed to prove accident of either a neck injury or psychological condition due to lack of credibility based on inconsistent history.

The erroneous admission of incompetent evidence did not warrant setting aside the award if it was otherwise supported.  The court noted the outcome was based on the finding that claimant was not trustworthy and not disregarding objective evidence which would have supported an award.

The employer had paid partial disability settlements in the two claims for neck injury and stress to settle the litigation. 

Experts:  Volarich, Driver, Shea