Cynthia Null v Albany Medical Center dba Northwest Medical Center Association
2018 MO WCLR LEXIS ----
Inj. 12-100528 12/20/2018
https://labor.mo.gov/sites/labor/files/decisions_wc/NullCynthia12-10052812-20-18.pdf
The Commission affirms an award of past and future medical related to a slip and fall in a parking lot that produced knee and ankle injuries and aggravated prior psychiatric conditions and found future treatment was reasonably likely.
The future medical award included treatment for chronic pain management, treatment related to a spinal cord stimulator, psychological counseling and medication for depression and psychological injury.
The past medical in dispute represented about $41,000.
The only issue in dispute was past and future medical.
The parties prior to hearing stipulated to disputed disability of $120,000 related to injuries to the ankle, foot and knee that required ORIF to the ankle and arthroscopy to the knee. The employer had paid more than $281,000 in medical benefits including treatment for pain management and psychiatric care. The fund had stipulated to $60,000 for a disputed PTD. The pro rata rate was substantially below the comp rate.
The Commission found the need for future medical treatment from an admitted accident was established with reasonable probability and as a matter of law rejected the employer's argument that claimant must show the accident was a prevailing factor in the need for medical treatment related to disputed psychiatric care. The Commission found the award of past medical care of about $41,000 was based on credible evidence even though the medical opinion was based in part on claimant's incomplete medical history.
Dr. Schmidt testified claimant's accident aggravated a prior major depressive disorder and caused a new pain disorder. He notes claimant has "unusual physical reactions" and acted "bizarrely." He rated her with a 15% new impairment and attributed an additional 10% to pre-existing. the employer's original expert felt claimant had post traumatic stress disorder among other conditions. The ALJ rejected the expert opinion that claimant had a permanent pain disorder or required medication indefinitely.
The ALJ detailed findings that claimant's prior medical history was 'less than entirely consistent'. The Commission found no lack of intent to deceive but concluded inconsistencies likely flowed from a confused mental state and impact of medication prescribed for her work injury. Claimant describes multiple 'black out' spells attributed to medication from multiple sources. Claimant was regarded as credible about her impairment following the accident.
A concurring opinion felt the alleged error argued by the employer was weakened because the employer had provided care for psychiatric treatment.
The parties reached an agreement prior to hearing that employer agreed to pay $10,000 toward the disputed medical bills irrespective to any decision by the judge and the payment would be credited toward any award above that amount (the total medical in dispute was about $41,000). The ALJ found the employer failed to prove claimant's personal liability had been extinguished and ordered the entire amount.
The 69-page opinion describes prior issues with chronic pain and somatic disorder. She describes post-accident "black-out" spells (related in medication) and "unusual" presentation of pain. The diagnosis included major depressive disorder with pain syndrome with elements of complex regional pain disorder.
Atty: Dickson, Doyle, Shine
Expert: Schmidt , Koprivica, Drieling, Rosenthal, Cordray
Treater: Pronko, Hu, Jura
