Arthur Antilla v Dyno Nobel
Release Date: Aug 4, 2020 (Accident Date Jan 3, 2014)
Venue: Kansas City/Joplin
Plot Summary:
The Commission reverses a PTD award of benefits based on failure to prove pre-existing qualifying conditions.
Cast
Fisher
Pitts, Atty
Mobeg, Atty
Bang, Atty
Paul
Eldred
Hughes
Comments: Claimant, 68, alleges occupational disease and accident arising on the same date and settled for the employer for neck disability apportioned between two claims for accident and occupational disease under a single injury number. The ALJ accepted expert opinion that any disability was due to a "combo" effect. The vocational expert identified the total as a last accident alone. Claimant alleged he had symptoms leading up the accident from driving on rough roads but denies they impacted any capacity to work.
The Commission found claimant's prior medical conditions did not qualify under 287.220.3.
"We further note that we are not convinced by the evidence that the occupational disease as described by Dr. Paul was a preexisting condition shown to be at maximum medical improvement on the day of the primary Injury. An occupational disease does not become a compensable injury until the disease causes disability. Such disability would exist where it is shown to affect the employee's ability to perform ordinary tasks or his earning capacity. Garrone v. Treasurer of State, 157 S.W. 3d 237,242 (Mo.App. E.D. 2004). Employee's clear testimony was that he was not inhibited from doing his work or other activities prior to the January 3, 2014 traumatic injury to his neck and left arm. Employee's vocational rehabilitation expert also confirmed this. However, a finding on this issue is not necessary to our conclusion that Fund liability has not been established."
Both parties had stipulated to compensable occupational disease and accident despite conflicting medical opinions whether claimant's findings in the spine were degenerative or traumatic from repetitive exposure. The Commission noted: "we believe the judge was in error in finding that both injuries were properly plead under one injury claim "via an amended claim."
"Where no provision gives "permission" to give effect to an action, its absence requires us to conclude that the legislature did not intend for such expansive use of the claim filing process. While we understand the notion that administrative proceedings should not unduly burden the parties with meaningless procedural formalities, the circumstances here show good reason why the statute does not expressly allow multiple injury claims to be filed within one claim. The record is unclear and inconsistent on employee's theory on two points: (1) whether these are two distinct primary injuries both of which stem from work with this employer as the prevailing factor and (2) what is the claimed preexisting disability. Clarity in these respects is essential to determine Fund liability. The approach taken by the administrative judge created confusion as to the relationship between primary and preexisting disabilities, which is the pivotal point of analysis in Second Injury Fund claims.6 As the Fund notes in its brief, the May 2016 amended claim filed by employee suggests an additional mechanism of injury but does not suggest it is a preexisting disability for Fund liability. The approach taken by the administrative law judge to find two injuries in one claim and then convert one of those injuries to a preexisting condition further confusion and inserted uncertainty into the theories for defense by the opposing parties. In certain circumstances, this practice could potentially raise a question of adequate notice to the parties that may give rise to due process issues. Extending this practice to the extreme could result in an omnibus approach to claim filing, including all conceivable descriptions of injuries wrapped into one claim, such that five, ten, fifteen, or more loosely related injuries could be wrapped together as one claim. The danger of allowing such expansive pleading practice raises obvious concerns for the clear delineation of issues for the defending party, as well as for the reviewing tribunal."
