Failure in burden of production when SIF claim incorporated nonqualifying prior conditions

Ray Ingles v Corrigan Bros.

Release Date:  8 18 2021  (Aug 2014)

Venue:  Callaway County

Summary:  Commission affirms denial of PTD benefits against the SIF when expert opinion exclusively relied upon qualifying and non-qualifying medical conditions.  A dissent regarded consideration by experts of non-qualifying disabilities was not reversible error.  ALJ Farmer further noted claimant failed to show PTD from a "single" pre-existing disability and opined he was "constrained" by the statute as it was "currently construed."  The Commission noted a lack of evidence that the prior aggravated or accelerated the disability based on the statute.  

14-102499

Cast

Viet

Donner

Volarich

Cordray

SIF liability not found for total hearing loss without evidence to show it meets SIF statutory categories

 Robert Schebaum v ABB Holdings

Released:  8-10-2021 (accident Jan 2014)

Venue:  Cole County

Plot summary:  Commission in 2-1 decision affirms denial of PTD against then fund for failure of proof of statutory requirements of 287.220.3(2) for bilateral knees and hearing loss when he was working 70 hours a week prior to primary 

The Commission found expert opinion on  PTD relied upon nonqualifying total hearing loss that did not fall within one of the four qualifying subcategories:

(i) A direct result of active military duty in any branch of the United States Armed Forces; or (ii) A direct result of a compensable injury as defined in section 287.020; or (iii) Not a compensable injury, but such preexisting disability directly and significantly aggravates or accelerates the subsequent work-related injury and shall not include unrelated preexisting injuries or conditions that do not aggravate or accelerate the subsequent work-related injury; or (iv) A preexisting permanent partial disability of an extremity, loss of eyesight in one eye, or loss of hearing in one ear, when there is a subsequent compensable work-related injury ....

It appears Eldred later attempted to modify opinion that PTD was due to knees alone.  ALJ found Eldred not persuasive by live testimony of PTD from knee injuries alone when prior opinion found claimant's hearing loss a combining factor in PTD.  Knees were found 25% and 45% disabled with 100% hearing loss (180 weeks) as part of a global disability presentation.  

Cast:

Fischer, ALJ

Snyder

Koprivica

Eldred

Commission finds back injury is an "opposite extremity" to support SIF total award.

 Brenda Comer v Central Programs 

Date:  8 11 2021  (Nov. 2016 accident date)

Venue:  Harrison County 

Summary:  SIF appeals PTD claim.   Commission affirms.  

16-085212

SIF argues prior hip (non-occupational) medical condition did not qualify under 287.220.3 and asserts a hip was not an opposite extremity for the primary back (400 week) injury and that any PTD was last accident alone based on lay opinion about symptoms (with no supporting expert opinion).  

The Commission found expert opinion that the primary back condition caused right leg symptoms to be regarded as opposite extremity to the prior left leg/hip condition and uncontroverted medical opinion to show substantial aggravation to qualify under the statute:

"[Employee’s] preexisting leg pain has combined with the current radicular symptoms to create a more significant disability than either considered in isolation. Further, Ms. Comer testified that the limp she has had since the 1987 injury has gotten worse and more painful since November 1, 2016. Her back and left hip hurt in conjunction with each other, which is why Dr. Koprivica opined her back pain is worse than it would have been if she did not have left hip pain and an altered gait. The hip shattered in the 1987 injury is directly adjacent to the lumbar spine where the 2016 work injury occurred. Thus, this is not an unrelated accident location but one that actively aggravates the subsequent work injury in numerous ways."  (emphasis added).

The ALJ denied future medical and noted claimant was unable to distinguish pain management needs attributable to the accident given her prior chronic pain. 

Cast:

Asbridge, ALJ 

Nordyke, atty

Levine, B atty

Cole, Candace, atty

Grace, Ashley, atty 

Koprivica

Bailey 

Reversible error to award fund total on cumulative prior BAW settlement

 Walter Adams v Jim Hawk Truck Trailers

Release Date:  Aug 18, 2021

Venue:  Clay County

Plot Summary:  SIF appeals PTD award in which the Commission reverses in a 2-1 decision and disqualified a prior settlement of 15% BAW which failed to allocate disability separately to either the back or bilateral knees and was considered as a basis for a SIF award. No expert indicated claimant would be PTD independent of consideration of the earlier "cumulative" 15% prior.  

Inj. No.  15-073485

Cast:

Siedlik, ALJ 

Doyle, atty 

Pritchard, atty 

Fournier, atty 

Cordray