William Copeland v. Thurman Stout, Inc. d/b/a Ram Tech

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 97-079441

Employee: William Copeland

Employer: Thurman Stout, Inc. d/b/a Ram Tech

Insurer: Wausau Insurance Companies

Date of Accident: August 13, 1997

Place and County of Accident: Greene County, Missouri

The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by section 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commission finds that the award of the administrative law judge is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Act. Pursuant to section 286.090 RSMo, the Commission affirms the award and decision of the administrative law judge dated April 13, 2005. The award and decision of Associate Administrative Law Judge L. Timothy Wilson, issued April 13, 2005, is attached and incorporated by this reference.

The Commission further approves and affirms the administrative law judge's allowance of attorney's fee herein as being fair and reasonable.

Any past due compensation shall bear interest as provided by law.

Given at Jefferson City, State of Missouri, this $16^{\text {th }}$ day of December 2005.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

Alice A. Bartlett, Member

John J. Hickey, Member

Attest:

Secretary

1. Are any benefits awarded herein? yes
2. Was the injury or occupational disease compensable under Chapter 287? yes
3. Was there an accident or incident of occupational disease under the Law? yes
4. Date of accident or onset of occupational disease: August 13, 1997
5. State location where accident occurred or occupational disease was contracted: Greene County, Missouri
6. Was above employee in employ of above employer at time of alleged accident or occupational disease? yes
7. Did employer receive proper notice? yes
8. Did accident or occupational disease arise out of and in the course of the employment? yes
9. Was claim for compensation filed within time required by Law? yes
10. Was employer insured by above insurer? yes
11. Describe work employee was doing and how accident occurred or occupational disease contracted: Claimant was involved in a motor vehicle accident.
12. Did accident or occupational disease cause death? N/A Date of death? N/A
13. Part(s) of body injured by accident or occupational disease: lumbar spine
14. Nature and extent of any permanent disability: 25 % permanent partial disability body as a whole referable to the lumbar spine
15. Compensation paid to-date for temporary disability:
16. Value necessary medical aid paid to date by employer/insurer?
17. Value necessary medical aid not furnished by employer/insurer?
18. Employee's average weekly wages: $\ 797.28
19. Weekly compensation rate: $\$ 531.52 / 278.42$
20. Method wages computation: stipulation

1. Amount of compensation payable:

Unpaid medical expenses: The employer and insurer are ordered to pay the employee $\ 178.36 which represents the unpaid balance owed to Dr. Stefanowicz

The employer and insurer are ordered to provide future medical care in order to cure and relieve the employee of the effects of the injury, as authorized and directed by Dr. Cross.

The employee's request for additional temporary total disability is denied.

100 weeks of permanent partial disability from Employer \$27,842.00

The evidence is insufficient to impose a 15 % penalty reduction under Section 287.120.5, RSMo.

Also, the employee's request for a doubling of the award is denied.

1. Second Injury Fund liability: No

TOTAL: $\quad \ 28,020.36

1. Future requirements awarded: future medical (see above)

Said payments to begin immediately and to be payable and be subject to modification and review as provided by law.

The compensation awarded to the claimant shall be subject to a lien in the amount of 25 % of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant:

William W. Francis

Employee: William Copeland

Injury No: 97-079441

Before the

DIVISION OF WORKERS'

COMPENSATION

Department of Labor and Industrial Relations of Missouri

Jefferson City, Missouri

Dependents: N/A

Employer: Thurman Stout, Inc., d/b/a Ram Tech

Additional Party N/A

Insurer: Wausau Insurance Companies

Checked by: LTW/mp

The above-referenced workers' compensation claim was heard before the undersigned Associate Administrative Law

Judge on June 14, 2004, and June 21, 2004. The record was left open until October 25, 2004, for the submission of additional evidence; and the parties were afforded an opportunity to submit briefs, resulting in the record being completed and submitted to the undersigned on or about October 25, 2004.[1]

The parties entered into a stipulation of facts. The stipulation is as follows:

(1) On or about August 13, 1997, Thurman Stout, Inc., d/b/a Ram Tech ("Ram Tech") was an employer operating under and subject to The Missouri Workers' Compensation Law, and during this time was fully insured by Wausau Insurance Companies.

(2) On the alleged injury date of August 13, 1997, William Copeland was an employee of the employer, and was working under and subject to The Missouri Workers' Compensation Law.

(3) The above-referenced employment and alleged accident of August 13, 1997, occurred in the State of Maryland. The employee alleges that the contract of employment between him and the employer was made in Missouri, and that venue is properly situated in Springfield, Missouri. (The issue of jurisdiction is disputed by the parties, and was adjudicated in the earlier hearing by Margaret Holden, Chief Administrative Law Judge, which resulted in Judge Holden issuing a Temporary or Partial Award finding Missouri to have jurisdiction. Judge Holden did not specifically address the issue of venue; and, thusly, it is assumed she found venue to be appropriately situated in Springfield, Missouri, insofar as the hearing and adjudication occurred in Springfield, Missouri.)

(4) The employee notified the employer of his injury as required by Section, 287.420, RSMo.

(5) The Claim for Compensation was filed within the time prescribed by Section 287.430, RSMo.

(6) At the time of the alleged accident, the employee's average weekly wage was $\ 797.28, which is sufficient to allow a compensation rate of $\ 531.52 for temporary total and permanent total disability compensation, and a compensation rate of $\ 278.42 for permanent partial disability compensation.

(7) Temporary disability benefits have been provided to the employee in the amount of $\ 105,019.99, representing 217 weeks in disability benefits, payable for the period of August 13, 1997, through October 10, 2001.

(8) The employer and insurer have provided medical treatment to the employee, having paid $\ 33,578.61 in medical expenses.

(9) On July 7, 2000, the employer and insurer paid the sum of $\ 7,441.28 to the employee as an advance toward payment of permanent disability compensation owed in this case.

The sole issues to be resolved by hearing include:

(1) Whether the State of Missouri has jurisdiction in this case; and, if so, whether venue properly lies in Springfield, Missouri?

(2) Whether the employee sustained an accident on or about August 13, 1997; and, if so, whether the accident arose out of and in the course of his employment with employer?

(3) Whether the alleged accident of August 13, 1997, causedthe injuries and disabilities for which benefits are now being claimed?

(4) Whether the employer is obligated to pay for past medical expenses in the amount $\ 7,955.00 ?

Exhibit FF Handwritten Notes from Claims Adjuster File Exhibit GG

Journal Entry from Claims Adjuster

Exhibit HH Journal Entry from Claims Adjuster

Exhibit II Withdrawn

Exhibit JJ Withdrawn

Exhibit KK Medical Invoices from Labcorp

Exhibit LL Medical Invoices from Patricia A. Williams, D.O.

Exhibit MM Medical Records from Countryside Clinic

Exhibit NN Medical Records from Southwest Missouri Neurosurgical Group

Exhibit OO Medical Records from St. John's Regional Health Center

Exhibit PP (Not Offered)

Exhibit QQ Precertification - Insurance Authorization Form Exhibit RR

Medical Records from Baxter County Hospital

Exhibit SS Invoices from John Stefano