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Kim Feld v. King O' Tile

Decision date: December 21, 20058 pages

Summary

The Commission affirmed the Administrative Law Judge's final award denying compensation in a workers' compensation case involving a low back injury alleged to have occurred on December 2, 1994, when the employee felt a pop in his low back while moving an optical machine. Although the injury was found to be compensable under Missouri law, no compensation benefits were awarded, with the case resolved through a stipulated compromise settlement.

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This workers' comp decision may point to a separate injury claim.

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Caption

FINAL AWARD DENYING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 94-199907

Employee: Kim Feld

Employer: King O' Tile (Settled)

Insurer: Hartford Insurance Company (Settled)

Additional Party: Treasurer of Missouri as Custodian of Second Injury Fund

Date of Accident: Alleged December 2, 1994

Place and County of Accident: St. Louis 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 March 1, 2005, and awards no compensation in the above-captioned case.

The award and decision of Administrative Law Judge Linda J. Wenman, issued March 1, 2005, is attached and incorporated by this reference.

Given at Jefferson City, State of Missouri, this $\qquad 21^{\text {st }} \qquad$ day of December 2005.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

Alice A. Bartlett, Member

John J. Hickey, Member

Attest:

Secretary

AWARD

Dependents:N/ABefore the Division of Workers'
Employer:King O Tile (settled)Compensation
Department of Labor and Industrial
Additional Party:Second Injury FundRelations of Missouri
Jefferson City, Missouri
Insurer:Hartford Insurance Company (settled)
Hearing Date:November 23, 2004 & December 2, 2004Checked by:LJW:tr

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? No
  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: December 2, 1994
  5. State location where accident occurred or occupational disease was contracted: St. Louis County
  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: While moving an optical machine Claimant felt a pop in his low back.
  12. Did accident or occupational disease cause death? No Date of death? N/A
  13. Part(s) of body injured by accident or occupational disease: Low back
  14. Nature and extent of any permanent disability: From Employer, 125,050.72 allocated for disability, payable at time of settlement; and 350.00 to be paid monthly for life, guaranteed for 240 months.
  15. Compensation paid to-date for temporary disability: None
  16. Value necessary medical aid paid to date by employer/insurer? None prior to settlement with Employer, at settlement $54,949.28 from Employer. Employee: Kim Feld Injury No.: 94-199907
  17. Value necessary medical aid not furnished by employer/insurer? None
  18. Employee's average weekly wages: 618.40
  19. Weekly compensation rate: 476.38 / $249.48
  20. Method wages computation: Stipulated per settlement

COMPENSATION PAYABLE

  1. Amount of compensation payable: Stipulated compromise settlement
  2. Second Injury Fund liability: No
Employee:Kim FeldInjury No.: 94-199907
Dependents:N/ABefore the
Division of Workers'
Employer:King O Tile (settled)Compensation
Additional Party:Second Injury FundDepartment of Labor and Industrial
Relations of Missouri
Jefferson City, Missouri
Insurer:Hartford Insurance Company (settled)Checked by: LJW:tr

PRELIMINARIES

The above referenced Workers’ Compensation claim was heard by the undersigned Administrative Law Judge on November 23, 2004 and reconvened on December 2, 2004. Briefs were received and the case was formally submitted with receipt of the final reply brief on February 15, 2005. Attorney John Schneider represented Kim Feld (Claimant). King O Tile (Employer) was insured by Hartford Insurance Company, and represented by Attorney John Palombi. Assistant Attorney General Lee Schaefer represented the Second Injury Fund (SIF).

Prior to the start of the hearing the parties identified the following issues for disposition in this case: accident; arising out of the course and scope of employment; notice; medical causation; liability of Employer for past medical expenses; wage rate for temporary total disability; future medical care; temporary total disability; and liability of Employer and/or SIF for permanent total disability or permanent partial disability.

Claimant offered Exhibits A-LL. Any objections to Exhibits A-N2 and P-LL were overruled and the exhibits admitted. The objection to Exhibit KK was sustained. The objections to Exhibits O1-O3 are rendered moot by Claimant's settlement with Employer. Employer offered Exhibits 1-6, and SIF offered Exhibits I-II. These exhibits were admitted without objection. Any objections not expressly ruled on in this award are overruled.

Following hearing conclusion, but prior to the issuance of this decision, Claimant and Employer reached a compromise settlement approved on January 27, 2005. Claimant and Employer agreed to a stipulated wage rate of $\ 476.38 for weekly temporary total disability. The parties also stipulated Employer would pay $\ 54,949.28 allocated to medical expenses. Permanent partial disability in the amount of $\ 125,050.72 was to be paid immediately, and is stipulated to represent 30 % BAW referable to Claimant's low back. Also, Employer agreed to provide a monthly payment of $\ 350.00 for life to Claimant to provide medical services and medications not covered by Medicare. The monthly payment is guaranteed for 240 months. Separately, provisions for funding a Medicare Set-Aside Trust were established in the settlement document.

SUMMARY OF EVIDENCE

As a result of the settlement between Claimant and Employer, the remaining issues and associated evidence is greatly reduced. The initial question that must be answered concerns the liability of SIF for permanent total disability (PTD). If SIF is not responsible for PTD benefits, all remaining issues would be moot. All evidence and testimony has been reviewed, but due to the voluminous evidence introduced at hearing, only testimony and evidence necessary to support this award will be summarized below.

Testimony

Claimant: Claimant is 46 years old, and has a tenth grade education. He has worked as a laborer throughout his working life. Prior to his last work injury, Claimant worked for Employer since 1991. Claimant was employed as a floor installer, installing carpet, tile, and hardwood floors.

On December 2, 1994, Claimant was working the night shift installing carpet in an optical office. As a part of this job, Claimant and his work partner were required to move and replace an optical machine weighing approximately 400 pounds. While replacing this machine, Claimant heard a pop in his back, and felt immediate pain. At the time of injury, Claimant was wearing a back brace as a preventative measure, and kneepads supplied by Employer. Claimant informed his work partner and went home to bed, not staying to assist in clean up.

The next day, Claimant asked his wife to arrange an appointment with Dr. Roedel, a chiropractor. He spent the weekend in bed due to back discomfort. Claimant returned to work the following week, and was treated by Dr. Roedel after working hours. When he did not improve under Dr. Roedel's care, Claimant sought treatment with Dr. Weiss, an orthopedist.

Claimant began treatment with Dr. Weiss on December 21, 1994. Claimant was given injections and physical therapy was provided. During this time period, Claimant worked approximately 32-40 hours per week. Claimant was offered, but did not work any overtime due to his back. Claimant last worked for Employer on January 5, 1995. In April 1995 a CT scan of Claimant's low back was obtained, and Dr. Weiss informed Claimant a disc was herniated in his back. Claimant was advised to see a neurosurgeon.

Claimant next saw Dr. Scodary, a neurosurgeon who reviewed Claimant's diagnostics, but provided no treatment. Employer then sent Claimant to Dr. Gragnani, who also provided no treatment. During June 1995, Claimant sought treatment in an emergency room due to increasing back pain.

Claimant's attorney referred him to Dr. Schoedinger. During the course of his treatment with Dr. Schoedinger, Claimant underwent four back surgeries. Claimant was also seen by multiple pain management specialists, and was provided different treatment modalities. Since 1999, Claimant has received pain management treatment under the care of Dr. Feinberg. Claimant has also received psychiatric care on occasion for depression.

Claimant's current complaints revolve around back pain that he considers continuous and excruciating. He reported non-stop pain for the last 1-2 years, and acknowledged taking multiple doses of methadone on a daily basis. Additionally, Claimant experiences sleep disturbance, as he has difficulty laying flat. In December 2003, Claimant fell down his basement stairs after losing his balance. Claimant's symptoms initially flared, but shortly returned to baseline. Claimant continues to drive, and he drove himself to the hearing. Claimant was released by Dr. Schoedinger in 2000, and has not seen him since.

Claimant testified to multiple preexisting injuries that included the following: a 1980 motor vehicle accident in which he fractured his pelvis; a 1982 injury from a scaffold fall in which he injured his back and fractured his right foot, requiring surgery to the foot/ankle; a 1983 injury that fractured his right wrist; another 1983 injury in which he was thrown from a motorcycle; a head/neck injury in 1984 after being assaulted; a 1984 work injury that resulted in his first back surgery; and a 1987 work injury to his right ankle.

Regarding his preexisting injuries Claimant testified as follows: following his 1984 back surgery, Claimant testified to experiencing stiffness, but had no difficulty lifting, bending, or stooping. Claimant later clarified his back soreness was due to the heavy work he did. He also never missed work, took medication, or had to seek post-release medical care for his back. Regarding his foot/ankle, including the 1987 re-injury, Claimant testified to stiffness/soreness, but never wore a brace at work, took no medication, and found it never limited his job duties. Regarding his neck, Claimant testified he had one neck spasm since recovering from the initial injury. Finally, Claimant acknowledged deposition testimony where he reported the ability to always do his job 100 % after recovery from each preexisting injury.

Dr. Barry Feinberg: Dr. Feinberg began to treat Claimant in 1999, upon referral from Dr. Schoedinger. Prior to treatment with Dr. Feinberg, Claimant had received pain management treatment with two other pain management specialists. In addition to routine pain management treatment, Claimant had undergone two specialized treatments. The first involved an attempt to break up scar tissue by use of an endoscope. The second treatment was a denervation of a lumbar nerve. Neither procedure provided relief.

When he first examined Claimant, Dr. Feinberg found multiple spinal abnormalities, and concluded that additional spinal surgery would not be beneficial. Dr. Feinberg has provided Claimant with a multi-faceted treatment approach including trigger point injections, epidural steroid injections, facet blocks and medic

Full decision text continues in the plain-text archive copy.

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