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Zelda Walls v. Wal-Mart

Decision date: January 10, 20067 pages

Summary

The Missouri LIRC affirmed the Administrative Law Judge's award denying compensation in a workers' compensation case involving an alleged work-related injury on August 8, 2001. The employee failed to establish that an undiagnosed preexisting condition (multiple sclerosis) constituted an obstacle to employment sufficient to trigger Second Injury Fund liability.

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Caption

Issued by THE LABOR AND INDUSTRIAL RELATIONS COMMISSION
FINAL AWARD DENYING COMPENSATION(Affirming Award and Decision of Administrative Law Judge)
Injury No.: 01-126813
Employee:Zelda Walls
Employer:Wal-Mart (Settled)
Insurer:Self-Insured (Settled)
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund
Date of Accident:Alleged August 8, 2001
Place and County of Accident:Alleged Kansas City, Jackson County, Missouri
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided bysection 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commissionfinds 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, theCommission affirms the award and decision of the administrative law judge dated May 11, 2005, and awards no compensation in the above-captioned case.
The award and decision of Administrative Law Judge Lisa Meiners, issued incorporated by this reference.May 11, 2005, is attached and
Given at Jefferson City, State of Missouri, this 10th day of January 2006.
LABOR AND INDUSTRIAL RELATIONS COMMISSION
William F. Ringer, Chairman
Alice A. Bartlett, Member
DISSENTING OPINION FILED
John J. Hickey, Member
Attest:
***_******_******_***____
Secretary
DISSENTING OPINION
I have reviewed and considered the competent and substantial evidence on the whole record. Based on my

review of the evidence as well as my consideration of the relevant provisions of the Missouri Workers' Compensation Law, I believe the decision of the administrative law judge should be reversed.

The parties stipulated that employee sustained a permanent partial disability of 12.5 % of the body as a whole as a result of her August 8, 2001, work-related injury. As to preexisting injuries and conditions, the administrative law judge found that employee failed to meet her burden of establishing that her undiagnosed multiple sclerosis was an obstacle or hindrance to employment or reemployment such that it triggered Second Injury Fund liability under § 287.220.1 RSMo.

[I]n order for there to be Fund liability, a claimant has the burden of proving that he had a preexisting permanent partial disability of such seriousness as to constitute a hindrance or obstacle to his employment or reemployment, and that such preexisting disability existed at the time the workrelated injury was sustained. Tidwell v. Kloster Co., 8 S.W.3d 585, 589 (Mo. App. 1999); Carlson v. Plant Farm, 952 S.W.2d 369, 373 (Mo. App. 1997). The Fund is not available where the employee is not shown to have had a preexisting disability at the time of the subsequent work-related injury. Tiller v. 166 Auto Auction, 941 S.W.2d 863, 865 (Mo. App. 1997).

Loven v. Greene County, 63 S.W.3d 278, 284 (Mo. App. 2001).

The inquiry is whether there was a preexisting permanent partial disability, known or unknown, at the time of employment which will thereafter combine with a new disability to cause a greater disability than the new injury.

Garibay v. Treasurer of Mo. as the Custodian of the Second Injury Fund, 964 S.W.2d 474, 479 (Mo. App. 1998).

The crux of Garibay is that an otherwise-qualified disability could not be ignored just because it was not diagnosed before the work-related injury, was unknown to the employer, or the claimant did not know what he had.

Messex v. Sachs Elec. Co., 989 S.W.2d 206, 214 (Mo. App. 1999).

There is competent and substantial evidence in the record to conclude that employee's as-yet undiagnosed multiple sclerosis was a preexisting permanent partial disability. Employee has established that she experienced at least two distinct episodes of eye problems known to be associated with multiple sclerosis before her August 8, 2001, neck injury; the 1980 outward-turning eye incident, and earlier bouts with double vision. In addition, employee established through the medical records that she suffered from another multiple sclerosis marker headaches - for which she missed work. Dr. Parmet reports employee was suffering from headaches for more than a decade. Employee's multiple sclerosis symptoms were disabling before her work injury. The administrative law judge erred by ignoring this otherwise-qualified disability simply because it was not diagnosed before the work-related injury, was unknown to employer, and employee did not know what she had. Id.

Dr. Parmet testified that it was more likely than not that multiple sclerosis preexisted the August 8, 2001 neck injury. He based his opinion on objective evidence of employee's severe neurological compromise and significant lesions of the brain at the time of her ultimate diagnosis. Employee does not have to establish a preexisting permanent partial disability by absolute certainly. Rather, employee need only establish the preexisting permanent disability by a reasonable medical certainty. The testimony of Dr. Parmet satisfies employee's burden.

Employee has established that her multiple sclerosis was a disability as described in Garibay, that it existed on the date of the primary injury, and that it is permanent. Employee's multiple sclerosis constitutes a hindrance or obstacle to employment under § 287.220.1. Second Injury Fund liability has been triggered.

Terry Cordray, a vocational expert, testified that employee has less than a high school education and she has limited learning abilities. As a result of the primary injury, employee is limited to sedentary-light unskilled work. This results in a 49 % loss of access to available jobs in the area. Such jobs entail duties such as operating a

keyboard, operating a cash register, or assembling small products. Mr. Cordray explained that for these types of work, it is essential that an employee have good functional use of her upper extremities. Unfortunately, employee’s diminished functional use of her upper extremities due to her preexisting multiple sclerosis deprives employee of the opportunity to compete for even sedentary-light unskilled work. Based upon the foregoing, Mr. Cordray believes that it is the combination of the disability from employee’s neck injury (that deprives employee of the opportunity to perform greater than sedentary-light duty) and employee’s preexisting multiple sclerosis (that deprives employee of good functional use of her upper extremities) that renders employee unable to compete in the open labor market.I find credible the testimony of Terry Cordray. I find that employee is permanently and totally disabled. I conclude that the Second Injury Fund is liable for employee’s permanent total disability. I would reverse the award of the administrative law judge. Because my colleagues on the Commission disagree, I respectfully dissent from the award and decision of the majority.
John J. Hickey, Member
AWARD
Employee: Zelda Walls
Injury No. 01-126813
Dependents: N/A
Employer: Wal-Mart
Insurer: Self-Insured
Additional Party: Missouri State Treasurer, Custodian of Second Injury Fund
Hearing Date: April 18, 2005
Checked by: LM/In

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: August 8, 2001.
  5. State location where accident occurred or occupational disease was contracted: Kansas City, Missouri, Jackson 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: Employee injured neck while lifting a 50-pound bag of dog food.
  1. Did accident or occupational disease cause death? No. Date of death? N/A
  2. Part(s) of body injured by accident or occupational disease: Cervical region.
  3. Nature and extent of any permanent disability: 12.5 percent body as a whole.
  4. Compensation paid to-date for temporary disability: None.
  5. Value necessary medical aid paid to date by employer/insurer? $\ 24,291.78.
  6. Value necessary medical aid not furnished by employer/insurer? None.
  7. Employee's average weekly wages: $\ 239.57.
  8. Weekly compensation rate: $\$ 159.72 / \ 159.72.
  9. Method wages computation: By Stipulation.

COMPENSATION PAYABLE

  1. Second Injury Fund liability: There is no liability on behalf of the Second Injury Fund.

Any compensation awarded to the claimant shall be subject to a lien in the amount of 25 percent of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant: Mr. Jerry Kenter.

Employee:Zelda WallsInjury No: 01-126813

Dependency: N/A

Employer: Wal-Mart

Insurer: Self-Insured

Additional Party: Missouri State Treasurer, Custodian of the Second Injury Fund

Hearing Date: April 18, 2005

Checked by: LM/1h

The parties appeared for hearing on April 18, 2005. The Employee Zelda Walls appeared in person and through her attorney Jerry Kenter. The Employer, Wal-Mart, and its Insurer, American Home Assurance Company, settled their claim on April 18, 2005. The Second Injury Fund was present and represented by LaSandra Pearl.

STIPULATIONS

The parties stipulated that:

1) the Employer on or about August 8, 2001, was an employer operating subject to Missouri's workers' compensation law;

2) that its liability was fully insured by American Home Assurance Company;

3) that Ms. Zelda Walls was its employee;

4) that Ms Walls was working subject to the law in Kansas City, Missouri, Jackson County;

5) that Ms. Walls sustained an accident arising out of and in the course of her employment;

6) that she notified the employer of the injury as well as filed the claim within the time allowed by law;

7) that the average weekly wage was $\ 239.57, making the wage rate to be $\ 159.72;

8) that Ms. Walls last day of work was December 2, 2002, (a) the parties stipulated to 12.5 percent permanent partial disability body as a whole referable to the cervical neck due to the August 8, 2001 incident;

9) that the employer furnished medical aid in the sum of $\ 24,291.78 and has paid $\ 5,727.18 in temporary total disability compensation.

ISSUE

1) The issue to be resolved is whether there is Second Injury Fund liability.

On August 8, 2001, Ms. Walls, while working as a cashier at Wal-Mart sustained an injury to her neck when moving a 50-pound bag of dog food. She told her supervisors of the injury; then went to the emergency room at Research Medical Center.

Later in September of 2001, Dr. Terence Pratt diagnosed Ms. Walls with a herniated disc at the C6-7 level. Several doctors, including Dr. Pratt, Takacs and Kauffman, recommended a cervical fusion. Eventually, Ms. Walls underwent an anterior cervical fusion performed by Dr. Hylton on July 10, 2002.

Ms. Walls returned to light duty at Wal-Mart with restrictions imposed by Dr. Hylton in September of 2002. Indeed, Dr. Hylton opined Ms. Walls had reached maximum medical improvement on October 17, 2002, and placed permanent work restrictions of no lifting over 30 pounds. Dr. Hylton also noted Ms. Walls had a 10 percent impairment body as a whole due to the August 8, 2001, incid

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

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