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Jimmy Culley v. Royal Oaks Chrysler Jeep, Inc.

Decision date: August 4, 200628 pages

Summary

The Labor and Industrial Relations Commission affirmed the administrative law judge's denial of workers' compensation benefits, finding that the employee failed to provide timely notice of the accident to the employer and did not demonstrate lack of prejudice or good cause for the delay. The Commission determined that the notice issue was dispositive and all other disputed issues regarding medical causal relationship and benefits were rendered moot.

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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 by Separate Opinion)
Injury No.: 03-145458
Employee:Jimmy Culley
Employer:Royal Oaks Chrysler Jeep, Inc.
Insurer:Missouri Chamber of Commerce Group
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund (open)
Date of Accident:September 10, 2003
Place and County of Accident:St. Charles County, Missouri
This cause has been submitted to the Labor and Industrial Relations Commission (Commission) for review as provided bysection 287.480 RSMo. We have reviewed the evidence, read the briefs, and we have considered the entire record. Pursuant to section 286.090 RSMo, the Commission affirms the award and decision of the administrative law judge dated September 19, 2005, byissuing a separate opinion denying compensation in the above-captioned case.
I. Trial Issues and Award Issued by Administrative Law Judge
The parties stipulated before the administrative law judge that the following issues were in dispute:(1) notice of accident, section 287.420 RSMo; (2) whether or not employee sustained an injury due to an accident arising out of and in the course ofemployment; (3) medical causal relationship between employee’s complained of condition and alleged accident; (4) employer’s liability for past medical expenses; (5) employer’s liability for future medical treatment; and(6) nature and extent of temporary total disability.
Employee was requesting the issuance of a temporary award and there was no issue at trial concerning nature and extent of permanent disability, nor any evidence offered concerning thatissue.
In the award issued by the administrative law judge, compensation benefits were denied, as the administrative law judge did not find a medical causal relationship between employee’s conditions complained of and thealleged accident.
The Commission affirms the conclusion by the administrative law judge that employee is not entitled to any workers' compensation benefits. However, the basis of the denial by theCommission is that we find employee did not provide timely notice to employer, either written or verbal, and employee has failed to demonstrate that employer was not prejudiced by employee’s failure to provide timely notice. The Commission furtherfinds that employee did not have good cause for failure to timely provide notice to employer. The issue of notice was a stipulated issue, was fully tried by the parties, and is dispositive of the outcome of this case, and accordingly, we issue a final award and decision denying all compensation in this claim. All other issues aremoot.
II. Summary of Facts
Witness Jimmy Culley, employee
In summary fashion and as relevant to the notice issue, the testimony of Mr. Culley was as follows: as of the date of the accident, September 10, 2003, employee was employed as a new and used car salesperson; employee had

fifteen years experience in the field; his duties with employer were, among other things, to greet customers, and attempt to sell a potential customer a new or used automobile; and employee testified that if he was successful in completing a sale, it was his responsibility to follow-up with the needs of the customer and if necessary, deliver the vehicle, clean it, service it, etc.

As of the date of the accident employee was dating and residing with Ms. Ann Evans; Ms. Evans was the owner of an automobile which had been purchased from the employer; on September 10, 2003, the automobile owned by Ms. Evans was in the repair shop of the employer; and the requested repair work was completed that day by the employer.

Prior to September 10, 2003, employee, on several occasions, had driven the vehicle owned by Ms. Evans to and from his employment; employee testified that prior to the accident occurring September 10, 2003, he would, on occasion, leave work in order to pick up Ms. Evans at her job location, somewhere between 3:30 p.m. and 5:00 p.m.; and on September 10, 2003 the accident occurred at 3:37 p.m.

Employee testified that on the day of the accident he was working a split shift, from 9:00 a.m. until 1:00 p.m., and then a four-hour break until 5:00 p.m., at which time he would return to the employer and work from 5:00 p.m. until 9:00 p.m. Employee testified that he was not on the clock and his work shift was not adhered to in strict manner.

On September 10, 2003, employee testified that he informed Joe Gustafson, his supervisor, that the vehicle owned by Ms. Evans had been repaired, was finished, and he was going to return the vehicle to Ms. Evans and she would return him to work. Employee stated that while driving the motor vehicle owned by Ms. Evans from the employer's lot and while merging onto a public street, he was involved in a motor vehicle accident, and sustained personal injuries.

Immediately subsequent to the accident, employee was able to remove himself from the automobile and ambulate; an ambulance was summoned to the scene of the accident but employee, at that time, was not in need of any assistance; subsequently, approximately three hours later, employee presented himself to St. Joseph Health Center for medical treatment due to this accident; employee presented with complaints of stiffness, dizziness, back pain and perhaps being in shock due to the accident; and employee was treated and discharged.

Subsequent to the accident, employee separated from employment and continued to work as a car salesperson being employed with three different employers as of the date of the hearing.

By the date of the hearing employee had received extensive medical care and treatment including back surgery. This surgery was performed in 2005.

Witness Allan Brodhead

Mr. Brodhead was a sales representative for the employer on September 10, 2003; he was familiar with employee, Jimmy Culley; Mr. Brodhead was aware that Jimmy Culley was in a motor vehicle accident on September 10, 2003; Mr. Brodhead was further aware that employee was driving the automobile belonging to Mr. Culley's girlfriend, Ann Evans; Mr. Brodhead had never seen employee drive any other automobile other than the automobile owned by Mr. Culley's girlfriend, Ann Evans; and Mr. Brodhead verified that Mr. Culley's work shift the date of the accident, September 10, 2003, was similar to his, and that it was a split work shift, with the hours being 9:00 a.m. to 1:00 p.m. and 5:00 p.m. to 9:00 p.m. Mr. Brodhead admitted that the hours were not strictly enforced as business actually dictated the hours.

Witness Gary Clark

Mr. Clark was a salesman with the employer as of September 10, 2003; he was familiar with employee, Jimmy Culley; Mr. Clark was aware Mr. Culley was involved in a motor vehicle accident on September 10, 2003; Mr. Clark testified that Mr. Culley told Mr. Clark that the automobile belonged to himself and his girlfriend, Ms. Evans; Mr. Clark testified he was aware on several occasions that Mr. Culley drove the motor vehicle to and from work; and Mr. Clark verified the split shift schedule involving employee, i.e., 9:00 a.m. to 1:00 p.m. and 5:00 p.m. to 9:00 p.m., on the date of the accident

Witness Joseph Gustafson

Mr. Gustafson was the used car manager and supervisor of employee as of September 10, 2003; Mr. Gustafson was aware employee was involved in a motor vehicle accident on September 10, 2003; Mr. Gustafson unequivocally denied that employee requested permission of Mr. Gustafson to return the automobile owned by Ms. Evans to her; he unequivocally denied that employee informed him that he intended to return her car to her that afternoon; and Mr. Gustafson was aware that the automobile that employee was driving was owned by Ms. Evans and often times used by employee to go to and from work.

Sheryl Crisler

Ms. Crisler was the office manager, secretary, treasurer and the individual who handled insurance claims and injuries in behalf of the employer. If an employee was involved in a work related accident as of September 10, 2003, she was the person an individual was to notify, and upon being notified, she would immediately commence investigation of the accident as well as arrange immediate medical care and treatment for the injured employee.

Ms. Crisler unequivocally testified that she was never notified that employee, Jimmy Culley, was alleging a work related accident had occurred on September 10, 2003, until she received notice from the Missouri Division of Workers' Compensation (Division) that a formal Claim for Compensation had been filed. The formal Claim for Compensation was filed with the Division on December 23, 2004, more than fifteen months post accident. Employee never filed a written notice of accident with Ms. Crisler; employee never verbally apprised Ms. Crisler of the accident; and employee never requested Ms. Crisler or any supervisor or management personnel of the employer to provide him workers' compensation benefits in the form of medical treatment, temporary total disability, etc.

Ms. Crisler testified that she did not have an opportunity to investigate employee's alleged work accident or to arrange for medical care and treatment for him because she was never aware his accident was allegedly work related. Ms. Crisler testified that she heard other people talking that employee was involved in a motor vehicle accident in which he wrecked "his" car. Ms. Crisler testified that she never received actual notice of an alleged work related accident until she received a copy of the Claim for Compensation sent to her by the Division of Workers' Compensation some fifteen months post accident.

St. Joseph Hospital Emergency Room Records

The emergency room records of St. Joseph Hospital dated September 10, 2003, indicate employee was involved in a motor vehicle accident that was not work related.

III. Findings of Fact Conclusions of Law

As to the issue of notice of accident, the relevant statutory provision is section 287.420 RSMo, which provides:

"No proceedings for compensation under this chapter shall be maintained unless written notice of the time, place and nature of the injury, and the name and address of the person injured, have been given as soon as practicable after the happening thereof but not later than thirty days after the accident, unless the division or the commission finds that there was good cause for failure to receive the notice. No defect or inaccuracy in the notice shall invalidate it unless the commission finds that the employer was in fact misled and prejudiced thereby."

Accident is defined as "an unexpected or unforeseen identifiable event or series of events happening suddenly and violently, with or without human fault, and producing at the time objective symptoms of an injury." Section 287.020.2 RSMo. Employee's accident occurred on September 10, 2003. Although employee did not learn of the ultimate extent of his injuries until later, the motor vehicle accident occurred violently and suddenly and produced at that time objective symptoms of an injury as employee presented himself within approximately three hours to the emergency room of St. Joseph Hospital. Accordingly, employee had thirty days from September 10, 2003, to provide notice of the accident to the employer.

The purpose of this section is to give the employer timely opportunity to investigate the facts surrounding the accident and, if an accident occurred, to provide the employee medical attention in order to minimize the disability. Gander v. Shelby County, 933 S.W.2d 892 (Mo. App. E.D. 1996). However, the failure to give timely written notice may be excused if the Commission finds either that there was good cause for the failure or that the failure did not prejudice the employer. Willis vs. Jewish Hospital, 854 S.W.2d 82 (Mo. App. E.D. 1993).

The most common way for an employee to establish lack of prejudice is for the employee to show tha

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