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Eddie Edwards v. U.S. Nursing

Decision date: November 3, 20068 pages

Summary

The Commission affirmed the Administrative Law Judge's decision denying compensation in this workers' compensation case involving a nursing employee kicked in the shoulder by a patient on October 16, 2002. Although the injury was found to be compensable and arose out of employment, no permanent disability was determined, resulting in zero compensation awarded despite prior temporary disability and medical payments.

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Caption

FINAL AWARD DENYING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 02-110459

Employee: Eddie Edwards

Employer: U. S. Nursing

Insurer: Safety National Casualty

Date of Accident: October 16, 2002

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 April 21, 2006, and awards no compensation in the above-captioned case.

The award and decision of Administrative Law Judge Grant C. Gorman, issued April 21, 2006, is attached and incorporated by this reference.

Given at Jefferson City, State of Missouri, this $3^{\text {rd }}$ day of November 2006.

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:U.S. NursingCompensation
Additional Party:NoneDepartment of Labor and Industrial
Relations of Missouri
Jefferson City, Missouri
Insurer:Safety National Casualty
Hearing Date:January 12 and 18, 2006Checked by: GCG

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: 10/16/02
  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 treating a patient, employee was kicked in the shoulder.
  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: Left Shoulder, Back
  14. Nature and extent of any permanent disability: None
  15. Compensation paid to-date for temporary disability: $\ 108,336.73
  16. Value necessary medical aid paid to date by employer/insurer: $\ 128,694.57

Employee: Eddie Edwards Injury No.: 02-110459 17. Value necessary medical aid not furnished by employer/insurer? None. 18. Employee's average weekly wages: Above the statutory maximum. 19. Weekly compensation rate: $649.32 / 340.12$ 20. Method wages computation: Statutory Calculation

COMPENSATION PAYABLE

  1. Amount of compensation payable: $\ 0

Unpaid medical expenses: $\ 0 0 weeks of temporary total disability (or temporary partial disability)

0 weeks of permanent partial disability from Employer
0 weeks of disfigurement from Employer
22. Second Injury Fund liability: No
TOTAL:
23. Future requirements awarded: None

FINDINGS OF FACT and RULINGS OF LAW:

Employee:Eddie Edwards
Dependents:N/A
Employer:U.S. Nursing
Additional Party:None
Insurer:Safety National Casualty

Injury No.: 02-110459 Before the Division of Workers' Compensation Department of Labor and Industrial Relations of Missouri Jefferson City, Missouri Checked by: GCG

INTRODUCTION

The above referenced case was heard by the undersigned Administrative Law Judge beginning on January 12, 2006, and concluded on January 18, 2006. The record was left open for Claimant to submit certain medical bills from St. Mary’s Health Center until February 7, 2006. Claimant was present in person and represented by David Tarlow. Martin Klug represented Employer U.S. Nursing and its insurer Safety National Casualty.

The parties stipulate that: On October 16, 2002, Claimant sustained an accidental injury arising out of and in the course of employment. Claimant was an employee of Employer. Venue is proper in the City of St. Louis. Employer received proper notice. Claim was filed within the time prescribed by law. Claimant’s average weekly wage was above the statutory maximum resulting in a rate of $\ 649.32 for total disability benefits and 340.12 for permanent partial disability benefits. Employer has paid temporary total disability benefits (TTD) in the amount of $\ 108,336.73 representing 166 and 6/7ths weeks. Employer has paid 128, 694.57 in medical benefits.

The issues in dispute are: Medical causation of certain injuries. Nature and extent of employer liability. Whether

employer is liable for past medical care. Whether Claimant is entitled to future medical care. Whether Attorney Theodore Pashos is entitled to enforce his attorney fee lien.

I. Live Testimony.

Claimant is a 49-year-old male who was working for Employer as a critical care nurse. Claimant is right hand dominant. Claimant was a nurse for 19 years. He began working for Employer in April 2002. The incident that is the subject of this case happened on October 16, 2002. Claimant testified that on that date, he treating the burns of a large Downs Syndrome patient. The patient was in 4-point restraints, and when Claimant had removed one of the leg restraints to treat the area under the restraint, the patient kicked him in the shoulder, causing Claimant to strike his back against the wall. Claimant's testimony was that he was struck with such force that his feet came up off the floor, and that after striking the wall, he then slumped to the floor.

Claimant returned to work to complete that shift after about an hour break. Claimant saw a doctor within 24 hours. He testified that at the time of the incident he had pain in the back of his head, his left elbow and shoulder, and his buttocks. Claimant's initial treatment was with an occupational doctor at St. John's Hospital.

Claimant testified that Dr. Doerr was the first treating physician. Dr. Doerr took x-rays and performed other diagnostic tests. Claimant stated that Dr. Doerr told him that he could not do much for Claimant and referred him to Dr. Schoedinger. Dr. Schoedinger ordered mylogram and discogram tests on Claimant. Claimant's impression was that these tests revealed protrusions and bulges at the L3, L4, and L5 vertebrae and that Dr. Schoedinger wanted to perform surgery, but the insurance company denied coverage for the procedure, hence there was no operation performed.

Dr. Schmidt then treated Claimant. Claimant's understanding of Dr. Schmidt's diagnosis was that he had Reflex Sympathetic Dystrophy (RSD), Myofascial Pain Syndrome, and Cauda Equina. Claimant testified that he had previously had RSD in conjunction with Carpal Tunnel Syndrome (CTS) in 2000 or 2001, but that it had not bothered him since the surgery to repair the CTS, approximately two years prior to this incident.

Subsequent to Dr. Schmidt, Dr. Strege treated Claimant. Dr. Strege treated Claimant with therapy and pain injections. It is Claimant's understanding that Dr. Strege rated him at 25 % disability in the shoulder and 30 % disability for the RSD. According to Dr. Strege, Claimant was at Maximum Medical Improvement (MMI). Since Dr. Schmidt could not give him any more pain injections, he then went to his personal physician, Dr. Abbott. Dr. Abbott took over his pain control and treatment.

Claimant was admitted to St. Mary's Hospital in August 2003 for pain and subsequently ended up in a "narcotic coma." He has visited the emergency on other occasions for pain. Claimant testified pain is a daily problem, that he takes medication for the pain, and that he did not have to take pain medication for at least one year prior to this incident.

Claimant testified that he had been treating with the above referenced physicians for about two years when he began seeing Dr. Irvin for depression. He had not worked during those two years. Before treating with Dr. Irvin, he had never been treated by a psychiatrist. Dr. Irvin suggested Claimant get a job. Claimant testified that he did in fact try teaching, but there was too much "running around," and that the pain in his back was a "problem." Claimant also testified that he was still taking narcotics for pain, and this also affected his ability to teach. Dr. Irvin also referred Claimant to Dr. Schwabo for behavior modification.

Claimant testified that he was prescribed the drug Seroquil as part of his treatment. He testified that the use of Seroquil resulted in his breasts enlarging. The swelling was painful and therefore he underwent a "bilateral mastectomy." As a result of this operation, his chest is disfigured from the scars, he can't take his shirt off in public, and that this has all made his depression worse.

Claimant testified that he had treated for back pain one time prior to this injury. His treatment was not on a regular basis and he took over the counter medications.

Claimant testified that his current problems are: Pain in his lower back, RSD, Capsulitis in shoulder, Major Depression, Post-Traumatic Stress Disorder, and bowel and bladder dysfunction that requires him to wear a diaper when in public. Claimant walks with a cane and has a wheelchair, but doesn't use the wheelchair often. One time he tried not to use the cane, but "paid for it" the next day.

He testified that his day-to-day activities include playing with his dog and sometimes attending local medical seminars that are sponsored by his attorney, Mr. Tarlow. Claimant feels he needs continued treatment for pain with Dr. Abbott and for Depression with Dr. Irvin. He further testified he also currently suffers from Radiculopathy and Sciatica.

During cross-examination, Claimant testified he does not recall a Worker's Compensation settlement from 1997 in which he received a PPD settlement of 5 % for the Lumbar Spine and 7.5 % for the left elbow. (Employer's Exhibit 3). He

does remember a Workers' Compensation claim form Nebraska in 2001 for Carpal Tunnel Syndrome (CTS), in which he received a PPD settlement of 20\% of the left upper extremity. (Employers Exhibit 4). Claimant also concedes that he did not tell Dr. Abbott or Dr. Cohen that he had RSD prior to this accident.

He further testified that he has had two injuries since the work injury of October 16, 2002. An August 2003 occurrence at St. Mary's Hospital, which resulted in Claimant being in a narcotic coma. Claimant testified that his injuries were "all mental," but have physical manifestations. He was initially more depressed, but he has returned to his normal level. He testified that he first began psychiatric treatment after this incident.

Claimant testified that he was an automobile accident in 2004. He went to the hospital 1 hour after accident and received a pain shot. He testified that his back problems increased after this accident, but his back condition has returned to where it was prior to this accident.

Geraldine Breite testified on behalf of Claimant. Breite is a Life Care Planner and a Legal Nurse Consultant. Breite testified that as a Nurse Life Care Planner she evaluates long-term medical issues in response to injury or illness and addresses the medical needs of the patient. Breite prepared a voluminous report of her findings marked as Claimant's Exhibit S. Counsel for Claimant initially moved for the admission of Exhibit S, however, Counsel for Employer objected. Claimant then withdrew his request at that time, and never renewed his request that Exhibit

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

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