I have reviewed and considered all of the competent and substantial evidence on the whole record. Based upon 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.
As indicated in the Commission majority's decision, the ultimate determination of credibility of witnesses rests with the Commission. Unfortunately, the Commission majority relies upon the expert medical opinion of Dr. Randolph. I disagree and find the deposition testimony from Dr. Schlafly to be more credible, persuasive, and worthy of belief.
Dr. Randolph was not subject to any type of questioning or cross-examination to probe the basis of his opinions. Only his written report is part of our record. His report is highly conclusory and provides little detail. On the other hand, Dr. Schlafly was subject to the questions of both parties during his deposition and provided detailed reasons for his belief that employee's 13 years of repetitive, hand-intensive work as a driver was a substantial factor in causing employee's carpal tunnel syndrome.
Furthermore, Dr. Schlafly, unlike Dr. Randolph, is a board certified orthopedic surgeon specializing in upper extremity maladies. Unlike Dr. Randolph, Dr. Schlafly exhibited his familiarity with employee's day-to-day duties and discussed why those repetitive activities caused employee's carpal tunnel syndrome. Dr. Schlafly discussed his greater experience in dealing with and treating carpal tunnel in drivers.
Dr. Schlafly also provided specific reasons for why he believed that diabetic neuropathy was not a substantial factor for employee's carpal tunnel problems. He testified that conventional wisdom indicates that diabetic neuropathy (if present)
should be more severe in the feet than the hands because the nerves running to the feet are longer and more prone to disease than the shorter nerves leading to the fingers. Consequently, since employee was not complaining of any numbness in his feet, logic would suggest that his carpal tunnel was not related to his mild diabetes but, rather, to his repetitive, hand-intensive work.
Employee's medical expert must have established the probability that conditions in employee's workplace caused his occupational disease. Dawson v. Associated Elec., 885 S.W.2d 712, 716 (Mo. App. W.D. 1994) (reversed on other grounds in Hampton v. Big Boy Steel Erection, 121 S.W.3d 220 (Mo. 2003)). Dr. Schlafly convincingly satisfied this burden. Therefore, I respectfully dissent from the decision of the Commission majority to deny employee's benefits.
John J. Hickey, Member