Belinda Markworth v. Shirley Leisure Acres

On August 30, 2006, the employee and employer appeared for a final hearing. The Division had jurisdiction to hear this case pursuant to $\S 287.110$. The employee, Ms. Belinda A. Markworth, appeared in person and with counsel, David W. White. The employer appeared through its counsel, David P. Macoubrie and Danette L. Rardon. The Second Injury Fund was not a party to the case. The primary issues the parties requested the Court to determine were whether or not Ms. Markworth suffered an accident arising out of and in the course of her employment on May 26, 2006, and whether she sustained any disability. For the reasons noted below, I find that Ms. Markworth did not suffer an injury that arose out of and in the course of her employment. Therefore, I deny her claim.

The parties stipulated that:

1. On or about May 26, 1999 ("the alleged injury date"), Shirkey Leisure Acres ("Shirkey") was an employer operating subject to Missouri’s Workers’ Compensation law with its liability fully self-insured;
2. Ms. Markworth was its employee working subject to the law in Richmond, Ray County, Missouri;
3. Ms. Markworth both notified Shirkey of her alleged injury and filed her claim within

the time allowed by law; and,

1. Ms. Markworth earned a $\ 772.40 average weekly wage resulting in a weekly compensation rate of $\ 514.93 for temporary total and $\ 294.73 for permanent partial disability compensation.

ISSUES

The parties requested the Division to determine:

1. Whether Ms. Markworth sustained an accident or occupational disease arising out of and in the course of employment?
2. Whether Ms. Markworth is entitled to temporary total disability benefits from June 11, 1999 through August 1, 1999 representing $71 / 7 weeks for compensation totaling \ 3,751.63 ?
3. Whether Shirley must provide the employee with additional medical care? And,
4. Whether Ms. Markworth suffered any disability and, if so, the nature and extent of the disability?

Ms. Markworth testified on her own behalf and presented the following exhibits, all of which were admitted into evidence without objection:

Exhibit A - Affidavit \& Records from Two Rivers Psychiatric Hospital

Exhibit B - Deposition of Belinda Markworth, December 19, 2001

Exhibit C - Deposition of Donald Wayne Hinton, M.D., November 7, 2005

Exhibit D - Deposition of Joseph S. Edwards, PhD, December 28, 2005

Exhibit E - Deposition of Kathryn Ballou, PhD, August 25, 2005

Shirkey subpoenaed Ms. Michele Kist and Ms. Jennifer Hosman to testify and presented the following exhibits, all of which were admitted into evidence without objection:

Exhibit 1 - Handwritten Note, Belinda Markworth, June 11, 1999

Exhibit 2 - Letter dated June 22, 1999 from Belinda Markworth

Exhibit 3 - Medical Report, Wayne A. Stillings, M.D., September 4, 2002

Based on the above exhibits and the testimony of Ms. Markworth, Ms. Kist and Ms. Hosman, I make the following findings. Ms. Markworth is 52-years old and lives with her husband in Higginsville, Missouri. She is a high school graduate and has obtained degrees as a LPN and BSN. Ms. Markworth worked at Shirley from October 1978 to May 1987 and again from August 1989 through June 11, 1999. Shirley is a nursing home. Prior to working for Shirley in 1989, Ms. Markworth worked at Ray County Memorial Hospital as a staff nurse and at Pleasant Valley Manor as a Director of Nursing Services. Ms. Markworth prefaced her testimony with the caveat that she had suffered a stroke in 2004 which she stated negatively affected both her speech and memory. However, I specifically noted that she spoke with perfect clarity and without any uncertainty in recollecting the pertinent facts and situations surrounding her claim. She was quite forthright in testifying that her stroke "miraculously" cured her of her depression. However, Ms. Markworth testified that she continues to take Lexapro ( $20 \mathrm{mg} /$ day) - a prescription anti-depressant - and Xanax as needed, usually twice a month.

Regarding her claimed injury, Ms. Markworth testified that on May 26, 1999 she was employed as the Director of Nursing Services at Shirley. Her job included organizing and directing nursing services, arranging monthly in-service education programs and developing nursing care programs for each resident. Out of the previous eleven (11) workdays before the alleged incident, Ms. Markworth worked only four (4) days. On May 25, 1999, Shirley's board of directors gave the facility employees forty-eight (48) hours to correct the deficiencies

which were received in March of 1999. Ms. Markworth was told to go home and not to worry about it. Ms. Markworth left the facility that same afternoon. On May 26, 1999, Ms. Markworth took an overdose of Libruim and was admitted to Carroll County Hospital in Carrollton, Missouri, and was then later admitted to Two Rivers Psychiatric Hospital.

Ms. Markworth has suffered from depression, panic disorder, and anxiety for a good part of her life. She remembers being depressed as a child and was first diagnosed with depression in the early 1990's. She has been on medication for the condition since 1990-1991. Ms. Markworth was first diagnosed for anxiety and panic disorder in 1996 or 1997 and has been on medication ever since. Before May 26, 1999, Ms. Markworth was hospitalized at Shawnee Mission Hospital in 1996 and College Meadows. Both times, Ms. Markworth left the facilities against medical advice. Ms. Markworth has shown a pattern of periodic episodes of hospitalizations. The evidence was that before May 26, 1999, Ms. Markworth would work two or three years and then require treatment and hospitalization for anxiety, panic disorder and depression. This occurred at least two times from around 1995 and again in about 1997. The same situation occurred after Ms. Markworth worked for the Lexington Public Schools. She began her employment in August of 1999 and worked for two and a half years before her mental condition caused her to resign.

Ms. Markworth's family situation in May 1999 was complicated by events surrounding her daughters, Rikki and Betty. In 1997 Rikki began serving a ten year sentence at the Women's Eastern Correctional Facility in Vandalia, Missouri for selling narcotics. See, Claimant's Exhibit B at 10:14-19. Betty, her other daughter, was receiving treatment for bipolar disorder, which she had dealt with for most of her life. In 2000 Betty began serving a five year sentence for forgery at the same prison. See, Claimant's Exhibit B at 8:19-9:13. A foster family adopted one of Betty's children, and Betty's other child was placed in foster care with the same family. Id. at 9:2410:2.

Ms. Markworth resigned as Director of Nursing on June 11, 1999. In her resignation letter, she asked to stay on as a staff nurse but did not state that she had any disability to prevent her from working. See, Employer's Exhibit 1. Ms. Markworth began working at the Lexington Public School District in August 1999 and worked as a teacher for three years. Currently, she is employed with a nursing home in Lexington, Missouri, as a registered nurse.

Ms. Markworth entered into evidence the deposition of Donald Hinton, M.D. Dr. Hinton is a practicing psychiatrist in Independence, Missouri and treated Ms. Markworth when she was hospitalized at Two Rivers Psychiatric Hospital in May 1999. Dr. Hinton opined that the stress that Ms. Markworth experienced at work was "the straw that broke the camel's back." See, Claimant's Exhibit C at 52:17. Dr. Hinton also admitted that her work-related stress was a "triggering" effect. Id. at 52:19-23. And, although Dr. Hinton admitted that Ms. Markworth had anxiety disorder before working at Shirley, he opined that her work possibly did - and possibly did not - make her condition worse. Id. at 63:18-23. Dr. Hinton first learned under questioning on cross-examination that Ms. M