Walter Wyman v. Missouri Department of Mental Health St. Louis Regional Center for Developmentally Disabled

1. Are any benefits awarded herein? Yes
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: September 18, 2003
5. State location where accident occurred or occupational disease contracted: St. Louis City, MO
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 happened or occupational disease contracted: While involved in a crisis intervention, Employee was assaulted by a client.
12. Did accident or occupational disease cause death? No
13. Parts of body injured by accident or occupational disease: Psychological injury
14. Compensation paid to-date for temporary disability: None
15. Value necessary medical aid paid to date by employer/insurer? None
16. Value necessary medical aid not furnished by employer/insurer? None

1. Employee's average weekly wages: $\ 304.95
2. Weekly compensation rate: $\$ 203.30 / \ 203.30
3. Method wages computation: Stipulated

1. Amount of compensation payable:

Unpaid medical expenses:

To be determined

94 weeks of temporary total disability (or temporary partial disability)

$\ 19,110.20 and ongoing

TOTAL:

TO BE DETERMINED

Each of said payments to begin immediately and be subject to modification and review as provided by law. This award is only temporary or partial, is subject to further order, and the proceedings are hereby continued and the case kept open until a final award can be made.

IF THIS AWARD IS NOT COMPLIED WITH, THE AMOUNT AWARDED HEREIN MAY BE DOUBLED IN THE FINAL AWARD, IF SUCH FINAL AWARD IS IN ACCORDANCE WITH THIS TEMPORARY AWARD.

The compensation awarded to the claimant shall be subject to a lien in the amount of 25 % of all payments in favor of the following attorney for necessary legal services rendered to the claimant: Thomas A. Traube

Employee: Walter Wyman

Injury No.: 03-144756

Dependents: N/A

Employer: MO Department of Mental Health

St. Louis Regional Center for Developmentally Disabled

Department of Labor and Industrial

Additional Party: Second Injury Fund (open)

Jefferson City, Missouri

A hearing was held regarding the above referenced Workers' Compensation claim by the undersigned Administrative Law Judge on September 28, 2006. [1] Walter Wyman seeks issuance of a temporary order providing psychiatric treatment and any necessary temporary disability. Attorney Thomas P. Traube represented Walter Wyman (Claimant). The Missouri Department of Mental Health - St. Louis Regional Center for the Developmentally Disabled (Employer) is self-insured by the State of Missouri, and was represented by Assistant Attorney General LaVander Smith. Briefs were filed and the case was formally submitted on October 27, 2006.

Prior to the start of the hearing the parties identified the following issues for disposition in this case: medical causation; temporary total disability (TTD) as relates to a temporary order; future medical care as it relates to a temporary order; and a statute of limitations defense.

Claimant offered Exhibits A-E, and Employer offered Exhibits 1-4. The exhibits were admitted into the record. Any markings contained within any exhibit were present when received. Any objections not expressly ruled on in this award are overruled.

All evidence presented has been reviewed. Only testimony necessary to support this award will be summarized.

Claimant: Claimant began working for Employer in 1989, left his employment for approximately one year, but resumed employment with Employer until 2004. Claimant served as a Behavior/Crisis Intervention Technician during his period of employment with Employer. Claimant's job duties involved interacting with clients who had their jobs or placement at risk due to their behavior. The clients Claimant dealt with frequently had dual diagnoses including both developmental and mental health disorders, and they were prone to violent outbursts. Claimant received outstanding performance reviews, and was presented with a Governor's Award during his employment with Employer. Claimant has a history of attention deficit hyperactivity disorder (ADHD), depression, and a history of gambling addiction. During the course of his employment Claimant remained in therapy with a psychiatrist.

During 2000, Claimant injured his low back after being assaulted by a client. Claimant required two surgeries to correct a herniated disc at L4-5. When Claimant returned to work, he expressed concern over working with aggressive clients, and his inability to protect himself from further injury. Claimant discussed his concerns with his supervisor, and his future assignments reflected an attempt to limit his exposure when it was possible.

On June 24, 2002, Claimant responded to a crisis involving "Brian". Brian was fourteen years old, tall for his age, and weighed approximately 350 pounds. During the intervention Claimant was assaulted, " 911 " had to be called, and Brian was removed from his placement and admitted to St. Anthony's Medical Center. Following this incident Claimant became increasingly fearful of being unable to protect himself, had difficulty concentrating, began experiencing nightmares, experienced periods of "fog", [2] and had an episode at his office that humiliated him. Despite his problems, Claimant continued to work for the next year.

On September 18, 2003, Claimant responded to a crisis involving "Nate". During this intervention, Nate threatened to kill Claimant. Nate managed to pin Claimant's hands behind his back, and began to strike Claimant. Claimant extricated himself, and " 911 " was called. Following this incident, Claimant became dysfunctional, was even more fearful for his safety, suffered flashbacks, experienced panic attacks, and had further mental clarity problems. Claimant spoke to his supervisor on a daily basis, and frequently made her aware of his fears of aggressive clients. Claimant requested treatment, but Claimant's supervisor referred him to a mandatory employee assistance program. Despite his prior mental health history, Claimant had never experienced these symptoms.

Following the September 2003 assault, Claimant was unable to return to work. In January 2004, Claimant went

on long term disability which lasted twenty-four months. During that time Claimant continued to treat with his psychiatrist, and also sought treatment with the Center for Trauma Recovery at the University of Missouri - St. Louis (UMSL). At UMSL, it was determined Claimant met the diagnostic criteria for post traumatic stress disorder (PTSD). As of the date of hearing, Claimant does not believe he is capable of returning to work at this time, he is seeking additional mental health treatment due to the assaults, and he emphasized the need for treatment is not due to job related stress.

Upon cross-examination, Claimant acknowledged although he had highly successful performance reviews as related to work with clients, he had received disciplinary reprimands on occasion. Claimant verified he was frequently late completing work related paperwork, but attributed the difficulty due to his ADHD. Finally, Claimant also acknowledged his job description demonstrated his job was to work with aggressive and sometimes violent clients.

Dr. Stromsdorfer: Dr. Stromsdorfer is Claimant's treating psychiatrist. Dr. Stromsdorfer was not deposed, and Claimant's treatment records as recorded by Dr. Stromsdorfer are outlined as follows:

7/31/01 - Claimant has a longstanding history of personal and family depression. Claimant was diagnosed with major depressive disorder, and medication was started.

12/14/01 - Claimant's condition is slightly worse. His depression is rated 8 (out of 10)(8/10), and his anxiety is 6/10. Medication is adjusted.

2/6/02 - Claimant is noted to be depressed, tense, and dysphoric.

3/8/02 - Claimant is noted to be "doing somewhat better."

4/5/02 - Claimant is noted to be doing better, and more focused.

4/30/02 - Claimant's focus is better, it is noted "I'm able to read." His depression and anxiety are both rated at 0/10.

7/30/02 - It is noted Claimant continues to focus well, and a return visit is scheduled for three months.

11/23/02 - The impression is Claimant is "doing o.k." Claimant's next visit is scheduled for six weeks.

2/8/03 - Impression is fair. Claimant is noted to be mildly dysphoric. Depression is $0 / 10, and anxiety is 8 / 10$.

2/19/03 - A telephone call is received from "Karen", reporting Claimant is not sleeping, anxious, and having nightmares. A sleeping aid is prescribed.

2/25/03 - Claimant is noted to be mildly dysphoric. Depression is noted to be $2 / 10$, and his anxiety is variable.

4/6/03 - Depression is noted at 3/10, and anxiety is considered variable.

6/17/03 - Note indicated Claimant is not doing well, is frozen with anxiety, feeling helpless, not getting things done, and missing work for six weeks. Depression is noted to be 10/10, his anxiety is variable, and his GAF is 50. Diagnosis on Axis IV is indicated as work stress.

7/15/03 - Claimant's mood is fluctuating. Depression is noted to be 7/10, and