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Tobias Fortenberry v. M & M Market Management

Decision date: June 27, 20077 pages

Summary

The Labor and Industrial Relations Commission affirmed the Administrative Law Judge's decision denying workers' compensation benefits to Tobias H. Fortenberry for an alleged right knee injury sustained on August 20, 2004, at a store in Perryville, Missouri. The Commission found that the injury did not arise out of and in the course of employment and was therefore not compensable under Missouri's Workers' Compensation Act.

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This workers' comp decision may point to a separate injury claim.

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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)
Injury No.: 04-132527
Employee:Tobias H. Fortenberry
Employer:M & M Market Management
Insurer:American Family Mutual Insurance Company
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund (Open)
Date of Accident:Alleged August 20, 2004
Place and County of Accident:Alleged Perryville, Missouri
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided bysection 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commissionfinds 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, theCommission affirms the award and decision of the administrative law judge dated December 11, 2006, and awards no compensation in the above-captioned case.The award and decision of Administrative Law Judge Gary L. Robbins, issued December 11, 2006, is attached and incorporated by this reference.Given at Jefferson City, State of Missouri, this 27th day of June 2007.LABOR AND INDUSTRIAL RELATIONS COMMISSION
William F. Ringer, Chairman
Alice A. Bartlett, Member
John J. Hickey, Member
Attest:
Secretary
ISSUED BY DIVISION OF WORKERS’ COMPENSATION
FINAL AWARD

Employer: M \& M Market Management

Additional Party: N/A

Insurer: American Family Mutual Insurance Company

Hearing Date: September 28, 2006

Checked by: GLR/kh

SUMMARY OF FINDINGS

  1. Are any benefits awarded herein? No
  2. Was the injury or occupational disease compensable under Chapter 287? No
  3. Was there an accident or incident of occupational disease under the Law? No
  4. Date of accident or onset of occupational disease? Alleged August 20, 2004
  5. State location where accident occurred or occupational disease contracted: Alleged Perryville, Missouri
  6. Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes
  7. Did employer receive proper notice? No
  8. Did accident or occupational disease arise out of and in the course of the employment? No
  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: The employee alleged he injured his right knee while conducting an inventory at a store in Perryville, Missouri.
  12. Did accident or occupational disease cause death? No
  13. Parts of body injured by accident or occupational disease: Alleged right knee.
  14. Nature and extent of any permanent disability: None. See Award.
  15. Compensation paid to date for temporary total disability: $\ 0
  16. Value necessary medical aid paid to date by employer-insurer: $\ 0
  17. Value necessary medical aid not furnished by employer-insurer: No benefits paid. See Award.
  18. Employee's average weekly wage: $\ 425.00
  19. Weekly compensation rate: $\ 283.35 for temporary total, permanent total and permanent partial disability.
  20. Method wages computation: By agreement
  21. Amount of compensation payable: $\ 0
  22. Second Injury Fund liability: N/A
  23. Future requirements awarded: None

No attorney fees are ordered in this case.

FINDINGS OF FACT AND RULINGS OF LAW

On September 28, 2006, the employee, Tobias H. Fortenberry, appeared in person and by his attorney, James J. Sievers, for a hearing for a final award. Rachael R. Brown represented the employer-insurer at the hearing. The Court took judicial notice of all of the records contained within the files of the Division of Workers' Compensation. At the time of the hearing, the parties agreed on certain undisputed facts and identified the issues that were in dispute. These undisputed facts and issues, together with a statement of the findings of fact and rulings of law, are set forth below as follows:

UNDISPUTED FACTS

  1. The employer was acting under and subject to the provisions of the Missouri Workers' Compensation Act, and liability was fully insured by American Family Mutual Insurance Company.
  2. On or about the date of the alleged accident or occupational disease, the employee was an employee of M \& M Market Management and was working under the Workers' Compensation Act.
  3. The employee's claim was filed within the time allowed by law.
  4. The employee's average weekly wage is $\ 425.00. His rate for temporary total and permanent total disability is $\ 283.35 per week. His rate for permanent partial disability is $\ 283.35 per week.
  5. The employer-insurer provided no medical aid in this case.
  6. The employer-insurer provided no temporary disability benefits in this case.

ISSUES

  1. Whether on or about August 20, 2004 the employee sustained an accident or occupational arising out of and in the course of his employment?
  2. Whether the employer had notice of the employee's accident?
  3. Whether the employee's injury was medically causally related to his accident or occupational disease?
  4. Whether the employer-insurer is liable for past medical bills?
  5. Nature and extent of permanent partial disability?

EXHIBITS

The following exhibits were offered and admitted into evidence:

Employee's Exhibits

A. Report of David T. Volarich, D.O

B. MRI dated October 4, 2005

C. Medical records from Christian Northeast-Northwest Hospital

D. Medical records from HealthSouth Rehabilitation of Florissant

E. Medical records of Rafat S. Nashed, M.D.

F. Medical records of Frank O. Petkovich, M.D.

G. Medical records from St. John's Mercy Sports \& Therapy

H. Unpaid medical bills

Employer-Insurer's Exhibits

  1. Medical report of Russell C. Cantrell, M.D.
  2. Division of Workers' Compensation Medical Treatment Form
  3. Division of Workers' Compensation Claim for Compensation
  4. Division of Workers' Compensation Report of Injury
  5. Division of Workers' Compensation Stipulation for Compromise Settlement

STATEMENT OF THE FINDINGS OF FACT:

Three witnesses testified live at trial, Tobias H. Fortenberry, the employee, Mark Tons, President and owner of M \& M Market Management and Susan Tons, Vice President and co-owner of M \& M Market Management (herein after referred to as $\mathrm{M} \& \mathrm{M} or employer).

The employee testified that he worked for \mathrm{M} \& \mathrm{M}$ for about three years. He indicated that his employment involved market research and auditing of stores that sold cigarette products. As part of his duties he drove to stores and would inventory the product that was there. The goal was to determine which products sold the best. On average, the employee indicated that he traveled to three or four stores a week and then would return to the home office in Chesterfield, Missouri.

The employee testified that he had an injury to his right knee on or about August 20, 2004. At trial, he indicated that he was

counting product at a store. He said he squatted to count some of the cartons, and when he got up he stumbled and felt a pop in his right knee. After the injury, he testified that he drove to another store and completed an audit there before returning to his home in St. Louis. He indicated that the next day he audited three more stores before returning to the office in Chesterfield. He said that he saw Jackie-a manager, and was told that a store had not been done properly and asked him to redo it. The employee testified that he complied and redid the work. He testified that his knee hurt and it was hard to get in and out of a car. The next day he said that his knee got worse and worse. He additionally testified that on the day of the injury, he did not tell anyone at the store that he had injured his knee.

After he returned to the home office, the employee testified that he told Mr. Toms and Venessa that he had messed up his knee the last trip. He indicated that when he first told them about the knee problem, he did not ask for any medical care. However, the employee testified that he told Mr. Toms that he was going to see Dr. Nashed before he ever did so.

The employer-insurer conducted a cross-examination of the employee during trial. The employee testified by deposition in March 2005. During his testimony, the employee stated that he might have mentioned the knee problem to Dr. Nashed before October 29, 2004 and he might have asked his personal doctor about his knee. He testified that he is positive that the injury occurred while he was in Perryville at Smokes To Go. In his deposition, he apparently testified that the injury happened at Forsake Of Argument. At his deposition, the employee apparently stated that he first noticed pain when he walked up the steps at his house. He denied that statement at trial and indicated that the pain started when he initially stood up and got worse when he was driving back from Perryville. He then agreed with his deposition testimony where it is reported he said he first noticed he hurt himself when he was trying to get in and out of the vehicle.

Dr. Nashed had been treating the employee for other problems prior to August 20, 2004. One of his records dated September 25, 2003 reports that the employee was complaining of pain in his left knee. The record additionally reports that the employee stated that he did not know how he hurt his knee. Follow up records concerning the left knee revealed degenerative changes.

The first record that Dr. Nashed has about the employee's right knee is dated October 29, 2004. That record states "He is mainly complaining today about his right knee but also about his neck". The record does not contain any history about a work related injury occurring on or about August 20, 2004. Dr. Nashed saw the employee on November 12, 2004 and recommended surgery. The employee had right knee surgery on November 30, 2004. The are other records from Dr. Nashed dated December 9, 2004, December 30, 2004, January 27, 2005, and February 11, 2005; all dealing with the right knee. There is no mention of any work related accident or injury in any of these records. The first mention that Dr. Nashed has of a work related injury occurs in his record dated March 25, 2005. That record reports "He informs me today that the injury that began since his pain in the right knee occurred between August 20, 200 and August 23, 2004. He squatted down while at a store where he was doing his job. His then felt pain in the right knee. He drove on further on to the rest stop. When he got out of the car his knee swelled up. He did not seek immediate treatment because he thought it would get better and therefore he showed up next to see me on October 29, 2004 at which time we discussed the problem with his right knee and went on towards evaluation and eventually treatment of it." He is doing very well and has recovered nicely from the surgery". (emphasis added) On April 14, 2005, the employee reported that his knee was 80 % better than it was before surgery.

Additional medical records about the right knee show that the employee was seen at Christian Hospital on October 29, 2004. The records indicate that the employee was there as he felt that his right knee was about to give out. The report further states, "He has not had any history of recent injury". (emphasis added)

In 1999 the employee had received previous treatment to his right knee. Dr. Petkovich's medical record dated October 4, 1999 reports a forklift injury to the right knee. In this instance the report indicated that the employee reported a work related injury and gave a history of how the injury occurred.

Dr. Volarich saw the employee on November 7, 2005 and prepared a report dated the same date. In the report Dr. Volarich reported that his opinions are based on the premise that the history given by the employee and other information was true and accurate.

In the

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