Ralph Brown v. Onyx Waste

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: March 15, 2005
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 performing his daily job duties for Employer, Claimant developed bilateral hand numbness and bilateral knee pain.
12. Did accident or occupational disease cause death? No
13. Parts of body injured by accident or occupational disease: Bilateral hands and bilateral knees.
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? $\ 1,123.88

Employee: Ralph Brown

Injury No.: 05-021701

1. Employee's average weekly wages: $\ 834.90

1. Weekly compensation rate: $\$ 556.60 / \ 354.05
2. Method wages computation: Stipulated

1. Amount of compensation payable:

Unpaid medical expenses:

$\$ 1,123.88^{*}$

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

TOTAL:

$\$ 1,123.88^{*}$

* OWED TO DATE

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: Clare R. Behrle

Employee: Ralph Brown

Dependents: N/A

Employer: Onyx Waste

Additional Party: Second Injury Fund (open)

Insurer: Insurance Company State of PA

Injury No.: 05-021701

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: LJW:tr

The above referenced Workers' Compensation claim was heard by the undersigned Administrative Law Judge on April 18, 2007. Ralph Brown seeks issuance of a temporary award providing medical treatment for his hands and knees. Briefs were received and the case was formally submitted on May 18, 2007. Attorney Clare Berhle represented Ralph Brown (Claimant). Onyx Waste, (Employer) was insured by Insurance Company of the State of Pennsylvania, and represented by Attorney Robert Hendershot. Second Injury Fund (SIF) will remain open. Claimant's award is subject to a child support lien filed by the Missouri Division of Child Support Enforcement.

Prior to the start of the hearing, the parties identified the issues for disposition in this case: occupational disease; medical causation; liability of Employer for past medical expenses; medical care as relates to issuance of a temporary award; and temporary total disability (TTD) as relates to issuance of a temporary award. Hearing venue is correct, and jurisdiction properly lies with the Missouri Division of Workers' Compensation.

Claimant offered Exhibits A-E, and Employer offered Exhibit 1. All exhibits were admitted into the record without objection. Any markings contained within any exhibit were present when received, and the markings did not influence the evidentiary weight given the exhibit. 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 reviewed and summarized.

1. Claimant is forty-three years old, and worked for Employer as a boom truck driver for approximately eleven years. Claimant began his employment working residential trash removal, and for the last $31 / 2$ years as a container delivery driver. Claimant's job duties included delivery and removal of commercial dumpsters, and repair of dumpsters. Claimant covered seven

counties, drove 200-300 miles daily, and delivered 10-54 dumpster a day. Claimant was also required to inspect and clean his truck.

1. At each stop Claimant would climb in and out of his truck 2-3 times. Claimant's truck was approximately $21 / 2-3$ feet off the ground, had two steps, and two handrails that Claimant would use to pull himself into the truck. Claimant was also required to enter the dumpster to stomp down trash, and to push/pull the dumpster into position to be emptied. Claimant used hydraulic levers located near his right hand to empty the dumpster into his truck.
2. When repairing dumpsters, Claimant used cutting torches, sledge hammers, hacksaws, wrenches, and welding equipment. Claimant also had to assemble new dumpsters by applying wheels and lids. Claimant would assemble approximately 20-30 new containers a month.
3. During December 2004 and January 2005, Claimant began to experience bilateral hand numbness and loss of grip. Claimant also began to notice increased knee pain, with pain worse in his right knee versus his left knee. By March 2005, Claimant requested medical care from Employer. Employer denied his request, and Claimant sought medical care on his own.
4. On March 21, 2005, Claimant's physician sent him for an x-ray of his right knee, and for a nerve conduction velocity study (NCV). Claimant's right knee x-ray was read as showing unremarkable bony structures, and a questionable minimal joint effusion. Claimant's NCV demonstrated mild evidence of median nerve entrapment of the bilateral carpal tunnels affecting both motor and sensory fibers.
5. As of hearing, Claimant continues to experience bilateral hand numbness, especially at night, which affects his sleeping and ability to drive. Claimant has a loss of grip strength, and pain when using his hands in repetitive motion. Claimant is right hand dominant, but now finds his left hand to be stronger than his right hand. Claimant also experiences right knee pain once or twice daily, left knee pain every couple of weeks, and his right knee has given way twice.
6. Claimant used to work on his own cars, installing stereos, working on the car's interior, and changing oil and brakes. Claimant stopped doing "heavy" auto work 1-1 1/2 years ago. Claimant purchased an ATV during February or

March 2005, rode it for approximately one hour every day, stopped riding during 2006, but already had hand symptoms before he purchased the ATV. Claimant purchased a ski boat to use in fishing last summer, drives it at speeds of $25-30 \mathrm{mph}$, and has to tie it onto a trailer for transport.

1. Dr. Cohen examined Claimant on October 27, 2005. Dr. Cohen found abnormalities of Claimant's grip strength, Claimant's ability to squat, and found Claimant to have a positive McMurray's test of his right knee. Dr. Cohen diagnosed an overuse disorder of Claimant's upper and lower extremities. He opined Claimant's history was suggestive of bilateral carpal or cubital tunnel, Claimant had degenerative joint disease of his knees and/or meniscus tears. Dr. Cohen felt Claimant needed to be examined by orthopedic and hand surgeons. Dr. Cohen also felt Claimant needed repeat EMG/NCV testing of his upper extremities, and MRIs of both knees. Dr. Cohen opined Claimant's work was a substantial factor in causing injury to his arms and knees. Dr. Cohen did not find Claimant to be at maximum medical improvement (MMI).
2. Dr. Cantrell examined Claimant on August 7, 2006. Upon examination, Dr. Cantrell noted Claimant had a positive Phalen's sign that only produced numbness to his wrists, but not to his fingers. Claimant had mild crepitus in his right knee greater than his left knee. Dr. Cantrell obtained an x-ray of Claimant's cervical spine and right knee. Dr. Cantrell interpreted the right knee x-ray as demonstrating lateral tilting of Claimant's patella. The cervical spine x-ray showed no acute bony abnormalities and no significant degenerative changes. Dr. Cantrell opined he did not consider Claimant's work to be highly repetitive, and he did not consider Claimant's work activities to place Claimant at risk of developing carpal tunnel syndrome (CTS). Dr. Cantrell did not find Claimant's complaint of entire arm numbness to be a symptom that was consistent with CTS, and did not find his arm complaints to be work related. Nor did Dr. Cantrell find Claimant's knee complaints to be work related. Dr. Cantrell opined Claimant's right knee pain was the result of a biomechanical abnormality.

Having given careful consideration to the entire record, based upon the above testimony, the competent and substantial evidence presented, and the applicable law of the State of Missouri, I find the following:

Claimant alleges two occupational diseases that arose from his work duties. Section 287.067 RSMo., defines occupational disease as:

. . . an identifiable disease arising with or without human fault out of and in the course of the employment. Ordinary diseases of life to which the general public is exposed outside of the employment shall not be compensable, except