- Amount of compensation payable:
Unpaid past medical expenses: $46,144.53
| 88 4/6 weeks of temporary total disability | $56,493.08 |
| 80 weeks of permanent partial disability from Employer | $28,324.00 |
| 22. Second Injury Fund liability: Yes |
| Permanent total disability benefits from Second Injury Fund: |
| Weekly differential ($283.09) payable by SIF for 80 weeks beginning |
| August 26, 2005, and thereafter $637.14 for Claimant's lifetime | * |
| TOTAL: $130,961.91 * |
| 23. Future requirements awarded: See Award |
| Said payments to begin immediately and to be payable and be subject to modification and review as provided by law. |
| The compensation awarded to the claimant shall be subject to a lien in the amount of 25% of all payments hereunder in favor of the following attorney fornecessary legal services rendered to the claimant: |
| Frank Niesen |
| FINDINGS OF FACT and RULINGS OF LAW: |
| Employee: | Ronald Fisher |
| Dependents: | N/A |
| Employer: | Midwest Floor Company |
| Additional Party: | Second Injury Fund |
| Insurer: | ACE Property & Casualty Ins. Co. |
| Injury No.: | 04-124062 |
| Before the |
| Division of Workers' |
| Compensation |
| Department of Labor and Industrial |
| Relations of Missouri |
| Jefferson City, Missouri |
| Checked by: | MDV:tr |
| ISSUES PRESENTED |
| The issues presented for resolution by way of this proceeding were accident or occupational disease, arising out ofand in the course of employment, medical causation, past due medical expenses, future medical expenses, the nature andextent of any temporary total disability benefits, the nature and extent of permanent disability, the liability of the SecondInjury Fund and the statute of limitations. |
| FINDINGS OF FACT |
| 1. | Claimant is a 50 year old veteran and former Marine who served in Vietnam in 1969 and 1970. Claimant has |
worked the last 38 years for Midwest Floor as a floor layer in the carpenter's union. His job entailed lifting bags of concrete and grout in 25 and 50 pound bags, mixing cement, laying sub floors and tiles, carrying tiles and tools. He spent 75 % of his day on his knees and was required to repetitively squat and stoop and stand up.
- In 1988, Claimant had a back injury while moving a roll of sheet vinyl. He was off work for several weeks and returned to work.
- In 1990, he fell on the right knee. Claimant underwent a series of aspirations and treatments for his right knee over the years and in 1997 underwent a right knee meniscectomy.
- Dr. Wagner treated Claimant following his 1990 knee injury to the right knee when he slipped and fell on a piece of marble. He suffered from patella tendon bursitis and was treated with aspirations, antiinflammatories, and an injection of Depo Medrol and was off work for about a month.
- In 1996 Claimant was off regular work, working in the office due to complications involving his knees. He returned after that to floor work and prior to the 1997 meniscectomy.
- During that procedure, Claimant had a lateral release, the medial femoral condyle was shaved, the lateral femoral condyle was shaved, the patella and trochlea were smoothed and the surgeon excised a Baker's cyst.
- Claimant was off work a couple months and returned to work performing his regular duties. His knee continued to give him significant difficulties at work with frequent swelling and required numerous aspirations.
- In 1998, he had an injury where he twisted his right knee.
- Claimant started having difficulty with his left wrist in the early 1990s and was diagnosed with rheumatoid arthritis. This affected his ability to work on his hands and knees and he underwent injections into the left wrist. Claimant suffered from left elbow bursitis in 1995.
- Claimant wore a back brace for his back condition and a wrist brace for his left wrist condition. Claimant also wore knee pads at work.
- On December 2, 2004, Claimant slipped while working on a job. That is the injury under consideration here. He told the Employer he injured his knee and needed a helper and needed to file a workers' compensation claim. The Employer said the only help we can give you is workers' compensation. The Employer asked Claimant to stay a little longer because it was a busy time for them. Claimant iced up the knee and got an apprentice and found it extremely difficult to work. His apprentice was taken away on December 13, 2004 and Claimant's right knee locked up while working, he hopped to the truck, called his supervisor and told him that Claimant was finished, unable to work anymore. Claimant was sent to Dr. Rende who looked at Dr. Berni's x-rays of Claimant's knees and said it was not work related. The claim was filed January 14, 2005 and Dr. Berni did a full knee replacement in February of 2005. He last saw Dr. Berni on January 8, 2007 for a maintenance cortisone injection.
- In December of 2005, Claimant filed a Claim for Compensation regarding his left and right knees. Dr. Berni surgically replaced the right knee on February 28, 2005. He diagnosed osteoarthritis on the basis of subchondral cysts and spurs.
- Dr. Volarich concurred in the osteoarthritis diagnosis determining that rheumatoid arthritis affects the upper extremities more than the lower and also would be symmetric and since Claimant only had dominant right side knee problems that he suffered from degenerative arthritis rather than rheumatoid arthritis.
- Dr. Volarich also testified that floor layers who work longer than 25 years all seem to have a high incidence of knee osteoarthritis. Claimant has been performing the job for 38 years.
- Dr. Rende opined on behalf of the Employer that Claimant suffered only from rheumatoid arthritis but his testimony was not particularly credible. He previously diagnosed severe degenerative arthritis and old age as causing the knee problems, but changed his opinion to rheumatoid arthritis at the deposition.
- Claimant fractured his pelvis in 1997 in a four-wheeler accident. He was off work $21 / 2$ months and continued to suffer pain and stiffness of the hip and back which interfered with his work over the years.
- Joyce Parsons, an employee benefits supervisor for Employer, testified that of the 60 to 70 employees in the field doing work similar to Claimant's, none of them had claimed work related degenerative arthritic conditions in their knees from work although many had knee injuries.
| 18. | Dr. Berni testified that carpet layers and baseball catchers have a pre-disposition for degenerative knee joint disease. Dr. Berni believes that Claimant’s floor laying was a substantial factor in the development of his knee osteoarthritis. Dr. Berni testified that it is Claimant’s rheumatoid arthritis working with his osteoarthritis that is causing his inability to return to gainful employment. |
| 19. | Claimant’s rheumatoid arthritis is severe. He had failed most medications by December of 1999. He had failed multiple non-steroidal anti-inflammatory drugs, Methotrexate, Arava, and Enbrel, and was proposing to the insurance company that he try extracorpeal immunoabsorption with Prosorba column for treatment of rheumatoid arthritis. This treatment is for moderate to severe rheumatoid arthritis sufferers with longstanding disease if they have failed or are intolerant to anti-rheumatic drugs. |
| 20. | Dr. Volarich rated Claimant’s disability at 80% of the right lower extremity at the knee, 50% of the left lower extremity at the knee, and 20% preexisting referencing the lumbosacral spine and fractured pelvis, and 15% for rheumatoid arthritis. |
| 21. | Dr. Volarich believed that Claimant was unable to engage in any substantial gainful employment and was permanently and totally disabled as a result of the work related knee injury in December of 2004 in combination with preexisting medical conditions. He did not feel that the Claimant was permanently and totally disabled considering the right knee alone. |
| _______________________ |
| **RULINGS OF LAW** |
| 1. | Claimant sustained an accident which arose out of and in the course of h |