Dr. Margolis concluded that employee suffered from several pre-existing conditions, including bilateral carpal tunnel syndrome, bilateral cubital tunnel syndrome, bilateral shoulder impingement, right ulnar nerve entrapment at the wrist, left medial epicondylitis, history of cervical strain/sprain, degenerative cervical disc disease, degenerative disease of the lumbar spine, and multiple sclerosis. According to Dr. Margolis, these pre-existing conditions combined with employee’s primary injury of bilateral carpal tunnel syndrome to create a greater overall disability. Dr. Margolis opined that employee was permanently and totally disabled based on employee’s disabilities.
James England, vocational expert, provided unimpeached and uncontradicted testimony. Mr. England opined that employee was unable to sustain work in the open labor market in any job. Mr. England opined that employee was not a good candidate for vocational rehabilitation and was likely to remain permanently and totally disabled from a vocational standpoint.
After considering the entire record, including the expert opinions of Dr. Margolis and Mr. England, we conclude that employee is permanently and totally disabled due to a combination of her pre-existing disabilities and December 16, 2003 work-related injury.
Section 287.200.1(4) RSMo, provides:
"the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee's average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to one hundred five percent of the state average weekly wage."
Employee introduced Exhibit SS, a pay stub reflecting one week of employee's wages from November 16, 2003 through November 21, 2003, as evidence of employee's average weekly earnings. Exhibit SS showed that employee worked 48 hours that week and earned $\ 14.56 per hour. Employee testified at hearing that she earned $\ 14.56 per hour, and testified that the number of hours listed on Exhibit SS accurately reflected the number of hours she worked for employer. Exhibit SS showed a weekly earnings of $\ 757.12. Pursuant to section 287.200.1(4), the applicable rate for permanent total disability benefits is $\ 504.75 ( $\$ 757.12 \times 66$ 2 / 3 % ).