Mary Mezo v. Meramec Group, Inc.

Employee: Mary Mezo

Injury No. 04-137073

Dependents:

None

Employer: Meramec Group, Inc.

Additional Party: None

Insurer: Self-Insured

Hearing Date: October 11, 2007

Before the<br>DIVISION OF WORKERS' COMPENSATION<br>Department of Labor and Industrial Relations of Missouri<br>Jefferson City, Missouri

Checked by: GCG/In

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 3, 2004
5. State location where accident occurred or occupational disease contracted: Franklin County, 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? 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: Repetitive Motion
12. Did accident or occupational disease cause death? No Date of death? Not Applicable
13. Parts of body injured by accident or occupational disease: Bi-lateral hands and wrists.
14. Compensation paid to-date for temporary disability: None

1. Value necessary medical aid paid to date by employer/insurer? \$2,032.12
2. Value necessary medical aid not furnished by employer/insurer? Undetermined

Employee: Mary Mezo Injury No. 04-137073

1. Employee's average weekly wages: $\ 293.35
2. Weekly compensation rate: $\ 195.96 TTD/PPD
3. Method wages computation: Stipulation

1. Amount of compensation payable: Undetermined

Unpaid medical expenses:

$\ 0

Total: Undetermined

Each of said payments to begin as of the date of this award 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 hereunder in favor of the following attorney for necessary legal services rendered to the claimant:

Ronald Edelman

Before the DIVISION OF WORKERS' COMPENSATION

Department of Labor and Industrial Relations

of Missouri

Jefferson City, Missouri

Hearing was held in the above styled case on October 11, 2007 before the undersigned ALJ in Franklin County, Missouri. Claimant was present in person and represented by Jeff Estes. Employer was represented by Tim Tierney. The Second Injury Fund is not a party to this action.

The issues presented for determination by hearing are as follows: Whether Claimant has an occupational disease; whether the occupational disease arose out of and in the course of employment/medical causation; is Employer liable for past medical in the amount of $\ 194.89; is Employer liable for medical treatment; and the nature and extent of Claimant's disability.

The parties made the following stipulations of fact: On or about September 3, 2004 Claimant alleges she sustained an occupational disease; Claimant was an employee of Employer; Venue is proper in Franklin County; Employer received proper notice of claim; the claim was timely filed; at the relevant time Claimant earned an average weekly wage of $\ 293.35, resulting in applicable wage rates of $\ 195.96 for temporary total disability (TTD) benefits and permanent partial disability (PPD) benefits; Employer has not paid any TTD benefits to date; and Employer has paid medical benefits totaling $\ 2,032.12.

Claimant worked for Employer from January 19, 2004 through September 3, 2004. She held three different positions during her tenure with Employer, each of which was a manufacturing job that required intensive use of both hands. Claimant testified while performing her job as a turntable operator, the second of the three positions she held, she felt a "pop" in her left wrist. She continued to work but later developed pain and numbness in her left wrist. She testified she also developed pain and numbness in her right wrist, but that it was not as bad as the left. The "pop" and the onset of pain occurred about three days after she began working as a turntable operator. She initially sought treatment for her left wrist. Dr. Sudekum, the physician to which Employer referred her, provided evaluation and treatment for the left wrist only.

Dr. Sudekum testified by deposition on March 1, 2007 (Employer's Exhibit 1). Dr. Sudekum testified that he diagnosed Claimant with carpal tunnel syndrome in the left wrist. He initially felt that her work was a substantial factor in causing the condition. Claimant was given conservative medical treatment. He later opined Claimant would need surgery to correct the condition. However, surgery was never provided as Dr. Sudekum was provided with additional medical history consisting of an automobile accident. The records indicate the accident was in February 2004, and that Claimant made complaints of numbness and tingling in her hands due to a cervical injury after the accident. Dr. Sudekum then revised his opinion regarding causation, opining work was merely a triggering or precipitating factor, and he no longer considered it a substantial factor. Dr. Sudekum further testified that Claimant had not made any complaints regarding her right wrist.

A medical examination of Claimant was performed by Dr. Robert Poetz. Dr. Poetz testified by deposition on September 25, 2007 (Claimant's Exhibit H). Dr. Poetz diagnosed Claimant with bi-lateral carpal tunnel syndrome, left worse than right. He opined that Claimant was not at maximum medical improvement, and that if she received no further treatment she had permanent partial disability of 30 % to each arm at hand and wrist. He also felt that it was more probable than not that Claimant required surgical intervention.

Based on the competent and substantial evidence presented in this case, including the medical records received into evidence, the expert medical testimony presented, the testimony of Claimant, my personal observations of

Claimant, and all other evidence presented, I find the following:

Although a final award was requested, it is necessary to issue a temporary award pursuant to $\S 287.510$, as all of the medical evidence presented indicates that Claimant is not at maximum medical improvement (MMI) and that she requires additional treatment. A disability is "permanent" if "shown to be of indefinite duration in recovery or substantial improvement is not expected." Tiller v. 166 Auto Auction, 941 S.W.2d 863, 865 (Mo.App. S.D. 1997). As additional treatment or surgical intervention is warranted in this case, a final award is premature.

As previously discussed, Dr. Poetz opines that Claimant has bi-lateral carpal tunnel syndrome caused by her work activities. Dr. Sudekum initially felt that Claimant had carpal tunnel syndrome in her left hand and wrist, and that work was a substantial factor in causing the condition. He did not examine or render an opinion regarding the right hand and wrist. Only after receiving the medical information regarding the automobile accident in February 2004 did he revise his opinion. On cross-examination, however, he conceded that the nerve conduction study indicated that the condition was localized at the wrist, and that it did not seem to originate in from a cervical condition. Dr. Sudekum also did not adequately explain how, even in light of the emergence of the additional medical evidence pertaining to the automobile accident, Claimant's work activities were no longer a substantial factor in the development of carpal tunnel syndrome.

It is reasonably probable, based on the competent and substantial evidence in this case, that Claimant contracted bi-lateral carpal tunnel syndrome, and that her employment at Meramec Group, Inc. was a substantial factor in the development of this occupational disease.

Regarding past medical care, Claimant has failed to adduce evidence that the $\ 194.89 of past medical care, apparently evidenced by a Medicare lien against this claim, is related to her treatment for carpal tunnel syndrome. The claim for past medical in the amount of $\ 194.89 is denied.

Regarding future medical treatment, for an award of temporary disability and medical aid, proof of cause of injury is sufficiently made on reasonable probability. Griggs v. A. B. Chance Company, 503 S.W.2d 697, 703 (Mo. App. 1973). Winsor v. Lee Johnson Const. Co., 950 S.W.2d 504 (Mo. App. W.D.1997). Based on the competent and substantial evidence presented in this case, it is reasonably probable that Claimant is entitled to medical aid to cure and relieve the work related carpal tunnel syndrome. Employer is to provide the surgical treatment as recommended by Dr. Sudekum and Dr. Poetz for her left arm at the wrist and hand. Employer is also to provide Claimant diagnostic testing and treatment as may be required for her right arm at the wrist and hand.

No award was requested and no evidence for past TTD was presented. However, a period of TTD may be appropriate during treatment as awarded herein.

A lien of 25 % is granted in favor of Ronald Edelman on any amounts awarded herein as and for attorney fees for necessary legal services provided.

All other issues presented remain open for future determination.

Date: January 10, 2008

Made by: /s/ GRANT C. GORMAN

GRANT C. GORMAN

Administrative Law Judge

Division of Workers' Compensation

A true copy: Attest:

/s/ JEFFREY W. BUKER

JEFFREY W. BUKER, Director

Division of Workers' Compensation