Ray Reed v. Associated Electric Cooperative, Inc.
Decision date: July 31, 200835 pages
Summary
The Commission affirmed the Administrative Law Judge's decision denying compensation in injury case 02-157598 (alleged June 9, 2002), finding no compensable occupational disease or accident. However, benefits were awarded in the related injury case 01-116248 (September 26, 2001), which was found to be compensable and arising out of employment.
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Caption
| Employee: | Ray D. Reed |
| Employer: | Associated Electric Cooperative, Inc. |
| Insurer: | Self-Insured T/P/A CCMSI |
| Additional Party: | Treasurer of Missouri as Custodian of Second Injury Fund |
| Date of Accident: | September 26, 2001 |
| Place and County of Accident: | New Madrid County, Missouri |
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by section 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commission finds 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, the Commission affirms the award and decision of the administrative law judge dated January 24, 2008. The award and decision of Administrative Law Judge Lawrence C. Kasten, issued January 24, 2008, is attached and incorporated by this reference.
The Commission further approves and affirms the administrative law judge's allowance of attorney's fee herein as being fair and reasonable.
Any past due compensation shall bear interest as provided by law. Given at Jefferson City, State of Missouri, this 31st day of July 2008. LABOR AND INDUSTRIAL RELATIONS COMMISSION William F. Ringer, Chairman Alice A. Bartlett, Member John J. Hickey, Member Attest:
FINAL AWARD DENYING COMPENSATION <br> (Affirming Award and Decision of Administrative Law Judge)
Injury No.: 02-157598
Employee: Ray D. Reed
Employer: Associated Electric Cooperative, Inc.
Insurer: Self-Insured T/P/A CCMSI
Additional Party: Treasurer of Missouri as Custodian of Second Injury Fund
Date of Accident: Alleged June 9, 2002
Place and County of Accident: New Madrid County, Missouri
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by section 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commission finds 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, the Commission affirms the award and decision of the administrative law judge dated January 24, 2008, and awards no compensation in the above-captioned case.
The award and decision of Administrative Law Judge Lawrence C. Kasten, issued January 24, 2008, is attached and incorporated by this reference.
Given at Jefferson City, State of Missouri, this 31st day of July 2008.
LABOR AND INDUSTRIAL RELATIONS COMMISSION
William F. Ringer, Chairman
Alice A. Bartlett, Member
John J. Hickey, Member
Attest:
AWARD
Employee: Ray D. Reed
Injury No. 01-116248 \& 02-157598
Employer: Associated Electric Cooperative, Inc.
Additional Party: Second Injury Fund
Insurer: Self-insured T/P/A CCMSI
Hearing Date: October 22, 2007
Checked by: LK/kh
SUMMARY OF FINDINGS
- Are any benefits awarded herein? Yes in 01-116248
No in 02-157598
- Was the injury or occupational disease compensable under Chapter 287? Yes in 01-116248
No in 02-157598
- Was there an accident or incident of occupational disease under the Law?Yes in 01-116248
No in 02-157598
- Date of accident or onset of occupational disease? On or about September 26, 2001.
- State location where accident occurred or occupational disease contracted: New Madrid County, Missouri.
- Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes in 01-116248 and 02-157598
- Did employer receive proper notice? Yes in 01-116248
- Did accident or occupational disease arise out of and in the course of the employment?
Yes in 01-116248
No in 02-157598
- Was claim for compensation filed within time required by Law?
Yes in 01-116248 for employer-insurer; Moot in 01-116248 for Second Injury Fund
Yes in 02-157598
- Was employer insured by above insurer? Yes in 01-116248 and 02-157598
- Describe work employee was doing and how accident happened or occupational disease contracted: The employee slipped and twisted his back on September 26, 2001.
- Did accident or occupational disease cause death? No in 01-116248 and 02-157598
- Parts of body injured by accident or occupational disease: Low back and body as a whole in 01116248 . N/A in 02-157598
- Nature and extent of any permanent disability:
Permanent Total Disability against Employer in 01-116248
N/A in 02-157598
- Compensation paid to date for temporary total disability: \$11,978.37 in 01-116248
None in 02-157598
- Value necessary medical aid paid to date by employer-insurer? \$22,253.47 in 01-116248
None in 02-157598
- Value necessary medical aid not furnished by employer-insurer?
$\ 148,461.55 in 01-116248 N/A in 02-157598
- Employee's average weekly wage: Undetermined in 01-116248 \& 02-157598
- Weekly compensation rate: $\ 628.90 PTD/TTD and $\ 329.40 PPD in 01-116248 \& 02-157598
- Method wages computation: By Agreement in 01-116248 \& 02-157598
- Amount of compensation payable: $\ 148,461.55 in previously incurred medical
$\ 72,323.50 in additional temporary total disability
$\ 150.43 for underpayment of temporary total disability.
TOTAL: $\ 220,935.48 in 01-116248.
N/A in 02-157598
- Second Injury Fund liability: None in 01-116248 N/A in 02-157598
- Future requirements awarded: See Rulings of Law for future medical and permanent total disability in 01-116248
Said payments to begin (see rulings of law) and 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 attorney Ron Little for necessary legal services rendered.
FINDINGS OF FACT AND RULINGS OF LAW
On October 22, 2007, the employee, Ray Reed, appeared in person and by his attorney, Ron Little for a hearing for a final award. Also present was Ruth Reed, the employee's wife. The employer was represented at the hearing by its attorney, Joe Page. The Second Injury Fund was represented by Assistant Attorney General Frank Rodman. 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 the findings of fact and rulings of law, are set forth below as follows:
UNDISPUTED FACTS:
- In Injury Number 01-116248 and 02-157598, Associated Electric Cooperative, Inc. was operating under and subject to the provisions of the Missouri Workers' Compensation Act and was qualified as a selfinsured employer through their TPA, CCMSI.
- On or about September 26, 2001 and on or about June 9, 2002, Ray Reed was an employee of Associated Electric Cooperative, Inc. and was working under the Workers' Compensation Act of Missouri.
- The employer had notice of the employee's alleged September 26, 2001 accident in Injury Number 01116248 .
- The employee's claims in Injury Number 01-116248 and Injury Number 02-157598 were filed against the employer within the time allowed by law. The claim against the Second Injury Fund in injury number 02-157598 was filed within the time allowed by law.
- The rate of compensation Injury Number 01-116248 and 02-157598 is $\ 628.90 for temporary total disability and permanent total disability. The rate of compensation is $\ 329.40 for permanent partial disability.
- The employer paid a total of $\ 22,253.47 in medical aid in Injury Number 01-116248.
- The employer has not paid any medical aid in Injury Number 02-157598.
- The employer paid temporary total disability in the 01-116248 case in the amount of $\ 11,978.37 representing 19 2/7 weeks compensation from September 26, 2001 through March 19, 2002. The employer paid temporary disability at the rate of $\ 621.10. Based upon the agreed upon rate of compensation of $\ 628.90, there was an underpayment of temporary total disability of $\ 7.80 per week. The employee is entitled to and the employer shall pay to the employee an additional $\ 150.43 (19 2/7 weeks $x \ 7.80 per week) in temporary total disability.
- The employer has not paid any temporary disability in Injury Number 02-157598.
ISSUES:
- Accident in injury number 01-116248.
- Accident or occupational disease in injury number 02-157598.
- Notice of the alleged accident of occupational disease in injury number 02-157598.
- Medical causation in injury number 01-116248.
- Medical causation in injury number 02-157598.
- Claim for previously incurred medical benefits in injury number 01-116248.
- Claim for previously incurred medical benefits in injury number 02-157598.
- Direct medical fee dispute filed by Dr. Gornet in injury number 01-116248 in the amount of \$53,562.50.
- Claim for additional or future medical aid in injury number 01-116248.
- Claim for additional or future medical aid in injury number 02-157598.
- Additional temporary total disability in injury number 01-116248.
- Additional temporary total disability in injury number 02-157598.
- Nature and extent of permanent disability in injury number 01-116248.
- Nature and extent of permanent disability in injury number 02-157598.
- Liability of the Second Injury Fund for permanent partial disability or permanent total disability in injury number 01-116248.
- Liability of the Second Injury Fund for permanent partial disability or permanent total disability in injury number 02-157598.
- Statute of limitations for the claim filed against the Second Injury Fund in injury number 01-116248 case.
- Dependency status of the employee's wife under Schoemehl v Treasurer of the State of Missouri, 217 S.W.3rd 900 (Mo.2007) in injury number 01-116248.
- Dependency status of the employee's wife under Schoemehl v Treasurer of the State of Missouri, 217 S.W.3rd , 900 (Mo.2007) in injury number 02-157598.
EXHIBITS: The following exhibits were offered and admitted into evidence:
Employee's Exhibits
- Southeast Missouri Hospital records
- Saint Francis Medical Center Records
- Medical records of Dr. Scott Gibbs
- Medical records of Dr. Hatfield
- Medical records of Dr. Schisler
- Medical records of Ozark Physical Therapy
- Medical records of Mid-America Rehab
- Medical records of Dr. Chen
- Medical records of Barnes Jewish West County Hospital
- Medical records of Dr. Gornet
- Medical records of Missouri Southern Healthcare
- Medical bills of Overturf Drugs
- Medical bills of Southeast Missouri Hospital
- Medical bills of Dr. Gibbs
- Medical bills of Saint Francis Medical Center
- Medical bills of Dexter Medical Center
- Withdrawn prior to being offered
- Medical bills of Ozark Physical Therapy
- Medical bills of Dr. Chen
- Medical bills of Dr. Gornet
- Medical bills of Washington University
- Medical bills of Barnes Jewish West County
- Medical bills of Southern Missouri Healthcare
- Medical bills of Mid-America Rehab
- Medical bills of Dr. Schisler
- Deposition of Dr. Cohen with exhibits.
- Deposition of Mr. England with exhibits
- Deposition of Dr. Stillings with exhibits.
- Deposition of Dr. Gornet with exhibits
- Deposition of Vincent Stock with exhibits
- Medical bills spreadsheet
- Attorney contracts
- TTD calculations
- Correspondence documenting pursuant of treatment
- Marriage license
Employer's Exhibits
- CV of Dr. Gibbs
- Medical records of Dr. Gibbs
- Medical records of Ozark Physical Therapy
- Medical records of Mid-America Rehab
- Deposition of Donna Abram
- Deposition of James England
- Withdrawn prior to being admitted
- Deposition of Dr. Gibbs
- Deposition of Chad Casey, PT, ATC
- Deposition of Craig Brown, PT, CEAS
- TTD paid
- Medical paid
The following exhibits were not admitted into evidence:
Employee A: Medical records of Dr. Jung
Employee JJ: Treatment History
Employee KK: Work history.
Witnesses: Ray Reed, the employee; Ruth Reed, wife of the employee; Shawn Reed, son of the employee
Judicial notice of the contents of the Division's file in injury number 01-116248 and
Full decision text continues in the plain-text archive copy.