James Hall v. Ameren UE
Decision date: September 30, 200814 pages
Summary
The Labor and Industrial Relations Commission affirmed the Administrative Law Judge's award of workers' compensation benefits to James Hall for work-related bilateral cubital tunnel syndrome sustained on March 26, 2003. The employee reached maximum medical improvement on March 17, 2005, following left cubital tunnel release surgery, and temporary total disability benefits were awarded through that date.
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Caption
| Issued by THE LABOR AND INDUSTRIAL RELATIONS COMMISSION |
| FINAL AWARD ALLOWING COMPENSATION (Affirming Award and Decision of Administrative Law Judge by Supplemental Opinion) |
| Employee: | James Hall |
| Employer: | Ameren UE |
| Insurer: | Self-Insured |
| Additional Party: | Treasurer of Missouri as Custodian of Second Injury Fund |
| Date of Accident: | March 26, 2003 |
| Place and County of Accident: | Jefferson 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, read the briefs, heard oral arguments 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 March 11, 2008. In addition, the Commission would like to clarify the evidence surrounding the award of temporary total disability benefits to employee. “[T]emporary total disability” is a judicial creation that is defined by case law and not by statute. . . . Temporary total disability benefits are owed until the employee can find employment or the condition has reached the point of “maximum medical progress.” Thus, temporary total disability benefits are not intended to encompass disability after the condition has reached the point where further progress is not expected.Cardwell v. Treasurer of Mo., 249 S.W.3d 902, 909 (Mo.App. E.D. 2008) (internal citations omitted). “[T]he Commission does not have to make its decision only upon testimony from physicians; it can make its findings based on the entire evidence.”Pavia v. Smitty’s Supermarket, 118 S.W.3d 228, 234 (Mo.App. 2003) (citing Smith v. Richardson Bros. Roofing, 32 S.W.3d 568 (Mo.App. 2000)).Dr. Ollinger opined that employee could return to work on January 21, 2004. However, Dr. Ollinger did not believe employee’s cubital tunnel syndrome was work related. The administrative law judge specifically rejected that portion of Dr. Ollinger’s opinion, and found that employee’s bilateral cubital tunnel syndrome was caused by employee’s work. Therefore, employee was not at maximum medical improvement on January 21, 2004, because his bilateral cubital tunnel syndrome had yet to be addressed.On March 8, 2005, Dr. Park performed left cubital tunnel release surgery on employee. Dr. Park released employee from his care on March 17, 2005. Employee was not happy with the results of that surgery, so he did not have the same surgery performed on his right elbow. Therefore, as of March 17, 2005, employee’s bilateral cubital tunnel syndrome was no longer expected to improve. As such, employee reached maximum |
medical improvement on that date and his total temporary disability ended.
Based on the above, the award and decision of Administrative Law Judge Carl Strange, issued March 11, 2008, is affirmed, as supplemented herein, and is attached and incorporated by this reference.
Given at Jefferson City, State of Missouri, this 30th day of September 2008.
LABOR AND INDUSTRIAL RELATIONS COMMISSION
William F. Ringer, Chairman
Alice A. Bartlett, Member
John J. Hickey, Member
Attest:
Secretary
Smith was overruled on other grounds by Hampton v. Big Boy Steel Erection, 121 S.W.3d 220 (Mo. banc 2003).
AWARD
Employee: James Hall
Injury No. 03-071311
Dependents: N/A
Employer: Ameren UE
Additional Party: Second Injury Fund
Insurer: Self-Insured
Hearing Date: December 28, 2007
Checked by: CS/kh
SUMMARY OF FINDINGS
- Are any benefits awarded herein? Yes
- Was the injury or occupational disease compensable under Chapter 287? Yes
- Was there an accident or incident of occupational disease under the Law? Yes
- Date of accident or onset of occupational disease? March 26, 2003
- State location where accident occurred or occupational disease contracted: Jefferson County, Missouri
- Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes
- Did employer receive proper notice? Yes
- Did accident or occupational disease arise out of and in the course of the employment? Yes
- Was claim for compensation filed within time required by law? Yes
- Was employer insured by above insurer? Yes
- Describe work employee was doing and how accident happened or occupational disease contracted: Employee did repetitive twisting, turning, pulling and keyboarding for employer over the course of several years which caused bilateral carpal tunnel syndrome and bilateral cubital tunnel syndrome.
- Did accident or occupational disease cause death? No
- Parts of body injured by accident or occupational disease: Bilateral Upper Extremities
- Nature and extent of any permanent disability: $\ 51,324.11 (See Findings)
| • | Compensation paid to date for temporary total disability: $0.00 |
| • | Value necessary medical aid paid to date by employer-insurer: $10,028.63 |
| • | Value necessary medical aid not furnished by employer-insurer: $3,304.30 (See Findings) |
| • | Employee's average weekly wage: $1,269.23 |
| • | Weekly compensation rate: |
| $649.32 for temporary total disability and permanent total disability | |
| $340.12 for permanent partial disability | |
| • | Method wages computation: By Agreement |
| • | Amount of compensation payable: |
| Previously Incurred Medical Aid: | $3,304.30 |
| Temporary Total Disability: | $66,601.68 |
| Permanent Partial Disability: | $51,324.11 |
| Total: | $121,230.09 (See Findings) |
| • | Second Injury Fund liability: |
| Permanent total disability benefits from Second Injury Fund (See findings in Issue 5). | |
| • | Future requirements awarded: None |
| Said payments shall be payable as provided in the findings of fact and rulings of law, and shall be subject to modification and review as provided bylaw.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: Attorney Ronald Little and Shelia Blaylock |
FINDINGS OF FACT AND RULINGS OF LAW
On December 28, 2007, the employee, James Hall, appeared in person and by his attorney, Ronald Little and Shelia Blaylock, for a hearing for a final award. The employer-insurer was represented at the hearing by its attorney, John Dietrick. The Second Injury Fund was represented at the hearing by Assistant Attorney Eileen Krispin. 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:
- On or about March 26, 2003, Ameren UE was operating under and subject to the provisions of the Missouri Workers' Compensation Act and was a self-insured.
- On or about March 26, 2003, the employee was an employee of Ameren UE and was working under and subject to the provisions of the Missouri Workers' Compensation Act.
- The employer had notice of employee's accident.
- The employee's claim was filed within the time allowed by law.
- The employee's average weekly wage was $\ 1,269.23, his rate for temporary total disability and permanent total disability is $\ 649.32, and his rate for permanent partial disability is $\ 340.12.
- The employer has furnished $\ 10,028.63 medical aid to employee.
- The employer has paid no temporary total disability benefits.
ISSUES:
- Occupational Disease;
- Medical Causation;
- Previously Incurred Medical Aid;
- Nature and Extent of Disability; and
- Liability of the Fund.
EXHIBITS:
The following exhibits were offered and admitted into evidence:
Employee's Exhibits
- Medical Records and Medical Bills of Dr. Henry Ollinger;
- Medical Records and Medical Bills of Neurological \& Electrodiagnostic Institute;
- Medical Records and Medical Bills of Auburn Surgery Center;
- Medical Records and Medical Bills of Cape Neurological Surgeons;
- Medical Records and Medical Bills of Missouri Baptist Medical Center;
- Medical Records of St. Francis Medical Center;
- Medical Records of Cape Neurological Associates;
- Medical Records of Immediate Healthcare;
- Medical Records and Medical Bills of Dr. John Askew;
- Medical Records of Dr. John Askew;
- Medical Records of Southeast Missouri Hospital;
- Medical Records of Regional Primary Care Group;
- Medical Records of Dr. Gilberto Lozano;
- Deposition of Dr. Bruce Schlafly and Exhibits;
- Deposition of Dr. Raymond Cohen and Exhibits;
- Deposition of James England and Exhibits;
- Correspondence Requesting / Denying Medical Treatment;
- Medical Bill Spreadsheet;
- Temporary Total Disability Spreadsheet;
- Permanent Total Disability Spreadsheet;
- Archive Records from Division of Workers' Compensation; and
- Attorney Contract.
Employer-Insurer's Exhibits
- Deposition of Dr. Henry Ollinger and Exhibits.
FINDINGS OF FACT:
Based on the testimony of James Hall ("employee") and the medical records and reports admitted, I find as follows:
At the time of the hearing, the employee was 62 years old and was not married at the time of his injuries. He married his present wife on May 8, 2004. In addition to obtaining his high school diploma, the employee graduated from Union University with a Bachelor of Science Degree in Business Administration. His other specialized training included graduate work at Southeast Missouri University and electrical training in the US Army. Following his honorable discharge from the Army, the employee went to work in Operations at the New Madrid Power Plant. While employed at the New Madrid Power Plant, the employee injured his low back in a work related explosion. As a result of the injury, the employee underwent a left L5 partial hemilaminectomy with removal of an extruded disc on November 9, 1976 at Baptist Memorial Hospital. Following his injury, the employee began working at Sikeston Public Schools as a Youth Program Employment Coordinator. After two years, the employee went to work in Operations for the Sikeston Power Plant. In December of 1980, Ameren UE hired the employee to work in Operations at the Calloway Power Plant. After 7 years, the employee transferred to the Rush Island Plant in Jefferson County, Missouri.
Due to additional back problems and leg pain, the employee underwent a second surgery to his low back by Dr. Yong Kim on November 1, 1991. Dr. Kim performed a microlumbar diskectomy at L5-S1 on the left due to the recurrent herniated disc (Employee Exhibit F). On May 28, 1992, Dr. Kim rated the employee's 1976 surgery at 30\% permanent partial disability and his 1991 surgery as an additional 15 % permanent partial disability due to additional scarring around the nerve root (Employee Exhibit G). Following the second surgery, the employee continued to have occasional pain and numbness due to his back injury and receive sporadic treatment for it. On January 19, 1998, Dr. Reno R. Cova noted that the MRI of the employee's back indicated that he had scar tissue in his lumbar region. As a result of the employee's medical problems, Dr. Cova requested that the employer place the employee on light duty for 12 months with restrictions of lifting less than 25 pounds and no excessive pulling or repetitive bending. Due to the employee's performance, Dr. Cova issued a letter to the employer on April 28, 1999 and requested that the employee be left on a job that does not entail lifting (Employee Exhibit H). At the hearing, the employee testified that the employer left him on light duty for approximately 5 years. As part of his light duty, the employee
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