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Vannessa Crumpler v. Wal-Mart Associates, Inc.

Decision date: October 17, 20088 pages

Summary

The Commission affirmed the Administrative Law Judge's decision denying workers' compensation benefits to Vannessa Crumpler for a diabetic seizure suffered while working at a Wal-Mart deli counter. The court found that the injury did not arise out of and in the course of employment and was therefore not compensable under Missouri workers' compensation law.

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Caption

FINAL AWARD DENYING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 07-000315

Employee: Vannessa Crumpler

Employer: Wal-Mart Associates, Inc.

Insurer: American Home Assurance

Date of Accident: Alleged January 5, 2007

Place and County of Accident: Alleged Springfield, Greene 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 May 12, 2008, and awards no compensation in the above-captioned case.

The award and decision of Chief Administrative Law Judge Victorine Mahon, issued May 12, 2008, is attached and incorporated by this reference.

Given at Jefferson City, State of Missouri, this 17th day of October 2008.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

Alice A. Bartlett, Member

John J. Hickey, Member

Attest:

Secretary

Employee:Vanessa CrumplerInjury No.: 07-000315
Dependents:N/ABefore the DIVISION OF WORKERS’ COMPENSATION
Employer:Wal-Mart Associates, Inc.Department of Labor and Industrial
Additional Party:N/ARelations of Missouri
Jefferson City, Missouri
Insurer:American Home Assurance
Hearing Date:April 8, 2008Checked by: VRM/MB

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? No.
  2. Was the injury or occupational disease compensable under Chapter 287? No.
  3. Was there an accident or incident of occupational disease under the Law? No.
  4. Date of accident or onset of occupational disease: Alleged January 5, 2007.
  5. State location where accident occurred or occupational disease was contracted: Springfield, Greene 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? No.
  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 occurred or occupational disease contracted: Employee was working at the deli counter when she suffered a diabetic seizure.
  12. Did accident or occupational disease cause death? No. Date of death? N/A.
  13. Part(s) of body injured by accident or occupational disease: Employee claims no Permanent Partial Disability.
  14. Nature and extent of any permanent disability: None.
  15. Compensation paid to-date for temporary disability: None.
  16. Value necessary medical aid paid to date by employer/insurer? None.
  1. Value necessary medical aid not furnished by employer/insurer? None.
  2. Employee's average weekly wages: $\ 338.00.
  3. Weekly compensation rate: $\ 225.33.
  4. Method wages computation: Stipulation.

COMPENSATION PAYABLE

  1. Amount of compensation payable: None.
  2. Second Injury Fund liability: None.
  3. Future requirements awarded: None.

FINDINGS OF FACT and RULINGS OF LAW:

Employee: Vanessa Crumpler

Injury No.: 07-000315

Dependents: N/A

Employer: Wal-Mart Associates, Inc.

Additional Party: N/A

Insurer: American Home Assurance

Hearing Date: April 8, 2008

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

Checked by: VRM/MB

INTRODUCTION

The parties appeared before the undersigned Administrative Law Judge for a Final Hearing on April 8, 2008, in Springfield, Greene County, Missouri. Venessa Crumpler (Employee) appeared in person and by attorney Randy Alberhasky. Wal-Mart Associates, Inc., and its insurer, American Homes Assurance (Employer), appeared by its counsel Jerry Harmison. The Second Injury Fund is not a party to this proceeding. Employee seeks payment of a medical bill in the amount of $\ 3,154.38. Employee seeks no Permanent Partial Disability, no Temporary Total Disability, or other benefits. Employee also seeks costs pursuant to § 287.560 RSMo Cum. Supp. 2005, due to the Employer's alleged unreasonable refusal to provide reimbursement for medical care. Employer has filed a motion for sanctions, citing § 287.560 RSMo 2000 and § 287.128 RSMo Cum. Supp. 2005. Employer alleges that the claim is fraudulent. Both motions are made a part of the Legal File.

STIPULATIONS

  1. Employee Vanessa Crumpler was an employee of Wal-Mart Associates, Inc., on January 5, 2007, and was working on that date.
  2. On January 5, 2007, Wal-Mart Associates, Inc., was an Employer within the meaning of the Workers'

Compensation Law and was fully insured by American Home Assurance.

  1. Both Employee and Employer were operating under and subject to the Missouri Workers' Compensation Law on January 5, 2007.
  2. Employee provided notice of her alleged accident and her claim was filed timely.
  3. The alleged accident occurred in Springfield, Greene County, Missouri. Jurisdiction and venue are appropriate.
  4. Employee's average weekly wage was $\ 338.00, yielding a Temporary Total Disability and Permanent Partial Disability rate of $\ 224.33. Employee, however, seeks no weekly disability benefits.
  5. No medical or weekly benefits have been paid as of the date of the hearing.

ISSUES

  1. Did Employee sustain an accident arising out of and in the course of her employment?
  2. Did Employee sustain an injury that is medically and causally related to her work?
  3. Is Employer liable for past medical expenses in the amount of $\ 3,154.38 ?
  4. Is either party entitled to costs as a result of an unreasonable or fraudulent defense or prosecution?

EXHIBITS

Admitted Exhibits Offered by Employee:

A. Medical Records - Cox Medical Center

B. Medical Bills - Cox Medical Center

C. Claim for Compensation

D. Answer filed by Employer

E. Attorney Contract

F. Litigation Expenses

Admitted Exhibits Offered by Employer:

  1. Deposition - Vennessa Crumpler
  2. Request for Hearing

FINDINGS OF FACT

Employee has been a diabetic for 15 years and is insulin dependent. On January 5, 2007, Employee suffered an incident in which her blood sugar dropped too low. She collapsed at work, became unconscious, lost bladder control, and was shaking and foaming at the mouth. A customer, who also was a paramedic, called 911. Over the objections of her husband, Employee was transported to a nearby hospital where she was treated and released later that evening. Employee returned to work five days later with no additional injuries or disability. Employee seeks only reimbursement of the medical expenses she incurred on January 5, 2007, including the ambulance ride to the hospital.

Employee asserts that she is entitled to reimbursement of her medical expenses because 1) neither she or her husband requested any medical treatment; 2) Wal-Mart management authorized the medical treatment and assured Employee's husband that the bills would be paid; and 3) Employee suffered the diabetic episode only after Employer altered her work schedule and then refused to allow her to take her lunch break when necessary.

There is no dispute that when Employee first began working for Wal-Mart she had steady work hours, beginning and ending at the same time each day. When there was a change in management, Employee's hours were altered. But Charlotte Campbell, the lead Deli person, dispelled any notion that Employee's work schedule was erratic. Ms. Campbell explained that Employee normally worked days and her start time could fluctuate by an hour. Employee was required to take a lunch break within six hours and she additionally was provided two breaks, during which she could also eat. Employee admitted that even when she had a set work schedule, she had problems controlling her diabetes and previously had suffered a diabetic event while at work.

Employee began work at 6:00 a.m. on the morning of January 5, 2007. She would have been scheduled to take her lunch by Noon. Shortly before Noon, Employee advised her supervisor that she needed to eat something. Her supervisor, Charlotte Campbell, said that Employee could go to lunch as soon as her co-worker returned from her break, which was in about 15 minutes. Employee testified by deposition that, if her blood sugar is too low, she could eat a piece of candy to remedy the situation. Prior to Noon, Employee collapsed-without having made it to her lunch break.

Ms. Campbell said she observed Claimant on the floor, unconscious, jerking and shaking, with foam coming from her mouth. Employee had lost control of her bladder. A customer who was an off-duty paramedic came into the Deli area to tend to Employee. Ms. Campbell then called a "Code White" over the store intercom to alert the store's management that there was a medical emergency.

Despite conflicting testimony, Charlotte Campbell credibly testified that she did not initiate a call to Employee's mother or anyone else outside of the Wal-Mart store. Ms. Campbell did answer the telephone in the Deli area and spoke with Employee's husband who was on the other end of the phone line. Ms. Campbell did not assure Employee's husband or anyone else that Wal-Mart would pay for any medical bills. Ms. Campbell knew she had no authority to authorize any medical bills.

Shirley Piggott, an assistant manager in charge of safety, heard the "Code White" and responded to the Deli with other managers. She observed Employee who was incoherent, had lost control of her bodily functions, and was foaming from her mouth. It was Ms. Piggott who contacted Employee's mother and asked that she contact Employee's husband. Ms. Piggott did not call 911. As a result of the 911 call made by the customer/paramedic, an ambulance arrived about the same time that the store's management had arrived in the Deli. This also was about the same time that Employee's husband was on the phone with Charlotte Campbell.

When Ms. Campbell received the phone call in the Deli, she spoke briefly to Employee's husband and then handed the telephone to a paramedic who was attending to Employee. Employee's husband attempted to direct his wife's medical care and asked the paramedic not to transport his wife to the hospital; but the ambulance paramedic ignored the husband's request. The paramedics made the decision to transport Employee to the hospital. The personnel from Wal-Mart did not make the decision to transport Employee to the hospital.

Like Ms. Campbell, I find, based on all of the evidence, that Ms. Piggott also did not assure Employee's husband that Wal-Mart would pay any bills. While there were other managers on the scene in the Deli after Employee had collapsed, there is no credible evidence identifying any one of these other managers as having assured Employee's husband or mother that medical bills would be paid by Wal-Mart.

Employee still was incoherent when she left the store. Employee's mother stated that she, also, asked that her daughter not be sent to the hospital. Employee's mother, however, did not know that her daughter had lost bladder control or was foaming at the mouth.

Employee did not have health insurance because she did not believe she could afford the insurance premium. It was for this reason that Employee's husband did not want Employee taken to the hospital and incur expenses for what he believed was a minor incident. Employee's husband had been a diabetic and was familiar with the treatment for his wife's condition. While he testified that he believed the whole incident was ridiculous, he admitted that when he arrived at the hospital his wife still was unconscious. Even though he personally attempted to administer some sugar to his wife, she would not cooperate. Employee's husband admitted that t

Full decision text continues in the plain-text archive copy.

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