Decision date: January 27, 200910 pages
Summary
The Commission affirmed the Administrative Law Judge's decision awarding no compensation in case 05-049495 but awarding benefits in case 05-142896 for a left ankle injury sustained while assisting a patient on December 13, 2005. The employee received $775.00 in medical bills and $2,524.25 for permanent partial disability (7.5% ankle at 155 week level) in the compensable case.
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| Employee: | Stacy Vernon |
| Employer: | Cedar Hill Manor |
| Insurer: | Missouri Nursing Home Insurance Trust |
| c/o T/P/A Maxim Insurance Solutions, L.C. | |
| Additional Party: | Treasurer of Missouri as Custodian |
| of Second Injury Fund | |
| Date of Accident: | April 13, 2005 |
| 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 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 July 18, 2008, and awards no compensation in the above-captioned case.
The award and decision of Administrative Law Judge Lawrence Kasten, issued July 18, 2008, is attached and incorporated by this reference.
Given at Jefferson City, State of Missouri, this 27th day of January 2009. LABOR AND INDUSTRIAL RELATIONS COMMISSION
William F. Ringer, Chairman
Alice A. Bartlett, Member
John J. Hickey, Member Attest:
Employee: Stacy Vernon
Injury No. 05-049495 \& 05-142896
Dependents: N/A
Employer: Cedar Hill Manor
Additional Party: Second Injury Fund
Insurer: Missouri Nursing Home Insurance Trust c/o T/P/A Maxim Insurance Solutions, L.C.
Appearances: Daniel Gauthier for the employee
Patrick Reidy for the employer-insurer
Hearing Date: Commenced March 12, 2008
Completed April 18, 2008
- Are any benefits awarded herein? Yes in 05-142896 (December 13, 2005)
No in 05-049495 (April 13, 2005)
- Was the injury or occupational disease compensable under Chapter 287? Yes: 05-142896
No: 05-049495
- Was there an accident or incident of occupational disease under the Law? Yes: 05-142896
No: 05-049495
- Date of accident or onset of occupational disease? December 13, 2005- 05-142896
N/A: 05-049495
- State location where accident occurred or occupational disease contracted: Jefferson County, Missouri: 05142896 N/A: 05-049495
- Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes in both cases.
- Did employer receive proper notice? Yes in both cases.
- Did accident or occupational disease arise out of and in the course of the employment? Yes in 05-142896 No in 05-049495.
- Was claim for compensation filed within time required by law? Yes in both cases.
- Was employer insured by above insurer? Yes in both cases.
- Describe work employee was doing and how accident happened or occupational disease contracted: N/A in 05049495. The employee twisted her left ankle assisting a patient in 05-142895.
- Did accident or occupational disease cause death? No in both cases.
- Parts of body injured by accident or occupational disease: N/A in 05-049495. Left ankle in 05-142895.
- Nature and extent of any permanent disability: N/A in 05-049495. 7.5\% of the ankle at the 155 week level in 05-142896.
- Compensation paid to date for temporary total disability: None in either case.
- Value necessary medical aid paid to date by employer-insurer: \$1,107.19 in 05-049495. None in 05-142896.
- Value necessary medical aid not furnished by employer-insurer: None in 05-049495. \775.00 in 05-142896.
- Employee's average weekly wage: \ 325.71 in both cases.
- Weekly compensation rate: $\ 217.14 in both cases.
- Method wages computation: By agreement.
- Amount of compensation payable: 05-049495: None
05-142896: \ 775.00 in medical bills.
Total \ 2,524.25 for permanent partial disability.
- Second Injury Fund liability: None. Second Injury Fund Claim in each case was denied.
- 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 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 the following attorney for necessary legal services rendered to the claimant: Dan Gauthier.
On March 12, 2008, the employee, Stacy Vernon, appeared in person and by her attorney, Daniel Gauthier, for a hearing for a final award. The employer-insurer was represented at the hearing by its attorney, Patrick Reidy. The employee's claims against the Second Injury Fund were left open. 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:
- In both cases the employer, Cedar Hill Manor was operating under and subject to the provisions of the Missouri
Workers' Compensation Act and was duly qualified as a self-insured employer through the Missouri Nursing Home Insurance Trust c/o T/P/A Maxim Insurance Solutions, L.C.
- On April 13, 2005 and December 13, 2005, Stacy Vernon was an employee of Cedar Hill Manor and was working under the Workers' Compensation Act.
- On December 13, 2005 the employee sustained an accident arising out of and in the course of her employment.
- The employer had notice of the employee's accident on December 13, 2005 and the employee's alleged accident on April 13, 2005.
- The employee's claims were filed within the time allowed by law.
- In both cases, the employee's average weekly wage was $\ 325.71. The rate of compensation is $\ 217.14 per week.
- The employee's injury was medically causally related to the December 13, 2005 accident.
- The employer-insurer paid a total of $\ 1,107.19 for the alleged April 13, 2005 accident (Injury Number 05049495).
- The employer-insurer has not paid any medical expenses in the December 13, 2005 case (Injury number 05142896).
- The employer-insurer has not paid any temporary disability in either case.
- Accident in injury number 05-049495 (Alleged April 13, 2005 accident).
- Medical causation in injury number 05-049495 (Alleged April 13, 2005 accident).
- Claim for previously incurred medical benefits in injury number 05-049495 (Alleged April 13, 2005 accident).
- Claim for previously incurred medical benefits in injury number 05-142896 (December 13, 2005 accident).
- Nature and extent of permanent partial disability in injury number 05-049495 (Alleged April 13, 2005 accident).
- Nature and extent of permanent partial disability in injury number 05-142896 (December 13, 2005 accident).
The following exhibits were offered and admitted into evidence:
Employee's Exhibits
- Medical report of Dr. Volarich
- St. John's Hospital bill in the amount of \$1,039.25 for injury number 05-049495 (Alleged April 13, 2005 accident).
- Medical records from St. John’s Hospital in injury number 05-049495 (Alleged April 13, 2005 accident.)
- St. Anthony’s Medical Center bill in the amount of $\ 775.00 for Injury Number 05-142896 (December 13, 2005 accident).
- Medical records from St. Anthony’s Medical Center in injury number 05-142896 (December 13, 2005 accident).
- Concentra medical records for injury number 05-049495 (Alleged April 13, 2005 accident).
- Report of injury in injury number 05-049495 (Alleged April 13, 2005 accident).
Judicial notice of the contents of the Division's files was taken.
Witness: Stacy Vernon, the employee
At the hearing, the employee amended her claim by interlineation in injury number 05-049495 changing the date
of the alleged accident to April 13, 2005. At the hearing, the employer-insurer filed an amended Answer to Claim for Compensation in injury number 05-049495.
The employee filed an amended claim with the Division on March 12, 2008 in injury number 05-142896, the December 13, 2005 accident. The record was left open for the employer-insurer to file an amended Answer to the Claim for Compensation in injury 05-142896. The amended Answer was filed with the Division on April 18, 2008, and the record was closed.
Briefs: The employee's brief was received on March 24, 2008. The employer-insurer's brief was received on April 2, 2008 .
The employee testified that she had an accident at approximately 6:15 p.m. on April 13, 2005. A co-employee had a 300 pound resident in a shower chair. The shower chair broke and the co-employee called for help. The employee testified that she went into the shower room and helped hold up the broken shower chair in a squatting position with her left knee under the shower chair to brace it and her right leg was behind her and was pushed back up by the door to brace herself. A third employee got a hoyer lift to get the resident out of the broken chair. After the resident was situated, the employee walked out of the room, went about 4 steps, her right leg gave out and she fell to the floor. She had a bad strain feeling,
The employee testified that she reported her injury to charge nurse, Lucinda Brands who called Kim Craig the Director of Nursing. The employee spoke to Ms. Craig. Ms. Craig told the employee to get medical where she needed to go. Due to the pain, the employee could not drive and the employee's mother in law picked her up and took her to St. John's Emergency Room.
The employee testified that on April 14, she filled out an incident report with Shelia Huskey, the administrator. Ms. Craig also filled out paperwork but the employee has not seen what she had filled out. The employee testified that she was truthful with Ms. Craig on how the injury happened.
The report of injury filed by the employer for the alleged April 13, 2005 accident was prepared by Ms. Craig. In the space that listed specific activity the employee was engaged in when the accident occurred, listed was "walking down the hall". In the space that listed work process the employee was engaged in when the accident occurred listed was "getting items for O2 concentration". In the space that listed the equipment, material or chemicals the employee was using when the accident occurred, listed was "none". In the space that listed the sequence of events and to include any objects or substances that directly injured the employee listed was "none".
The employee testified when she was at St. John's Mercy she was truthful regarding how the injury happened.
The employee went to St. John's Mercy Hospital emergency room on April 13, 2005, and saw Dr. Judge for right leg pain. In the history, it stated that the employee was walking at work and had the acute onset of right leg pain in the inner aspect of her right thigh. She denied any other known precipitating factors. On exam, the employee pointed to the inner aspect of the right thigh as the area of pain. Dr. Judge did not see any soft tissue swelling or deformity. X-rays of the pelvis, hip and femur were negative. The employee was diagnosed with a right thigh muscle strain. The nurse's note in the chief complaint and history stated that the employee had right groin pain that radiated down the right leg with no known trauma.
The employee testified that she had not reviewed the medical records from St. John's which show that the employee was walking at work and had the acute onset of right thigh pain and denied any other known precipitating factors. The employee testified that she did not tell the physician that.
The employee testified that she was truthful and accurate with Dr. Homan and the physical therapist at Concentra regarding how the injury happened.
The employee saw Dr. Homan on April 14, 2005 for her right leg and reported that her injury was on April 13. The patient's statement was 'I was walking down hall right leg gave, I couldnt put and weight on it ended up on left knee when tried to get back up I felt extreme pulling and trigger of pain. Instead of relaxing I help transfer residents
Full decision text continues in the plain-text archive copy.
February 21, 2020#10-020815
The Missouri LIRC affirmed the Administrative Law Judge's final award denying all workers' compensation benefits to Janet K. Scott for a left ankle injury sustained on March 16, 2010, while inspecting parts at her workplace. Although the injury was found to be work-related and compensable under Missouri law, no benefits were awarded because the claim was not filed within the time required by law.
March 7, 2018#14-093366
The Commission affirmed the Administrative Law Judge's award allowing workers' compensation for an employee who suffered a right ankle injury while attempting to escape after being locked inside the employer's courtyard at the end of his shift. The Commission concluded that the employee's injuries arose out of and in the course of employment, as his activities were sufficiently incidental to his work, and provided supplemental analysis regarding the 2005 legislative changes to Missouri Workers' Compensation Law.
January 30, 2018#11-001987
The Labor and Industrial Relations Commission affirmed the Administrative Law Judge's decision denying all workers' compensation benefits for Gary Page's left ankle injury that occurred on January 12, 2011. Although the injury arose out of and in the course of employment, it was determined to be non-compensable under Missouri workers' compensation law.
May 3, 2017#14-063533
The Commission affirmed the Administrative Law Judge's award of workers' compensation to employee Kay Brown for an ankle injury sustained on August 21, 2014, when her foot became stuck under a rolling cabinet while performing work duties. The Commission found that Brown's injury arose out of and in the course of her employment and rejected the employer's credibility challenges regarding her account of the accident.
March 3, 2017#12-042672
The Labor and Industrial Relations Commission modified the administrative law judge's award, adopting most findings while addressing the admissibility of Dr. Stillings' medical report and determining permanent partial disability percentages for a right ankle injury sustained on June 6, 2012. The employee was awarded 35% permanent partial disability to the right ankle and 2% permanent partial disability of the body as a whole for psychiatric/psychological injuries causally related to the work accident.