Claimant is a 47 year old man who is currently unemployed. After graduating from high school, Claimant enlisted in the United States Navy, and served 18 months before receiving an honorable discharge. After serving in the Navy, Claimant returned to Missouri, where he performed heavy labor in a factory. In 1987, Claimant took a job as a prison guard, but was involved in a serious motor vehicle accident in which he sustained a right fractured femur and tibia/fibula which required multiple surgeries and hospitalizations, and required extensive internal fixation hardware. As a result of these injuries, Claimant received Social Security Disability benefits for 7 years. After his accident, Claimant could no longer run or kneel, ride a bicycle or walk distances. He walked with a limp, and had difficulty climbing ladders, and in and out of trucks.
In approximately 1994, after receiving additional education in the field of electronics, Claimant rejoined the work force, and eventually found work as a truck driver. In 1995, Claimant was injured in a tornado, and broke 4 ribs. Following that accident, Claimant had aching with weather changes.
Claimant had a prior low back injury in which he had a crushed L-5 vertebrae. Claimant continued to have stiffness in his lower back that has worsened with age.
In approximately 1999, Claimant injured his left knee at work. He filed a workers’ compensation claim which he settled for 15% of his left knee. After being released from treatment, Claimant’s knee was sore, especially with weather changes.
In approximately 1999, Claimant injured his right shoulder at work. Claimant sustained a rotator cuff tear for which he received therapy. Following his shoulder injury, Claimant had difficulty working overhead, and climbing in and out of trucks.
Before working for Employer, Claimant had no problems with either hand. He had some stiffness in his neck before working for Employer, and sought some chiropractic treatment. He sprained his neck in approximately 1990, but it cleared up. Claimant had no treatment for his neck since approximately 2001.
In 2001 Claimant began working for Employer as a truck driver. His duties included Driving an 18 wheel tractor trailer. His load consisted of 2000 to 4000 pounds of paper. Claimant made local deliveries within 60 miles of St. Louis. Claimant made between 10 and 15 deliveries a day. Although Claimant testified he worked 40 to 80 hours a week including a lot of overtime, Claimant's Exhibit J reflects Claimant worked between 32 and 54.85 hours in the 13 weeks preceding the primary injury.
On July 6, 2005, Claimant was driving a tractor trailer on Highway 100 in Franklin County, near Washington, Missouri. Claimant was stopped in traffic, while a vehicle in front of him attempted to make a left hand turn. Claimant was leaning over attempting to light a cigarette, when he felt a big jolt, and his glasses flew off his face and landed on the floor. Initially Claimant thought his load had shifted. He attempted to drive, but his truck stalled. He started the truck again and drove approximately 75 yards, when he realized a car had rear ended his vehicle and was stuck underneath his truck.
Claimant immediately contacted his Employer, and began to notice stiffness and soreness in his neck and back that afternoon. The next morning he had difficulty moving. When he returned to work, he asked for medical treatment, and was referred to Barnes Care.
On July 7, 2005, Claimant reported to Barnes Care complaining of neck, left shoulder, arm, and right forearm pain. Claimant reported feeling some tingling in his left hand, and reported awakening on the evening of the accident to use the bathroom and had bilateral numbness in his hands, which, at the time of his examination was bilateral tingling. Claimant complained of neck stiffness, and numbness/spasm in his left shoulder blade. Claimant reported a history of prior motor vehicle accidents with wrist, back, leg and some neck injuries. Claimant was released to work with restrictions of limited bending and twisting of his neck, and activities that required quick head/neck movements. Claimant was prescribed medication, and was released to full duty on July 18, 2005, but returned to Barnes Care on August 18, 2005, with complaints of increased numbness and tingling in his left upper extremity and "dropping things". Claimant was again released to full duty.
On August 8, 2005, Claimant was working. As he was cranking the handle on his truck, due to weakness in his hand, he lost his grip, and the handle came back and struck him in the face, knocking him to the ground. Claimant was treated at Barnes Care. An x-ray of Claimant's jaw was negative. Claimant was prescribed medication, and was released to work without restrictions.
Claimant returned to Barnes Care again on August 25, 2005, complaining of persisting numbness and tingling which came on after his work accident. A nerve conduction study performed on August 24, 2005 revealed carpal tunnel syndrome. Claimant was again returned to work without restrictions, and was released from treatment.
Claimant saw his personal physician, Dr. Warren on September 26, 2005, complaining of numbness in his hands, and neck stiffness. An MRI was performed on October 15, 2005, which revealed a small left lateral herniation at C3-4, a moderate left lateral disc herniation at C5-6, a moderate to large left lateral herniation at C6-7, and a tiny central disc herniation at C7-T1. Dr. Warren referred Claimant to Dr. Polinsky, a neurosurgeon.
Claimant saw Dr. Polinsky on October 24, 2005. Dr. Polinsky did not think Claimant's hand numbness was related to his cervical disc herniations, but suspected carpal tunnel syndrome.
Claimant returned to Dr. Warren in March 2006 complaining of neck and arm pain and numbness in both of his hands. Dr. Warren referred Claimant to Dr. Chapel to determine if his hand numbness was related to his neck or to carpal tunnel syndrome. Dr. Chapel thought Claimant's hand symptoms were related to his neck injury.
Claimant continued to request additional treatment from Employer which was denied. A hardship hearing was