Claimant filed a Claim for Compensation on December 14, 2001, alleging on or about December 11, 2001, he contracted an occupational disease from working for years as a welder and due to the inhalation of fumes, developed occupational asthma. On June 11, 2003, Claimant filed a claim against the Second Injury Fund alleging permanent total disability based upon a combination of his occupational asthma and his preexisting injuries of bilateral knees, low back, body as a whole - allergic rhinitis, and body as a whole GERD.
Claimant is a 64 year old man with a high school education, with training in welding and blue print reading. Claimant has worked as a welder since high school, with the exception of approximately five years where he worked in other labor positions. As a welder, Claimant used his hands to weld, cut and grind metals. When he welded metals, Claimant was exposed to welding fumes continually throughout the day. He worked without breathing devices, and the ventilation was poor.
Claimant began working for Employer in 1993, and worked there until December 28, 2001, when the plant closed. Claimant worked as a welder in an enclosed building, with no exhaust system. Claimant worked in a booth with a steel sheet as a curtain, and a small fan. There were one or two other welders performing the same job as Claimant. In addition to the fumes produced by welding metals, Claimant also breathed in paint fumes from spray painters. Claimant was exposed to smoke from oil and grease that arose after he applied heated torches to metals containing oil and grease. Employer had a breathing device available for Claimant to use, but it wouldn't fit under his hood, so he was unable to use it. The last couple of years of his employment Employer provided him with a breathing device.
Before December 19, 1998, Claimant had occasional wheezing, but had never been diagnosed with asthma. He was a smoker with a family history of asthma. On December 19, 1998, Claimant was exposed to a fire at work which was ignited by his welding tools. Claimant initially tried to put the fire out himself, and in the process inhaled smoke and fumes. He was treated at the emergency room at St. Louis University Hospital, where he was diagnosed with smoke inhalation, was prescribed Albuterol, and was told to follow up with Health Line.
Claimant followed up with HealthLine on January 5, 1999, and was diagnosed with smoke inhalation which had resolved, and was released to work without restrictions. Claimant returned to HealthLine on March 9, 1999, complaining of shortness of breath and wheezing. Claimant was referred for a pulmonary evaluation.
In March 1999, Claimant began treating with the Pulmonary Clinic at SLU Hospital. Pulmonary Function Tests performed in April 1999 were consistent with moderately severe obstructive airway disease with significant response to bronchodilators. Claimant was diagnosed with mild persistent asthma/reactive airway disease. Between 1999 and December 2001, Claimant's condition continued to deteriorate. In early 2001 Claimant had multiple episodes of exacerbation of his bronchial asthma. On November 28, 2001, Claimant was examined by Dr.
Garcia at the Pulmonology Department. Dr. Garcia diagnosed COPD secondary to tobacco abuse/mild persistent asthma.
Claimant returned to the Pulmonary Clinic in April 2002. Claimant was no longer working, and indicated he had applied for disability. He was diagnosed with mild persistent asthma, which Dr. Garcia did not believe precluded Claimant from working. In July 2002, Claimant reported to the Pulmonology clinic and Dr. Garcia indicated it was Claimant's seventh visit so far that year. Claimant continued to report daily exacerbations of his asthma, and he reported daily wheezing. Dr. Garcia indicated he previously classified Claimant as having mild persistent asthma, but noted his asthma had definitely gotten worse over the years, with seven visits to the office, and at least one visit to the emergency room over the past six months. Dr. Garcia diagnosed Claimant as having severe persistent asthma. In November 2002, Dr. Kleinhenz, expressed dismay Claimant's claim for Social Security Disability was denied, and reiterated Claimant had severe persistent asthma with a moderate to severe obstructive ventilator impairment. She stated Claimant had extreme airway responsiveness which was uncontrolled in the face of inhaled bronchodilators, oral and inhaled corticosteroids, and oral immunomodulating drugs. Claimant continued to treat for severe persistent asthma in 2003.
After leaving Employer, Claimant attempted to work as a welder for another employer, but only worked there three to five weeks because he was having too many breathing problems. Claimant's breathing has continued to worsen since leaving Employer. Claimant is unable to sleep, and wakes up coughing. He has difficulty performing household chores. If Claimant cuts his grass, it takes him four hours to do what used to take him one and one-half hours to do. He is no longer able to participate in sports. He used to play semi-professional baseball, football and basketball. He has difficulty climbing a flight of stairs, and lifting and carrying items.
Claimant has some preexisting injuries. He injured his right ankle and knee sliding while playing baseball. He never had surgery, and had no ongoing medical treatment or medical restrictions with regard to his right ankle or knee. He had a sore arm from throwing in baseball. Claimant also injured his back moving a part in 1999, and was treated conservatively. Claimant testified he had pain and cramping in his hands beginning in 1997 and 1998, and was diagnosed with carpal tunnel syndrome in 2005. Claimant testified he sometimes had trouble holding things, and had to make adjustments at work. Although Claimant had a back problem, and his shoulders, neck, back, hands and legs hurt, he didn't miss any days from work, and he had no permanent restrictions.
After the 1998 fire, Claimant made adjustments in his work. After Claimant left his last job he collected unemployment benefits. Claimant has received no unemployment benefits since April 1, 2003, and has not worked since that time.
Dr. Robert Poetz evaluated Claimant on two occasions, and testified on behalf of Claimant. Dr. Poetz first examined Claimant on August 27, 2002. Dr. Poetz diagnosed occupational asthma due to inhalation of fumes and other irritants, which progressed to chronic pulmonary disease on December 11, 2001. He also diagnosed Claimant as steroid dependent, December 11, 2001; right shoulder adhesive tenosynovitis, 1999; degenerative joint disease
bilateral knees, preexisting; allergic rhinitis, preexisting; and gastroesophageal reflux disease, preexisting. Dr. Poetz provided the following ratings: 70% PPD of the body as a whole measured at the lungs directly resulting from the December 11, 2001 work related injury; 20% PPD of the right shoulder preexisting; 25% PPD of the right and left knees preexisting; 15% PPD of the body as a whole at the lumbar spine, preexisting; 10% of the body as a whole due to allergic rhinitis, preexisting, and 15% PPD of the body as a whole due to gastroesophageal reflux disease, preexisting. Dr. Poetz opined Claimant is permanently and totally disabled, as a result of the combination of his occupational injury and his preexisting conditions, and is unemployable in the open labor market.
Dr. Poetz re-evaluated Claimant on March 7, 2008. Dr. Poetz increased Claimant's ratings for his preexisting lumbar spine condition to 25% of the body as a whole, and rated Claimant's preexisting cervical spine condition at 15% PPD of the body as a whole. The remaining ratings remained the same as in his previous report. Although Dr. Poetz opined Claimant is permanently and totally disabled as a result of the combination of the December 11, 2001 work related injury and his preexisting conditions, he stated: "However, if absent the prior injuries and medical conditions and he was only suffering from the December 11, 2001 injury alone, he would still be permanently and totally disabled.
Mr. James England, a certified rehabilitation counselor evaluated Claimant on July 24, 2006, and testified on behalf of Claimant. Mr. England concluded considering Claimant's age, limited education and the combination of his impairments, he does not believe Claimant would be competitively employable. Mr. England did not believe Claimant would be able to successfully acquire or sustain employment due to his combination of problems.
Dr. Thomas Dew, a board certified internist and pulmonologist, testified on behalf of Employer. Dr. Dew examined Claimant on July 18, 2006. When Dr. Dew examined Claimant he had some wheezing in both lungs, and some airway obstruction despite the fact he had taken his medicine that day, which indicated he still had active ongoing asthma. At that time the only precipitating factor for Claimant's injury Dr. Dew could come up with was the fire in December of 1998. He testified Claimant had a family history of asthma, so he was probably pre-disposed to developing asthma, but since 1998, his asthma had been out of control. Dr. Dew labeled Claimant's condition as asthma occupationally induced by the fire. Dr. Dew stated neither his cigarette smoking nor his family history of asthma, caused him to have asthma, but may have been mild precipitating factors, but the big precipitating factor was the fire in his place of employment in 1998, and the fact that he did not get good treatment early. He stated he thought Claimant was totally disabled from bronchial asthma which was related to the industrial fire in 1998.
Dr. Dew was unable to determine when Claimant became totally disabled, but testified that 2003 or 2004, when Claimant was found to be totally disabled by the Social Security Administration was as close as he could come to providing a date.
After opining Claimant was totally disabled as a result of the fire of 1998, Employer's attorney provided Dr. Dew with additional medical records to review. After reviewing those
records Dr. Dew continued to believe Claimant was totally disabled based upon his bronchial asthma, and not taking into account his other injuries. Dr. Dew, testified his opinion has been consistent that Claimant had a family history of asthma, Claimant had been asymptomatic, something happened in late 1998 where he started having more trouble with his asthma, and the disease got worse and worse. Dr. Dew testified welding can be a cause of occupational asthma, and in his opinion Claimant's work activity of welding was a significant contributor to his asthma. Dr. Dew testified it is possible to develop asthma from welding almost any metal compound. Although Dr. Dew did not believe Claimant had welder induced asthma, he believed once Claimant's asthma was precipitated, the welding added to his ongoing disability, and Claimant's welding from 1998 until 2001 was a substantial aggravating factor to his asthma.