Based on the testimony of Shelby Mays ("employee") and the medical records and reports admitted, I find as follows:
At the time of the hearing, the employee was 63 years old and has lived in Bloomfield, Missouri for several years. She went to school as far as the seventh grade, but had to quit at the age of thirteen in order to support herself. While in school, she took special education classes and her reading and grades were not very good. The employee later received her GED. Prior to working for the employer, the employee worked as a babysitter, housekeeper, clerk, waitress, cook, candy factory worker, and sewing machine operator. She began factory employment when she turned twenty years old. In 1988, she began employment with Arvinmeritor OE LLC ("employer"). When the employee first started, she worked in the muffler department as a spot welder, ran a turntable and packaged mufflers into containers. After some time, the employee transferred to the Y-Pipe department. There she ran machines and did whatever she was told to do. Over the years of employment with the employer, the employee worked in several capacities and departments including running machines, welding, office cleaning and office work.
On August 10, 1990, the employee saw Dr. August Ritter for a work injury to her left hand which included a partial amputation of the ulnar aspect of the distal phalanx of the long finger and had a nail bed avulsion and laceration nail bed, partial avulsion thumb. Following his treatment of the employee, Dr. Ritter rated the employee's impairment at twenty percent (20\%) of the long finger and five percent (5\%) of the thumb (Employee Exhibit A1, Pages 1-2).
The employee injured her right shoulder on July 28, 2000 while working for the employer. Following treatment with medication and physical therapy, Dr. Ritter diagnosed the employee with overuse rotator cuff tendonitis with adhesive capsulitis in her right shoulder. The employee underwent an MRI that did not show a tear but she continued to have problems with her right shoulder. On August 18, 2001, the employee underwent a right shoulder arthroscopy with subacromial decompression by Dr. Ritter. After noting that the employee should avoid repetitive overhead work, Dr. Ritter rated the employee at a seven percent (7\%) permanent partial disability of her right upper extremity at the level of the shoulder (Employee Exhibit A1, Pages 3-10). The employee later settled her claim against the employer for twenty-five (25\%)
permanent partial disability of her right upper extremity at the level of her shoulder (Employee Exhibit E).
Although the employee worked in an office setting for a long period following her right shoulder injury, she eventually returned to the plant floor where she was required to pull, push and lift pipes. On April 17, 2003, the employee's pain in her left shoulder finally increased to the point where she sought treatment for it. Following treatment with physical therapy and medicine, Dr. Ritter noted that the MRI dated June 24, 2003 showed a partial thickness tear, supraspinatus and bicep tendons on her left shoulder. Dr. Ritter performed a left shoulder arthoscopy with subacromial decompression on September 4, 2003. Shortly after the surgery, the employee began having left lateral elbow pain and Dr. Ritter diagnosed the employee with left elbow lateral epicondylitis. Despite the surgery and other treatment, the employee continued to have problems with both of her shoulders including bilateral upper shoulder pain that radiated to the left of her neck, bilateral hand numbness at night, and swelling in her hands and wrists. On January 19, 2004, Dr. Ritter opined that the employee's return to work should be with a long term restriction of no work above shoulder high and no prolonged reaching such as sweeping or raking. Following an FCE, Dr. Ritter noted on March 18, 2004 that the employee was unable to run a hyster and some other jobs, but opined that her present job as a sizer should be medically safe. Further, he opined that she should avoid repetitive above shoulder work on a long time basis and no lifting over 20 pounds. Dr. Ritter placed the employee at maximum medical improvement with regard to her bilateral shoulder tendonitis on August 26, 2004 and gave a rating of five percent (5\%) permanent partial disability of each shoulder (Employee Exhibit A1, Pages 11-20)(Employee Exhibit A2). The employee later settled her claim against the employer for twenty-five ( 25 % ) permanent partial disability of her left upper extremity at the level of her shoulder. Following that settlement, the employee settled her claim against the second injury fund for ( 25 % ) permanent partial disability of each of her upper extremities with a fifteen percent (15\%) load (Employee Exhibit D).
Despite her continued problems with her arms, the employee worked on the floor for the employer until March 3, 2005. At that time, the employee was operating a "sizer machine" and injured her back. The employee felt immediate pain in her back and down her lower extremities. The employee initially treated with Missouri Southern Healthcare. Following the MRI that indicated a bilateral lateral recess stenosis with a bulging annulus at L4-L5 and a moderate central disc protrusion at L5-S1, the employee underwent physical therapy from May 3, 2005 to June 30, 2005 (Employee Exhibit A4). The employee also began pain management on June 14, 2005 with Advanced Pain Centers. A post discogram CT was completed on December 13, 2005 and indicated a radial tear at L5-S1, disc filling an 8 mm central posterior protrusion, annular bulges of the L3-4 and L4-5 discs without a frank tear, and bilateral facet arthrosis at L3 through S