The parties presented evidence at a hearing on March 15, 2010. Only one issue was presented for determination: The liability of the Second Injury Fund.
The parties agreed that claimant's workers' compensation rate was $\ 193.33 per week.
At the time of the hearing claimant was 59 years old. He has a sixth grade education. For most of his life, claimant was a truck driver. For 25 to 30 years he drove as an over-the-road trucker. Claimant was employed by Transport Distribution Company on May 18, 2005. On that date, claimant sustained an injury when he fell while strapping down a load on a flatbed trailer. He had one foot on a ladder and one foot on the flatbed as he was reaching for a strap. The ladder came out from underneath him; and he fell about four feet, hitting his right buttocks, his back, and his head. Claimant received physical therapy for his injury. He was treated by Dr. Estep of Occumed in Joplin. Dr. Estep fully released claimant on August 26, 2005, noting a left bicep shoulder strain which was resolving and a right knee strain that had resolved. Dr. Estep provided no restrictions for claimant. Prior to Dr. Estep's release, the physical therapist recommended releasing claimant from physical therapy on July 30, 2005, while noting claimant still had some mild tenderness along the bicep tendon and mild tenderness along the medial right knee. Dr. Estep noted that claimant was back at his normal job without difficulty and was doing quite well. However, claimant returned to Dr. Estep on September 23, 2005. Dr. Estep noted that claimant had twisted his knee after a coworker bumped into him. Dr. Estep diagnosed a left knee MCL sprain, but he returned claimant to full duty. Dr. Estep also noted that claimant had been initially seen for an earlier left shoulder and a right knee injury as well as right knee pain, cervical strain, and groin strain in May.
Claimant testified that he continued to work for Transport Distribution Company following his May 2005 injury, albeit driving a tractor while pulling a "box trailer" as opposed to pulling a flatbed trailer. He continued to work until he received a ticket for driving under the influence. Claimant lost his commercial drivers' license and could not be employed as a truck driver. Thereafter, as a result, of the loss of his license, claimant was fired from his job with Transport Distribution Company. Claimant testified that he was able with some difficulty to perform his job as a truck driver up and to the time that he received his DUI and was fired.
After claimant was fired from his job Transport Distribution Company, he applied for and received unemployment benefits for 26 weeks. He then applied for a job at O'Sullivan Industries through Manpower and began working for Manpower at O'Sullivan. While working at O'Sullivan on September 15, 2006, on a production line, claimant had to lift four to five foot doors. He pivoted, and his left foot got caught between two pallets, thereby twisting his knee. Claimant was treated by Dr. Eric Miller on the date of his injury, claimant continued to treat with Dr. Miller through October 9, 2006. On October 9, 2006, Dr. Miller noted that claimant was feeling better. Dr. Miller noted his impression that claimant had a left MCL stress. There is nothing in the record indicating any continuing treatment for claimant's left knee injury following his last visit with Dr. Miller.
However, claimant continued to complain of his left shoulder injury when he was examined by Dr. David Rogers, an orthopedic surgeon, on March 1, 2007. Dr. Rogers opined that claimant had a partial thickness rotator cuff tear after reviewing an MRI. He noted that claimant had a probable superior labral tear and a subacromial impingement along the degenerative joint disease of the acromial clavicular joint.
Claimant also underwent an evaluation by Dr. Timothy L. Sprenkle for the Missouri Department of Elementary and Secondary Education Section of Disability Determinations. Dr. Sprenkle noted that claimant's chief complaints were "diffuse back pain, left shoulder pain, knee and hip pain, diffuse arthralgias, mild sleep apnea, hyperlipidemia." Dr. Sprenkle found that claimant had the following conditions:
1) Diffuse polyarthralgia with weakness, unexplained.
2) Possible early upper extremity bilateral carpal tunnel syndrome secondary to obesity.
3) Fibromyalgia. He exhibits several points of subcutaneous tissue tenderness.
4) Premorbid obesity.
5) Mild endogenous depression.
6) Degenerative joint disease.
7) Tension headaches.
8) Extremely poor vision.
9) Hyperlipidemia.
Apparently Dr. Sprenkle's assessment for claimant on June 20, 2007, involved an assessment of claimant so that he could obtain bariatric surgery to lose weight. Claimant subsequently obtained that surgery and has lost weight from 360 pounds to 190 pounds.
Claimant has had no surgery for any of his conditions. At the time of the hearing he was taking no prescriptive medication. However, claimant testified that every other day he takes approximately 16 to 18 Ibuprofen (without listing the size of the Ibuprofen.) Claimant testified that he would use some pain pills he received for dental pain for his other problems and that in the past he had borrowed pain medications from friends.
Claimant obtained the services of Dr. P. Brent Koprivica, an occupational medical specialist. Dr. Koprivica examined claimant, wrote two reports, and testified by deposition. Dr. Koprivica rated claimant's disability as 5 percent to the body as a whole for chronic thoracic pain, 15 percent to the left upper extremity at the 232 week-level for claimant's chronic impingement syndrome, and 10-15 percent to the body as a whole for chronic mechanical back pain. He combined those disabilities globally for a 30 percent permanent partial disability to the body as a whole for all injuries sustained on May 19, 2005. Dr. Koprivica also rated claimant's disability from the September 15, 2006, injury. He found that
claimant sustained a 15 percent permanent partial disability to the left lower extremity at the level of the knee ( 160 week-level) for that injury. Dr. Koprivica further opined that claimant had a 10 percent enhanced permanent partial disability based upon a combination of the two injuries. Dr. Koprivica also recommended that claimant be assessed vocationally.
Claimant obtained the services of Philip Eldred, a vocational rehabilitation counselor, who opined that claimant was permanently and totally disabled vocationally and that claimant could not be expected to be employed or placed in the open market nor would any reasonable employer be expected to hire claimant. Nevertheless, Mr. Eldred found that claimant could perform a very limited number of sedentary jobs even though he believed that Dr. Koprivica's restrictions would place claimant in the less-than-sedentary work capacity.
The Second Injury Fund obtained the services of James England, a vocational rehabilitation counselor, who opined that claimant was not permanently and totally disabled vocationally and that there were a limited number of jobs that claimant could perform under the restrictions provided by Dr. Koprivica.
Dr. Koprivica placed significant restrictions upon claimant's activities. In his September 9, 2008, report Dr. Koprivica set out the restrictions he imposed on claimant as follows:
In terms of ongoing activities, a number of the complaints at this point are subjective in nature.
Nevertheless, with the mechanical complaints that he continues to have, particularly the complaints invol