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Douglas Kaempfer v. G. A. Rich & Sons, Inc.

Decision date: March 22, 201138 pages

Summary

The LIRC modified the ALJ's April 15, 2010 award, agreeing that the employee is entitled to future medical care but disagreeing with the directive that it be provided by a specific physician. The Commission also reversed the ALJ's evidentiary rulings regarding Social Security Administration records, finding them relevant to establishing the disabling nature of the work-related injury.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge by Separate Opinion)
Employee:Douglas Kaempfer
Employer:G. A. Rich & Sons, Inc.
Insurer:Travelers Indemnity Company of Connecticut
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. We have reviewed the evidence and briefs, and considered the whole record. Pursuant to § 286.090 RSMo, we issue this final award and decision modifying the April 15, 2010, award and decision of the administrative law judge (ALJ). We adopt the findings, conclusions, decision, and award of the ALJ to the extent that they are not inconsistent with the findings, conclusions, decision, and modifications set forth below.The ALJ made numerous findings and conclusions with regard to the issues presented in this case. For the most part, we agree with the ALJ’s conclusions, however, we disagree with the ALJ’s decision to order employer to furnish additional medical aid under the direction and control of a specific doctor. In addition, we disagree with the ALJ’s decision to sustain the objections to the introduction of Exhibits 25 and 29.
Future Medical Section 287.140.1 RSMo requires that the employer provide “such medical, surgical, chiropractic and hospital treatment…as may reasonably be required…to cure and relieve [the employee] from the effects of the injury.” The employee must prove beyond speculation and by competent and substantial evidence that his or her work related injury is in need of treatment. Williams v. A.B. Chance Co., 676 S.W.2d 1 (Mo. App. 1984). However, conclusive evidence is not required. It is sufficient if employee shows by reasonable probability that he or she is in need of additional medical treatment. Bowers v. Highland Dairy Co., 132 S.W.3d 260, 270 (Mo. App. 2004).We agree with the ALJ’s conclusion that employee established through the medical opinions of Dr. Chaudhari and Dr. Randolph that he is in need of additional medical treatment to cure and relieve him from the effects of his March 16, 2001, work-related injury. The ALJ went on to hold that employer waived its right to select the treating physician by denying necessary medical aid after April 15, 2002, and therefore, ordered that the employer furnish additional medical aid under the direction and control of Dr. Chaudhari. We find that the ALJ’s ordering that the additional medical aid be given by a specific doctor was improper under Missouri Workers’ Compensation Law.

Enployee: Douglas Kaempfer

- 2 -

For the foregoing reasons, we conclude that employee has established he is entitled to future medical care to cure and relieve him of the effects of his work-related injury and we direct employer to provide the same.

Evidentiary Objections

During the June 17, 2009, hearing, employer offered into evidence as Exhibit 25, the certified and sealed record of the Social Security Administration for employee. The Second Injury Fund objected to the admittance of Exhibit 25 because it argued that the information was irrelevant and immaterial. The ALJ sustained the Second Injury Fund's objection and found that Exhibit 25 was not admitted into the record. We disagree with the ALJ's sustaining of this objection.

The Second Injury Fund's objection was based on the argument that the criteria by which the Social Security Administration finds one to be totally disabled, is different than that for a finding of permanent total disability under Missouri Workers' Compensation Law. We agree that there are different standards; however, the Social Security Administration records were being offered as relevant and material evidence that employee's injuries were disabling to some extent. Therefore, we disagree that the Social Security Administration records were irrelevant and immaterial and find that the ALJ erred in sustaining the Second Injury Fund's objection.

For the foregoing reasons, we find that Exhibit 25 is admitted because it was relevant and material evidence of employee's nature and extent of disability.

Also, during the June 17, 2009, hearing, employer offered into evidence as Exhibit 29, the deposition of employee. Employee objected to the admission of Exhibit 29. Specifically, employee objected to the use of Exhibit 29 for anything other than crossexamination purposes. The ALJ sustained the objection. On appeal, both employer and employee argue that Exhibit 29 should have been admitted.

Section 287.560 RSMo provides that "any party shall be entitled ... to take and use depositions in like manner as in civil cases in circuit court...." The use of depositions in court proceedings is covered by Missouri Supreme Court Rule 57.07, which provides, "[a]ny part of a deposition that is admissible under the rules of evidence applied as though the deponent were testifying in court may be used against any party who is present or represented at the taking of the deposition, or who had proper notice thereof. Depositions may be used in court for any purpose." The deposition of an opponent may be introduced as an admission even if the opponent has also testified in person. Still v. Ahnemann, 984 S.W.2d 568 (Mo. App. 1999).

Based upon the foregoing, we find that the ALJ erred in sustaining employee's objection. Exhibit 29 is admitted.

We modify the award of the ALJ as provided herein. In all other respects, we affirm the award.

The award and decision of Chief Administrative Law Judge Lawrence C. Kasten issued April 15, 2010, is attached hereto and incorporated herein to the extent not inconsistent with this decision and award.

The Commission further approves and affirms the administrative law judge's allowance of attorney's fees as being fair and reasonable.

Any past due compensation shall bear interest as provided by law.

Given at Jefferson City, State of Missouri, this $\qquad$ day of March 2011.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

Alice A. Bartlett, Member

John J. Hickey, Member

Attest:

Secretary

FINAL AWARD

Employee: Douglas Kaempfer

Injury No. 01-057079

Employer: G. A. Rich \& Sons, Inc.

Additional Party: Second Injury Fund

Insurer: Travelers Indemnity Company of Connecticut

Appearances: Robert W. Meyers, Attorney for Employee, Steve Prosperi, Attorney for Employer-Insurer, and Frank Rodman, Attorney for the Second Injury Fund

Hearing Date: June 17, 2009 (commenced)

Checked by: LCK/rf

August 26, 2009 (completed)

SUMMARY OF FINDINGS

  1. Are any benefits awarded herein? Yes.
  2. Was the injury or occupational disease compensable under Chapter 287? Yes.
  3. Was there an accident or incident of occupational disease under the Law? Yes.
  4. Date of accident or onset of occupational disease? March 16, 2001.
  5. State location where accident occurred or occupational disease contracted: Mississippi County, Missouri.
  6. Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes.
  7. Did employer receive proper notice? Yes.
  8. Did accident or occupational disease arise out of and in the course of the employment? Yes.
  9. Was claim for compensation filed within time required by law? Yes.
  10. Was employer insured by above insurer? Yes.
Employee:Douglas KaempferInjury No. 01-057079
11.Describe work employee was doing and how accident happened or occupational disease contracted: The employee fell and injured his neck and low back. Did accident or occupational disease cause death? No. Parts of body injured by accident or occupational disease: Low back, neck and body as a whole. Nature and extent of any permanent disability: 30% permanent partial disability of the body as a whole referable to the cervical spine and 37.5% permanent partial disability of the body as a whole referable to the lumbar spine against the employer-insurer. Permanent total disability against the Second Injury Fund. Compensation paid to date for temporary total disability: 33,855.74. Value necessary medical aid paid to date by employer-insurer: 195,207.40. Value necessary medical aid not furnished by employer-insurer: 6,901.51 Employee's average weekly wage: 1,164.20. Weekly compensation rate: 599.96 per week for permanent total and temporary total disability. 314.26 per week for permanent partial disability. Method wages computation: By agreement. Amount of compensation payable from the employer-insurer:16.
$6,901.51 in previously incurred medical benefits.
$88,108.41 in temporary total disability benefits.
$84,850.20 in permanent partial disability benefits
Total: $ 179,860.12
22.Second Injury Fund liability: Permanent total disability benefits. See Rulings of Law.
23.Future requirements awarded: See Rulings of Law for future medical benefits and permanent total disability.
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: Robert W. Meyers.

FINDINGS OF FACT AND RULINGS OF LAW

On June 17, 2009, the employee, Douglas Kaempfer, appeared in person and with his attorney, Robert W. Meyers, for a hearing for a final award. The employer-insurer was represented at the hearing by its attorney, Steve Prosperi. The Second Injury Fund was represented by Assistant Attorney General Frank Rodman. 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:

UNDISPUTED FACTS

  1. G. A. Rich \& Sons, Inc. was operating under and subject to the provisions of the Workers' Compensation Act and its liability was fully insured by Travelers Indemnity Company.
  2. On or about March 16, 2001, Douglas Kaempfer was an employee of G. A. Rich \& Sons, Inc. and was working under the Workers' Compensation Act.
  3. On or about March 16, 2001, the employee sustained an accident arising out and in the course of his employment.
  4. The employer had notice of the employee's accident.
  5. The employee's claim was filed within the time allowed by law.
  6. The employee's average weekly wage was $\ 1,164.20 per week. The rate of compensation for temporary total and permanent total disability is $\ 599.96 per week. The rate of compensation for permanent partial disability is $\ 314.26 per week.
  7. The employee's injury and treatment through April 15, 2002 was medically causally related to the accident.
  8. The employer-insurer paid $\ 195,207.40 in medical aid.
  9. The employer-insurer paid $\ 33,855.74 in temporary total disability beginning on March 17, 2001 and continuing through April 16, 2002.

ISSUES

  1. Medical causation after April 15, 2002.
  2. Claim for previously incurred medical.
  3. Claim for additional or future medical aid.
  4. The nature and extent of disability concerning the employer-insurer.
  5. The liability of the Second Injury Fund for permanent partial disability or permanent total disability.

EXHIBITS

The following exhibits were offered and admitted into evidence:

Employee and Employer-Insurer Joint Exhibits

A-1. Medical records of Dr. Chaudhari including A-1a, A-1b, A-1c, and A1-d.

B-2. Medical records of Southeast Missouri Hospital including B-2a and B2-b.

C-3. Medical records of Southeast Missouri Hospital including C-3a and C-3b.

D-4. Medical records of Cape Imaging.

E-5. Medical records of Jackson Physical Therapy (The Second Injury Fund's objection to this exhibit was sustained based on lack of

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