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Robert Goldman v. PCI Filtration Service

Decision date: June 2, 201115 pages

Summary

The Commission affirmed the ALJ's denial of permanent total disability benefits against the Second Injury Fund, finding that the employee sustained no permanent disability from his work-related injury despite being permanently and totally disabled overall. The employee fell from a cinder block while changing air conditioning filters, suffering head trauma and lumbar strain, but was released from treatment with 0% impairment rating.

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Third-Party Injury Check

This workers' comp decision may point to a separate injury claim.

  • A driver, contractor, property owner, or equipment company may share fault.
  • The injury involved a vehicle, unsafe premises, defective equipment, or a non-employer vendor.
  • A serious injury or death may need both benefits review and civil-claim analysis.

Caption

FINAL AWARD DENYING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge by Separate Opinion)

Injury No.: 09-041944

Employee: Robert Goldman

Employer: PCI Filtration Service (Settled)

Insurer: North American Specialty Insurance (Settled)

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. ${ }^{1}$ Having reviewed the evidence, read the briefs, and considered the whole record, the Commission finds that the award of the administrative law judge (ALJ) is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to § 286.090 RSMo, the Commission affirms the award of the ALJ dated November 17, 2010, by issuing a separate opinion denying compensation in the above-captioned case.

Preliminaries

Employee settled his claim against employer and proceeded to final hearing against the Second Injury Fund. The ALJ heard this matter to consider the nature and extent of any Second Injury Fund liability.

The ALJ found that although employee is permanently and totally disabled, his claim against the Second Injury Fund is denied because employee did not sustain any permanent disability from the primary injury.

Employee appealed to the Commission alleging that the ALJ erred in denying him permanent total disability benefits against the Second Injury Fund.

The only issue currently before the Commission is the nature and extent of any Second Injury Fund liability.

Findings of Fact

The findings of fact and stipulations of the parties were accurately recounted in the award of the ALJ and, to the extent they are not inconsistent with the findings listed below, they are incorporated and adopted by the Commission herein.

On June 9, 2009, employee climbed to the roof of an office building to change filters in an air-conditioning unit. As he stepped up on a cinder block to reach to remove the

[^0]

[^0]: ${ }^{1}$ Statutory references are to the Revised Statutes of Missouri 2008 unless otherwise indicated.

- 2 -

filter, the cinder block gave way; employee fell backwards, striking his head on another cinder block. Employee was sent to the emergency room for medical treatment, where he was kept overnight for observation. He was released the following day and returned to work on June 11, 2009.

On June 15, 2009, employee reported to Concentra Medical Center with complaints of back pain. Dr. Carper was the treating physician and saw employee on four occasions spanning between June 15, 2009 and July 2, 2009. On July 2, 2009, Dr. Carper released employee from his treatment without any restrictions, a diagnosis of a lumbar strain, and opined that employee sustained 0% impairment due to the primary injury.

Law

The first sentence of § 287.220.1 RSMo provides that "[a]ll cases of permanent disability where there has been previous disability shall be compensated as herein provided." The Courts have consistently interpreted this first sentence of § 287.220 RSMo as stating that "[i]n order for a claimant to recover against the [Second Injury Fund], he must prove that he sustained a compensable injury, referred to as 'the last injury,' which resulted in permanent partial disability." *Dunn v. Treasurer of Missouri as Custodian of Second Injury Fund*, 272 S.W.3d 267, 272 (Mo. App. 2008). Consequently, if the last injury does not result in any permanent disability, there is no need to proceed to the next step in the Second Injury Fund liability analysis.

Conclusions of Law

In this case, we find, as did the ALJ, that the competent and substantial evidence establishes that employee sustained no permanent disability as a result of the June 9, 2009, work-related injury.

We find Dr. Carper's and Mr. England's opinions are more credible than Ms. Gonzalez's and Dr. Volarich's opinions. Neither Ms. Gonzalez nor Dr. Volarich reviewed Dr. Carper's records from employee's final visit on July 2, 2009. Ms. Gonzalez and Dr. Volarich came to their conclusions that employee sustained permanent disability from the work injury without the knowledge that employee had been released to work without restrictions after four visits and that Dr. Carper was of the opinion that employee had sustained 0% impairment due to the June 9, 2009, injury. Because Ms. Gonzalez's and Dr. Volarich's opinions were made without this information, we do not find their opinions as credible as those of Dr. Carper and Mr. England. Dr. Carper was the treating physician for employee's primary injury and Mr. England is a vocational rehabilitation expert who reviewed employee's entire medical file. Because Dr. Carper and Mr. England had all of the relevant primary injury medical information available to them at the time they offered their opinions, they were in a position to give a much more educated and credible opinion regarding whether employee sustained permanent disability from the work injury.

Employee argues on appeal that Dr. Carper's opinion is not credible because he indicated in his records that his professional opinion was within "a reasonable degree of medical probability" as opposed to a "reasonable degree of medical certainty." (Emphasis added). Employee maintains that § 287.190.6(2) RSMo clearly states that

"[m]edical opinions addressing compensability and disability shall be stated within a reasonable degree of medical certainty."

The Court in Williams v. Daus, 114 S.W.3d 351 (Mo. App. 2003) noted that "the precise words used by an expert witness do not necessarily render his testimony inadmissible if he intended to express his opinion or judgment." Id. at 363 (citations omitted). The Court found that the experts in that case intended to express their opinions and/or judgments regarding the respondent's physical condition, "despite the fact that they did not always use the assertedly talismanic phrase, within a 'reasonable degree of medical certainty." Id. The Court also noted that the appellant in that case did not raise an objection to the experts' failure to use the phrase "within a reasonable degree of medical certainty" when soliciting testimony from the experts. The Court held that "[b]y failing to offer a specific objection at trial or during deposition, appellant deprived respondent of the opportunity to rephrase her questions in the form that he now demands on appeal." Ultimately, the Court held that by waiting until the case was being heard on appeal to challenge the basis of the experts' opinions, appellant waived its contention that the experts' testimony is inadmissible.

In this case, we find that Dr. Carper's opinions were intended to express his opinion or judgment regarding employee's physical condition and, therefore, are not rendered useless simply because he did not use the phrase "within a reasonable degree of medical certainty." Further, we find that employee declined to depose Dr. Carper prior to the hearing, and failed to object to Dr. Carper's records being made a part of the record when they were offered at the final hearing. We find that by employee failing to object or raise doubts about Dr. Carper's records before the ALJ, he waived his contention on appeal that Dr. Carper's opinions do not conform to § 287.190.6(2) RSMo.

Employee also argues that Dr. Carper's opinions were not based on objective medical findings or diagnostic procedures. We disagree.

Dr. Carper performed a physical examination during each of his visits with employee. In addition, on June 15, 2009, employee's first date of treatment with employee, Dr. Carper ordered an x-ray of employee's lumbar spine and reviewed the results on the same date. Dr. Carper also reviewed physical therapy records documenting employee's progression.

We find that Dr. Carper's opinions were based on objective medical findings.

Based upon the aforementioned, we find that employee sustained no permanent disability as a result of the primary injury. Consequently, our analysis ends at the first sentence of $\S 287.220$ RSMo.

We find that employee failed to prove Second Injury Fund liability.

Award

We affirm the ALJ's denial of Second Injury Fund liability for the reasons set forth herein.

The award and decision of Administrative Law Judge Margaret D. Landolt, issued November 17, 2010, is attached and incorporated to the extent it is not inconsistent with this final award.

Given at Jefferson City, State of Missouri, this $\qquad 2^{\text {nd }} \qquad$ day of June 2011.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer

Alice A. Bartlett, Member

NOT SITTING

John J. Hickey, Member

Attest:

Secretary

AWARD

Employee: Robert Goldman

Injury No.: 09-041944

Dependents: N/A

Before the

Employer: PCI Filtration Service (Settled)

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Additional Party: Second Injury Fund

Insurer: North American Specialty Insurance (Settled)

Hearing Date: September 2, 2010

Checked by: MDL

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? No
  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: June 9, 2009
  5. State location where accident occurred or occupational disease was contracted: St. Louis, 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
  11. Describe work employee was doing and how accident occurred or occupational disease contracted: While attempting to change a filter on an air conditioning unit, Claimant fell backward, striking his head on a cinder block and injuring his back.
  12. Did accident or occupational disease cause death? No
  13. Part(s) of body injured by accident or occupational disease: Body as a whole referable to the low back
  14. Nature and extent of any permanent disability: 0 %
  15. Compensation paid to-date for temporary disability: $\ 1,079.70
  16. Value necessary medical aid paid to date by employer/insurer? $\ 1,108.05

Employee: Robert Goldman

Injury No.: 09-041944

  1. Value necessary medical aid not furnished by employer/insurer? None
  2. Employee's average weekly wages: N/A
  3. Weekly compensation rate: $\$ 772.53 / \ 404.66
  4. Method wages computation: Stipulation

COMPENSATION PAYABLE

  1. Second Injury Fund liability: No

TOTAL:

  1. Future requirements awarded: None

Said payments to begin and to be payable and 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 N/A of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant:

FINDINGS OF FACT and RULINGS OF LAW:

Employee: Robert Goldman

Departments: N/A

Employer: PCI Filtration Service (settled)

Additional Party: Second Injury Fund

Insurer: North American Specialty Insurance (Settled)

Injury No.: 09-041944

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: MDL

PRELIMINARIES

A hearing was held on September 2, 2010, at the Division of Worker's Compensation in the City of St. Louis, Missouri. Robert Goldman ("Claimant") was represented by Mr. James Sievers. PCI Filtration Service ("Employer") previously settled its liability with Claimant, and this case proceeded to hearing against the Second Injury Fund ("SIF"), which was represented by Assistant Attorney General Karin Schute. Mr. Sievers requested a fee of 25 % of Claimant's Award.

The parties stipulated that on or about June 9, 2009 Claimant sustained an accidental

Full decision text continues in the plain-text archive copy.

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