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Louetta Elwell v. Stahl Specialty Company

Decision date: November 15, 201140 pages

Summary

The Commission affirmed the administrative law judge's award allowing compensation for an occupational pulmonary disease with a June 1, 2004 date of injury, finding workplace exposures were a substantial factor in the employee's condition. The employee was awarded 12.5% permanent partial disability, future medical care benefits of $4,559.83, and the Second Injury Fund was found liable for 24.03 weeks of permanent partial disability benefits.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Affirming Award and Decision of Administrative Law Judge by Supplemental Opinion)
Injury No.: 04-148856
Employee:Louetta K. Elwell
Employer:Stahl Specialty Company
Insurer:Self-Insured
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, read the parties'briefs, heard the parties' arguments, and considered the whole record. Pursuant to § 286.090 RSMo, the Commission affirms the award and decision of the administrative law judge dated February 10, 2011, with this supplemental opinion. The Commission adopts the findings, conclusions, decision, and award of the administrative law judge to the extent that they are not inconsistent with the supplemental opinion set forth below.
IntroductionThe issues stipulated in dispute at the hearing were: (1) accident; (2) occupational disease; (3) notice; (4) whether employee’s injuries arose out of and in the course of employment; (5) medical causation; (6) past medical expenses; (7) future medical care; (8) temporary total disability; (9) nature and extent of permanent disability; (10) liability of the Second Injury Fund; and (11) whether employee’s claim for compensation was timely filed.The administrative law judge made the following findings: (1) employee met her burden of proof as to future medical care; (2) employee sustained a 12.5% permanent partial disability of the body as a whole as a result of her work injury; (3) employee’s workplace exposures are a substantial factor resulting in her pulmonary injury; (4) the sum of $4,559.83 is reasonable to treat employee for her work-related pulmonary disease and employer must pay this sum to the employee, her attorney, and Healthnet; (5) employee is not entitled to temporary total disability benefits; and (6) the Second Injury Fund is liable for 24.03 weeks of permanent partial disability benefits.Employer submitted a timely Application for Review with the Commission alleging the administrative law judge erred: (1) in finding employee permanently and partially disabled and ignoring the testimony of Dr. Kerby and finding work a substantial factor in employee’s condition; (2) in finding employee’s date of injury was June 1, 2004, rather than a later date that would result in application of the 2005 amendments to this claim; and (3) in awarding medical benefits because employee’s condition didn’t arise out of her employment and work was not a prevailing or substantial factor in employee’s condition.

The Second Injury Fund also submitted a timely Application for Review with the Commission joining employer's arguments that the administrative law judge erred in finding permanent partial disability and in finding a date of injury before August 28, 2005.

Date of injury for employee's occupational disease

The appropriate date of injury of employee's occupational disease is a determinative issue in this matter, as it controls whether we apply the 2005 amendments to the Missouri Workers' Compensation Law to the facts of this case, see Tillman v. Cam's Trucking, Inc., 20 S.W.3d 579, 585-86 (Mo. App. 2000), and, by extension, whether employee may recover any benefits for her pulmonary condition, as it is apparent from the record that employee's expert medical evidence does not meet the "prevailing factor" standard for medical causation applicable after August 28, 2005, the effective date of the amendments. It appears that the administrative law judge found June 1, 2004, to be the date of injury, but did not specifically treat the issue in his award or provide any analysis. Accordingly, we write this supplemental opinion to explain why we believe that June 1, 2004, is the correct date of injury for this occupational disease claim.

Assigning a "date of injury" to an occupational disease that develops gradually over time can be a counterintuitive task, and the courts have acknowledged this difficulty. See Miller v. U.S. Airways Group, Inc., 316 S.W.3d 462, 468 (Mo. App. 2010) (Smart, J., concurring) (pointing out that "[u]nlike an injury due to accident, an occupational disease develops over a period of time and is not caused by an event on a single day").

Employer argues the date of injury is the same date that the statute of limitations begins to run under § 287.063.3 RSMo, or whenever it becomes reasonably discoverable and apparent to an employee that they have suffered a work injury. For purposes of this case, employer suggests this occurred on November 1, 2006, the date of a treatment note from Dr. Bower indicating the doctor's suspicion that there was a connection between employee's work environment and her pulmonary disease. Employer argues that McGhee v. W.R. Grace \& Co., 312 S.W.3d 447 (Mo. App. 2010) supports such an analysis. We believe employer misreads McGhee.

A review of the relevant case law reveals that the courts have consistently linked the "date of injury" in occupational disease cases to the date the disease first becomes "compensable," which typically has been interpreted to mean the date an employee first experiences some disability from the disease. See Garrone v. Treasurer of State, 157 S.W.3d 237, 242 (Mo. App. 2004) (holding that an employee's carpal tunnel syndrome did not become a compensable injury until the date he missed work for surgery, as he worked without restriction up until that date), and Coloney v. Accurate Superior Scale Co., 952 S.W.2d 755, 759 (Mo. App. 1997) (noting that "Missouri courts have interpreted section 287.063 to provide that an employee with an occupational disease is 'injured' ... when the disease causes a 'compensable injury'). McGhee is consistent with this trend. Although the McGhee court looked at the date of an employee's diagnosis of asbestosis (rather than the date of last exposure) to determine what compensation rates to apply, the actual holding in McGhee states that "the date of injury for purposes of determining which compensation rate cap should be applied under section 287.200 is the date on which the injury becomes 'compensable' -- the date on

http://www.guidetopharmacology.org/1998/10/01/guidetopharmacology.org

injury No.: 04-148856

Employee: Louetta K. Elwell

- 3 -

which the claimant becomes disabled." McGhee, 312 S.W.3d at 450. Clearly, the McGhee court equated a diagnosis of asbestosis with the employee's experiencing some disability from that condition: "[I]f Claimant's occupational disease 'injury' for purposes of section 287.200 'occurred' at the time he became disabled and unable to work, the applicable date of injury was in 2001, when he was diagnosed as having asbestosis ..." Id. at 455 (emphasis added). Notably, the McGhee court did not discuss whether the 2001 diagnosis of asbestosis involved a doctor's belief that there was a work connection.

Applying the principles espoused in the foregoing cases, we believe the appropriate date of injury for this claim is June 1, 2004, when employee first missed work (and thus experienced disability) as a result of her pulmonary condition. For these reasons we adopt the finding of the administrative law judge that the date of injury is June 1, 2004. As a result, the 2005 amendments are not applicable to this claim.

**Unauthorized past medical treatment**

At oral arguments in this matter, employer raised the contention that employee is not entitled to her past medical expenses because employer did not authorize that treatment. We disagree.

> [I]f an employee seeks necessary medical treatment for a work-related condition without knowledge at the time of that treatment that the condition was work related and the employer is not prejudiced by such treatment, then a liberal construction of 287.140 requires the employer to reimburse the employee for such medical treatment under section 287.140.1 even though the employer did not have the opportunity to select the treatment providers as granted by section 287.140.10.

Meyers v. Wildcat, Inc., 258 S.W.3d 77, 82 (Mo. App. 2008).

Here, the employee's occupational disease is a pulmonary condition that developed over time, the nature and symptoms of which were not immediately manifest to her. Employee was not aware that there might be a work connection behind her pulmonary issues until November 2006, when Dr. Bower suggested it. It follows that she could not have had the requisite "desire" to select her own physicians under § 287.140.1 RSMo (and thereby have voluntarily waived her right to medical expenses), because she was unaware that she had a workers' compensation claim for her pulmonary disease at the time she sought the treatment in question. See Meyers at 80: "A desire to choose one's own medical provider can only arise when an employee has knowledge of the existence of a work-related injury needing medical treatment and can, thus, voluntarily elect to forego the employer's obligation to provide medical treatment."

Given these circumstances, and the binding precedent of Meyers, we are not persuaded by employer's arguments regarding unauthorized treatment and we affirm the award of the administrative law judge that employee is entitled to her past medical expenses.

Conclusion

The Commission supplements the findings of the administrative law judge as to the appropriate date of injury referable to employee's occupational disease and as to the award of past medical expenses.

The award and decision of Administrative Law Judge Mark S. Siedlik issued February 10, 2011, as supplemented herein, is attached, affirmed, and incorporated by this reference to the extent it is not inconsistent with our findings, conclusions, award and decision herein.

We approve and affirm the administrative law judge's allowance of attorney's fee herein as being fair and reasonable.

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

Given at Jefferson City, State of Missouri, this $15^{\text {th }}$ day of November 2011.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

Alice A. Bartlett, Member

CONCURRING OPINION FILED

Curtis E. Chick, Jr., Member

Attest:

Secretary

I write separately to disclose the fact that I did not participate in the September 28, 2011, oral argument in this matter. I have reviewed the evidence, read the briefs of the parties, and considered the whole record. I concur with the decision of the majority of the Commission.

Curtis E. Chick, Jr., Member

AWARD

Employee: Louetta K. Elwell

Injury No: 04-148856

Dependents: N/A

Employer: Stahl Specialty Company

Additional Party: Second Injury Fund

Insurer: Self

Hearing Date: November 9, 2010

Briefs Filed: December 20, 2010

Checked by: MSS/lh

FINDINGS OF FACT AND RULINGS OF LAW

  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: June 1, 2004
  5. State location where accident occurred or occupational disease was contracted: Kingsville, Johnson 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
  11. Describe work employee was doing and how accident occurred or occupational disease contracted: Employee was repeatedly exposed to aluminum dusts, machine oils, and other workplace chemicals and compounds, which were a significant factor in causing injury and disability to her pulmonary system.

Issued by DIVISION OF WORKERS' C

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

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