Section 287.220 RSMo creates the Second Injury Fund and provides when and what compensation shall be paid in "all cases of permanent disability where there has been previous disability." As a preliminary matter, the employee must show that he suffers from "a preexisting permanent partial disability whether from compensable injury or otherwise, of such seriousness as to constitute a hindrance or obstacle to employment or to obtaining reemployment if the employee becomes unemployed ..." Id. The Missouri courts have articulated the following test for determining whether a preexisting disability constitutes a "hindrance or obstacle to employment":
[T]he proper focus of the inquiry is not on the extent to which the condition has caused difficulty in the past; it is on the potential that the condition may combine with a workrelated injury in the future so as to cause a greater degree of disability than would have resulted in the absence of the condition.
Knisley v. Charleswood Corp., 211 S.W.3d 629, 637 (Mo. App. 2007) (citation omitted).
Dr. Poetz opined that employee suffered permanent partial disability referable to preexisting bilateral wrist and low back conditions, and we have found that these conditions amounted to a 17.5 % permanent partial disability of the right wrist, a 15 % permanent partial disability of the left wrist, and a 25 % permanent partial disability of the body as a whole referable to the low back.
We are further convinced that employee's preexisting disabilities were serious enough to constitute hindrances or obstacles to employment for purposes of $\S 287.220$ RSMo. When we consider the potential for these conditions to combine with future work-related injuries, we are persuaded that
employee's bilateral wrist and low back disabilities had the potential to combine with future work-related injuries so as to cause greater disability than would result in the absence of these conditions. We conclude that at the time he sustained his November 3, 2003, work injuries, employee suffered from preexisting permanent partial disabling conditions of his bilateral wrists and low back and that these conditions constituted hindrances or obstacles to employment or reemployment.
We now proceed to the question whether employee met his burden of establishing entitlement to compensation from the Second Injury Fund. Section 287.220.1 RSMo provides, in relevant part, as follows:
After the compensation liability of the employer for the last injury, considered alone, has been determined by an administrative law judge or the commission, the degree or percentage of employee's disability that is attributable to all injuries or conditions existing at the time the last injury was sustained shall then be determined by that administrative law judge or by the commission and the degree or percentage of disability which existed prior to the last injury plus the disability resulting from the last injury, if any, considered alone, shall be deducted from the combined disability, and compensation for the balance, if any, shall be paid out of a special fund known as the second injury fund, hereinafter provided for. If the previous disability or disabilities, whether from compensable injury or otherwise, and the last injury together result in total and permanent disability, the minimum standards under this subsection for a body as a whole injury or a major extremity injury shall not apply and the employer at the time of the last injury shall be liable only for the disability resulting from the last injury considered alone and of itself; except that if the compensation for which the employer at the time of the last injury is liable is less than the compensation provided in this chapter for permanent total disability, then in addition to the compensation for which the employer is liable and after the completion of payment of the compensation by the employer, the employee shall be paid the remainder of the compensation that would be due for permanent total disability under section 287.200 out of a special fund known as the "Second Injury Fund" ...
The foregoing section requires us to first determine the compensation liability of the employer for the last injury, considered alone. If employee is permanently and totally disabled due to the last injury considered in isolation, the employer, and not the Second Injury Fund, is responsible for the entire amount of compensation. See ABB Power T \& D Co. v. Kempker, 236 S.W.3d 43, 50 (Mo. App. 2007).
We have found that, as a result of the last injury, employee sustained the following permanent partial disabling conditions: 32.5 % of the body as a whole referable to the neck, 25 % of the left shoulder, 27.5 % of the left elbow, 12.5 % of the left wrist, and 10 % of the right wrist. Both Dr. Poetz and Mr. England opined that employee is permanently and totally disabled due to a combination of employee's preexisting disabling conditions and his injuries sustained on November 3, 2003, and we have found the unopposed testimony of these experts to be credible. We conclude that the primary injury, considered in isolation, did not render employee permanently and totally disabled, but that employee is disabled due to a combination of his preexisting disabilities and conditions of ill as they existed on November 3, 2003, in combination with the injuries sustained on that date. We conclude, therefore, that employee has met his burden of establishing Second Injury Fund liability under § 287.220.1 for permanent total disability benefits.