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Tabitha Hasten v. Sonic Drive In of High Ridge

Decision date: May 2, 201218 pages

Summary

The Commission affirmed that the employee sustained a compensable work injury from a sexual assault that occurred on November 15, 2006, causing post-traumatic stress disorder and major depression, and modified the administrative law judge's award regarding the rate of compensation for permanent partial disability benefits. The employee was found 45% permanently partially disabled and entitled to workers' compensation benefits.

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FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge)
Employee:Tabitha Hasten
Employer:Sonic Drive In of High Ridge
Insurer:Mid-Century Insurance Company
This 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 briefs, heard the parties' arguments, and considered the whole record. Pursuant to § 286.090 RSMo, we issue this final award and decision modifying the award and decision of the administrative law judge. We adopt the findings, conclusions, decision, and award of the administrative law judge to the extent that they are not inconsistent with the findings, conclusions, decision, and modifications set forth below.
Introduction
The administrative law judge heard this matter to resolve the following disputed issues: (1) accident; (2) statute of limitations; (3) average weekly wage and compensation rates; (4) medical causation; (5) previously incurred medical expenses; (6) future medical expenses; (7) temporary total disability; (8) permanent total disability; (9) permanent partial disability; and (10) whether employee’s claim should be deemed admitted as a result of employer’s failure to file a timely answer.
The administrative law judge made the following findings: (1) employee sustained an accident arising out of and in the course of her employment on November 15, 2006; (2) employee’s claim is timely; (3) employee’s statement of eligibility for maximum compensation is an admitted fact because employer filed an untimely answer, and employee is therefore entitled to the maximum rate of compensation for temporary total and permanent partial disability benefits; (4) Dr. Packman is more credible than Dr. Harbit on the issue of medical causation, and the sexual assault that occurred on November 15, 2006, was the prevailing factor in causing employee’s post traumatic stress disorder and major depression; (5) that additional medical treatment is necessary to cure and relieve the employee from the effects of her injury; (6) that employer is liable in the amount of $2,896.50 for employee’s past medical expenses; (7) employee failed to meet her burden of proof on the issue of temporary total disability; and (8) employee sustained a permanent partial disability of 45% of the body as a whole referable to post-traumatic stress disorder and depressive disorder caused by the rape that occurred at work on November 15, 2006.
Employer filed a timely Application for Review with this Commission, alleging a number of errors.
We agree with the administrative law judge that employee is credible as to the accident and that Dr. Packman is more credible than Dr. Harbit, and that employee met her burden of proving she sustained a compensable work injury. However, for the reasons set forth herein, we believe we must modify the award of the administrative law judge on the issue of the rate of compensation for permanent partial disability benefits.

Discussion

Employer filed a late answer. Under 8 CSR 50-2.010(8) (B), employer is deemed to have admitted, for any further proceedings, the statements of fact in employee's claim for compensation. Lumbard-Bock v. Winchell's Donut Shop, 939 S.W.2d 456, 457-58 (Mo. App. 1996), overruled on other grounds by Hampton v. Big Boy Steel Erection, 121 S.W.3d 220, 224 (Mo. banc 2003).

The administrative law judge found employee is entitled to a compensation rate of $\ 376.55 per week for permanent partial disability benefits. We surmise that the administrative law judge derived this figure by calculating, pursuant to § 287.190.5(5) RSMo, 55 % of the state average weekly wage as of the date of the accident on November 15, 2006, in order to give effect to employee's allegation, in her claim for compensation, that her average weekly wage was "max rate."

Employer argues that it cannot be deemed to have admitted employee's entitlement to the maximum rate of compensation, because employee's allegation that her average weekly wage was "max rate" amounts to a legal conclusion, rather than a statement of fact, citing Anderson v. Veracity Research Co., 299 S.W.3d 720, 728 (Mo. App. 2009). The Anderson court held that legal conclusions, such as the statement that an employee's injuries "arose out of and in the course of employment," are not admitted by an employer's failure to file a timely answer. Id. In response, employee cites Aldridge v. S. Mo. Gas Co., 131 S.W.3d 876, 882 (Mo. App. 2004), which held that "[w]age rate is a question of fact, to be determined by the Commission according to the computations provided by statute."

After careful review, we are convinced that employer is correct. We find Aldridge distinguishable from the present circumstances. The employee in Aldridge alleged in his claim for compensation that his average weekly wage was $\ 550.00; the court found that this was a statement of fact. 131 S.W.3d at 882. But here, employee's allegation that her average weekly wage was "max rate" does not suggest or even imply any specific dollar amount, nor does it state any cognizable fact about employee's average weekly wage while working for employer. To our knowledge, there is no legal maximum rate in Missouri as to the wage employers may pay to employees. And employee did not put on evidence that employer had a maximum wage rate.

Employee alleges that the words "max rate" were intended as an assertion that employee's average weekly wage at the time of the accident was sufficient to yield, after application of the terms and provisions of $\S 287.170 .1(4) RSMo, \S 287.180 .1(4) RSMo, \S 287.190 .5(5) RSMo, and \S 287.200 .1(4)$ RSMo, compensation at the maximum rate allowed under each of those sections. But we believe the very process of going through such an explanation, and the fact such an explanation is necessary, illustrates why "max rate" is not a statement of fact. Instead, if it is anything, we believe it is a legal conclusion. See Gordon v. Puritan Chemical Co., 406 S.W.2d 822, 826 (Mo. App. 1966) (noting that conclusions of law, in contrast to findings of fact, generally will require interpretation or application of Chapter 287). As the Anderson court stated, "[t]here is a difference between the physical location of an accident and the legal conclusion that an accident met the statutory criteria for compensability." 299 S.W.3d at 728. Here, there is a difference between the dollar amount of an employee's average weekly wage and the

legal conclusion that the amount met the statutory criteria such that the employee is entitled to the maximum compensation rate provided by law.

For these reasons, we conclude that employer did not admit, by filing a late answer, that employee is entitled to a compensation rate of $\ 376.55 per week for permanent partial disability benefits. Having so concluded, we would normally turn now to the evidence on record to determine employee's average weekly wage. But there is no such evidence.

Employee does not remember her hourly wage in the weeks preceding the accident, did not present any documentary evidence such as W2s, time sheets, or check stubs, and ultimately agreed, on cross-examination, that she had no evidence at all as to what she earned while she was working for employer. As a result, we must conclude that employee has failed to meet her burden of proving her average weekly wage. The cases suggest the minimum $\ 40 compensation rate under $\S 287.190 .5(2)$ RSMo is appropriate where an employee sustains a compensable injury but fails to establish her average weekly wage. See Sullivan v. Masters Jackson Paving Co., 35 S.W.3d 879, 887 (Mo. App. 2001), overruled on other grounds by Hampton v. Big Boy Steel Erection, 121 S.W.3d 220, 224 (Mo. banc 2003).

We are sensitive to the fact that this employee suffered a horrible trauma at work, and we wish to make clear that her genuine inability to recall details from that time period, such as her average weekly wage in the thirteen weeks before the accident, does not strike us as unexpected or blameworthy in the least. But the task of proving an average weekly wage was by no means rendered impossible simply because employee was unable to remember what she earned while working for employer. To the contrary, it would seem there were many other possible sources of evidence to establish employee's wage. In fact, we note the objection by employee's counsel to Employer's Exhibit 2. That exhibit was a Wage Statement and constituted the only actual evidence of employee's average weekly wage offered at the hearing. As a result of counsel's objection, the exhibit did not come into the record, and we cannot consider it now.

We are bound to apply the law. We must conclude that the applicable rate of compensation is $\ 40 for permanent partial disability benefits.

Award

We modify the award of the administrative law judge as to the issue of average weekly wage and the rate of compensation for permanent partial disability benefits. We conclude employee failed to meet her burden of proving her average weekly wage. We conclude the rate of compensation for permanent partial disability benefits is $\ 40.00 per week, not $\ 376.55.

As a result, employee is entitled to, and employer is obligated to pay, $\ 7,200.00 in permanent partial disability benefits.

The Commission further approves and affirms 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.

The award and decision of Administrative Law Judge Maureen Tilley, issued August 24, 2011, is attached hereto and incorporated herein to the extent not inconsistent with this decision and award.

Given at Jefferson City, State of Missouri, this $2^{\text {nd }}$ day of May 2012.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

James Avery, Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

FINAL AWARD

Employee: | Tabitha Hasten |

Dependents:
Employer:
Additional Party:
Insurer:
Hearing Date:

Injury No. 06-135802

N/A

Sonic Drive In of High Ridge

N/A

Mark Cantor

June 1, 2011

Checked by: MT/rf

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? November 15, 2006.
  5. State location where accident occurred or occupational disease contracted: Jefferson 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:Tabitha HastenInjury No. 06-135802
11.Describe work employee was doing and how accident happened or occupational disease contracted: The employee was raped at work.
12.Did accident or occupational disease cause death? No.
13.Parts of body injured by accident or occupational disease: Body as a whole, psychiatric.
14.Nature and extent of any permanent disability: See findings.
15.Compensation paid to date for temporary total disability: None.
16.Value necessary medical aid paid to date by employer-insurer: None.
17.Value necessary medical aid not furnished by employer-insurer: See findings.
18.Employee's average weekly wage: Max rate.
19.Weekly compensation rate: $376.55/$718.87
20.Method wages comp

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