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Bruce McNamara v. Board of Education of North Kansas City

Decision date: May 31, 201216 pages

Summary

The Commission modified the administrative law judge's award to clarify that the employee is permanently and totally disabled due to the work-related right shoulder injury considered alone, and remanded the Second Injury Fund liability question for further determination. The employee, injured in August 2001 while working as a bus monitor, suffered a serious shoulder injury requiring four surgeries including total shoulder replacement, resulting in debilitating ongoing pain.

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

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Caption

FINAL AWARD DENYING COMPENSATION

(Modifying Award and Decision of Administrative Law Judge)

Injury No.: 01-091471

Employee: Bruce McNamara

Employer: Board of Education of North Kansas City (Settled)

Insurer: St. Paul Fire \& Marine Insurance Company (Settled)

Additional Party: Treasurer of Missouri as Custodian of Second Injury Fund

This workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by $\S 287.480$ RSMo. We have reviewed the evidence, read the briefs, and considered the whole record. Pursuant to § 286.090 RSMo, the Commission modifies the award and decision of the administrative law judge.

Discussion

In August 2001, employee was working as a bus monitor when an accident caused him to suffer a serious right shoulder injury that continues to produce debilitating pain despite four different surgeries, including a total shoulder replacement. Employee pursued claims against employer and the Second Injury Fund.

In his award, the administrative law judge found employee was permanently and totally disabled due to the work injury considered alone, but then, without explanation, awarded permanent partial disability benefits against employer and denied employee's claim against the Second Injury Fund. Employee filed an Application for Review with this Commission, arguing (among other things) that he is permanently and totally disabled owing to the effects of the work injury considered alone. Employer also filed an Application for Review, arguing (among other things) that employee is not permanently and totally disabled owing to the effects of the work injury considered alone.

While employee's appeal was pending here, we issued an Order Approving Stipulation for Compromise Settlement, which approved a settlement between employee and employer, in which employer agreed to pay employee a lump sum and waive any claim to the proceeds of employee's third-party action. In our Order, we dismissed employer's Application for Review, as well as employee's Application for Review so far as it relates to employee's claim against employer. Thereafter, employee filed a brief with this Commission arguing he is not permanently and totally disabled owing to the effects of the work injury considered alone, but instead due to a combination of the work injury and his preexisting conditions of ill, such that the Second Injury Fund is liable for permanent total disability benefits.

The only issues remaining before this Commission are (1) the nature and extent of permanent disability resulting from employee's work injury; and (2) employee's claim against the Second Injury Fund.

After a careful review of the entire record, we agree with the administrative law judge's finding that the more credible evidence demonstrates that employee is permanently and totally disabled owing to the effects of the work injury considered alone. But for unknown reasons, the administrative law judge issued an award that was inconsistent with this finding. Consequently, we must modify the administrative law judge's award in order to make clear and unequivocal findings as to the nature and extent of permanent disability resulting from the work injury, and to resolve the issue whether the Second Injury Fund is liable for benefits. Section 287.220.1 RSMo creates the Second Injury Fund and provides, in relevant part, as follows:

If the previous disability or disabilities, whether from compensable injury or otherwise, and the last injury together result in total and permanent disability, ... 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 treating surgeon (Dr. Satterlee), employee's evaluating doctor (Dr. Swaim), and the only vocational expert (Michael Dreiling) agree that if employee has to lie down during the day to relieve the pain in his right shoulder, he is permanently and totally disabled due to the effects of the work injury considered alone. We find this testimony credible. Employee testified that he lies down at least once or twice per day for right shoulder pain and attributed most of his current physical difficulties to his inability to use his dominant right extremity as a result of the work injury. We find this testimony from employee credible. We find that employee has to lie down during the day due to right shoulder pain attributable to the primary work injury.

When determining whether the Fund has any liability, the Commission must first determine the degree of disability from the last injury considered alone. Preexisting disabilities are irrelevant until this determination is made. If the last injury in and of itself rendered the claimant permanently and totally disabled, then the Fund has no liability and the employer is responsible for all compensation.

Mihalevich Concrete Constr. v. Davidson, 233 S.W.3d 747, 754 (Mo. App. 2007) (citations omitted).

In light of our foregoing findings, we conclude that the effects of the primary injury, considered alone and in isolation, render employee permanently and totally disabled. It follows that there can be no Second Injury Fund liability. ABB Power T \& D Co. v. Kempker, 236 S.W.3d 43, 50 (Mo. App. 2007).

Imployee: Bruce McNamara

Accordingly, employee's claim against the Second Injury Fund is denied.

Conclusion

We modify the award of the administrative law judge. Employee is permanently and totally disabled owing to the effects of the work injury considered alone and in isolation.

All other issues are moot.

The award and decision of Administrative Law Judge Mark S. Siedlik, issued August 22, 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 $31^{\text {st }}$ 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: Bruce McNamara

Injury No.: 01-091471

Dependents: N/A

Employer: BD of ED of North Kansas City

Insurer: St. Paul Fire \& Marine Insurance Company

Additional Party: Missouri Treasurer as Custodian of the Second Injury Fund

Hearing Date: April 5, 2011 Checked by: MSS/cy

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? Yes.
  2. Was the alleged 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 alleged accident or onset of occupational disease: August 20, 2001.
  5. State location where alleged accident occurred or occupational disease was contracted: Kansas City, 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 alleged 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? Yes.
  11. Describe work employee was doing and how alleged accident occurred or occupational disease contracted: Claimant was in a motor vehicle accident.
  12. Did accident or occupational disease cause death? No

Date of death? N/A

Issued By DIVISION OF WORKERS’ COMPENSATION

Employee: Bruce McNamara

Injury No. 01-091471

  1. Part(s) of body injured by accident or occupational disease: Right shoulder.
  2. Nature and extent of any permanent disability? 50 % permanent partial disability of the right shoulder.
  3. Compensation paid to-date for temporary disability: $\ 15,764.14
  4. Value necessary medical aid paid to date by employer/insurer? $\ 113,454.25
  5. Value necessary medical aid not furnished by employer/insurer? N/A
  6. Employee’s average weekly wages: $\ 301.50
  7. Weekly compensation rate: $\ 201.01
  8. Method wage computation: Agreement

COMPENSATION PAYABLE

  1. Amount of compensable payable: $\ 23,317.16 ( 50 x right shoulder from employer/insurer), however, employer/insurer entitled to a credit of $\ 27,717.91, leaving a credit due of $\ 4,400.75 due from Claimant.

The compensation awarded herein shall be subject to a lien in the amount of 25 % to attorney Henri Watson.

FINDINGS OF FACT and RULINGS OF LAW

Employee: Bruce McNamara

Injury No.: 01-091471

Dependents: N/A

Employer: BD of ED of North Kansas City

Insurer: St. Paul Fire \& Marine Insurance Company

Additional Party: Missouri Treasurer as Custodian of the Second Injury Fund

Hearing Date: April 5, 2011 Checked by: MSS/cy

This case comes on for hearing before Administrative Law Judge Siedlik in Kansas City, Missouri on April 5, 2011. The Claimant in this matter, Mr. Bruce McNamara, was present with his counsel, Mr. Henri Watson. The Employer and Insurer were represented by their counsel, Mr. Mike Wilson. The Second Injury Fund was represented by their counsel, Ms. Kimberly Fournier.

This claim involves injuries on or about the $20^{\text {th }}$ of August 2001 while the Claimant was in the employ of the Board of Education of Kansas City, North Kansas City School District, and sustained injuries by accident arising out of and in the course and scope of employment in Jackson County, Missouri. At the time of the injuries, the parties were subject to the Missouri workers' compensation law and the Employer's liability was insured by St. Paul Fire \& Marine. The Employer had notice of an injury and a claim was timely filed.

The average weekly wage has been agreed to be $\ 301.50 per week and the compensation rate agreed to be $\ 201.01. Weekly benefits totaling $\ 15,764.14 have been paid, representing 78 3/7ths weeks of benefits. Medical expenses in the amount of $\ 113,454.25 have been paid.

ISSUES

The issues to be resolved at this hearing are as follows:

1) The liability for past medical expenses;

2) The need for future medical care;

3) The nature and extent of permanent disability;

4) The liability of the Second Injury Fund;

5) Whether the Division has authority to determine the credit due the Employer based on third-party litigation and settlement under $\S 287.150$.

The evidence at trial consisted of the testimony of the Claimant and his wife in person, together with expert deposition testimony and other documentary evidence comprising of Claimant's Exhibits A through R and Employer/Insurer's Exhibits 1 through 34. The Second Injury Fund offered no evidence at this proceeding.

The Claimant testified that at the time of trial, he was 71 years old and on August 20, 2001, at the age of 60 years old, was working as a bus aide for North Kansas City School District. The Claimant had worked as a bus aide since December of 1999 and in that capacity helped handicapped students on and off the bus, generally assisted with the students being transported.

On or about August 20, 2001, the Claimant, while in the employ of North Kansas City School District and riding in a school bus, was involved in a motor vehicle accident. The Claimant, as a result of this accident, was thrown head first over the metal barrier at the front of the seat and down into the stairwell of the bus. Claimant was taken by ambulance to the hospital and diagnosed with a blunt chest trauma and multiple rib fractures, right scapular fracture, scalp laceration and left forearm laceration.

The Claimant was taken off work and treatment was begun primarily with Dr. Newland. The most serious injury appeared to be to the right shoulder, which initially was provided conservative tr

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

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