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Ronland Ranson v. Cracker Barrel

Decision date: June 22, 201220 pages

Summary

The Commission reversed the ALJ's denial of workers' compensation benefits, finding that the employee did sustain a work-related accident involving a slip and twisting motion that caused a lower back strain. The Commission found that medical records and documentation, including post-accident drug testing and nursing assessments, supported the employee's claim of a work-related injury that the ALJ had overlooked or failed to properly consider.

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Caption

TEMPORARY AWARD ALLOWING COMPENSATION (Reversing Award and Decision of Administrative Law Judge)
Injury No.: 10-051797
Employee:Ronland Ranson
Employer:Cracker Barrel
Insurer:Indemnity Company of North America c/o CCMSI
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund (Open)
This cause has been submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. ${ }^{1}$ We have reviewed the evidence and briefs, heard oral argument, and considered the whole record. Pursuant to § 286.090 RSMo, the Commission reverses the award and decision of the administrative law judge (ALJ) dated November 23, 2011.
PreliminaryThe ALJ heard this matter to consider: 1) whether employee sustained an accident or occupational disease arising out of and in the course of his employment; 2) whether employee's injury was medically causally related to the accident; 3) whether employee should be awarded future medical care; 4) whether employee should be awarded temporary total disability benefits; and 5) whether employee should be awarded costs for employer defending the claim upon unreasonable grounds under § 287.560 RSMo.
The ALJ found that employee failed to establish that he sustained a work-related accident. The ALJ deemed all other issues moot and issued a final award denying employee's claim for benefits.
Employee appealed to the Commission, alleging: 1) employee proved he had an accident at work; 2) the work accident was the prevailing factor in causing his injury; 3) employee is entitled to future medical care; 4) employee is entitled to temporary total disability benefits for the period of June 30, 2010, through April 10, 2011; and 3) employee is entitled to an award of costs under § 287.560 RSMo.
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 adopted and incorporated by the Commission herein.
The ALJ stated in her findings of fact that during employee's June 20, 2010, visit to St. Francis Medical Center, "[employee] told the nurse he had pain and tenderness in his left lower back." The ALJ went on to state that employee "said his pain was caused by body motion and twisting. He alleges he was referring to the work incident when he gave that description." Missing from the ALJ's discussion of employee's June 20, 2010, visit is the fact that the Nursing Assessment shows "Pt states he slipped at work and caught himself in a twisting motion thinks [sic] he strained his back." (Emphasis added). In addition, employee participated in drug testing at St. Francis Medical Center and signed the custody and control form stating the reason for the test was "Post Accident."
The ALJ discussed employee's visit to Missouri Delta Express Care on June 30, 2010, and noted that the records indicate employee had a slip at work one and one-half weeks before the
1 Statutory references are to the Revised Statutes of Missouri 2009 unless otherwise indicated.

appointment and that sometimes he experiences numbness in his left leg. The ALJ also noted that employee testified that a nurse from Missouri Delta called one of his managers. However, the ALJ failed to note that a record of this call was made in the "Workman's Compensation Employee Work Status Report," which shows a telephone call was made by Amy Folson PAC to one of employer's managers on June 30, 2010, at 11:00 a.m.

The ALJ indicated in her award that one of employee's managers, Patrick Sauer, submitted an employee claim form on July 1, 2010, indicating employee complained of an injury, but did not discuss what Mr. Sauer specifically stated in the claim form. Mr. Sauer stated in the form that:

[R]onland called this morning and said he hurt his back in the dishroom [sic]. He said he slipped. [I] asked him if he notified a manger [sic] and he said he told [L]eonard [S]picer (am). [I] called [L]eonard and asked if he was notified and he said no he was never told. [I] called repeatedly to get him up here for the chain of custody form to take with him. [H]e never called back or showed up. [I] left a message with a female that stayed with him and told her he has to come in today and pick this up and leave me [a] doctors [sic] note today or there is nothing [I] can do for him.

With respect to whether employee reported the work injury to management, we find employee's testimony more credible than employer's witnesses' testimony. Employee's testimony is fully corroborated by the documentary evidence submitted by employee.

Conclusions of Law

Section 287.020.2 RSMo defines "accident" as "an unexpected traumatic event or unusual strain identifiable by time and place of occurrence and producing at the time objective symptoms of an injury caused by a specific event during a single work shift. An injury is not compensable because work was a triggering or precipitating factor."

Section 287.020.3 RSMo provides, as follows:

(1) In this chapter the term 'injury' is hereby defined to be an injury which has arisen out of and in the course of employment. An injury by accident is compensable only if the accident was the prevailing factor in causing both the resulting medical condition and disability. 'The prevailing factor' is defined to be the primary factor, in relation to any other factor, causing both the resulting medical condition and disability."

(2) An injury shall be deemed to arise out of and in the course of the employment only if:

(a) It is reasonably apparent, upon consideration of all the circumstances, that the accident is the prevailing factor in causing the injury; and

(b) It does not come from a hazard or risk unrelated to the employment to which workers would have been equally exposed outside of and unrelated to the employment in normal nonemployment life."

In this case, the accident was not witnessed and, therefore, we must look to other evidence to verify the facts alleged by employee. The ALJ placed a significant amount of weight on the testimony of employee's managers stating that employee did not report the injury. However, employee offered multiple records showing he gave a consistent accident history to anyone

Employee: Ronland Ranson

willing to record what he said. Specifically, employee provided medical reports in which he described his accident, the post-accident drug test, the nurse's notation that she called and spoke to a manager at employee's work to report an accident, the employee claim form filed by Mr. Sauer, and the recorded interview, and the notes Katie Martz posted on the insurer's computer.

We find, based upon the aforementioned evidence and the record as a whole, that employee met his burden of proving that on June 18, 2010, he sustained an accident, as defined by § 287.020.2 RSMo.

Having found that an accident occurred, we must now turn to the issue of whether the injury arose out of and in the course of employment.

Dr. Bowen issued an opinion stating that the June 18, 2010, accident was the prevailing factor in aggravating a preexisting condition resulting in his current medical condition. Dr. Doll diagnosed a mild left lumbar strain related to the work accident.

Dr. Bowen did not believe employee was at maximum medical improvement and wanted to try additional treatment options including intrascapular injections. Dr. Doll, on the other hand, opined that employee is at maximum medical improvement and sustained no permanent partial disability attributable to the alleged June 2010 incident.

Based on all of the evidence presented, we find that employee's accident on June 18, 2010, was the prevailing factor in causing employee's injury on that day. Therefore, we find that employee's injury is medically causally related to the June 18, 2010, work-related accident.

In addition to the aforementioned, we find Dr. Bowen's opinion that employee has not achieved maximum medical improvement more convincing than Dr. Doll's opinion stating the opposite. Therefore, we order employer to provide all future medical care reasonably required to cure and relieve the effects of the injury.

With regard to employee's claim for temporary total disability benefits, we do not believe employee met his burden of proving he was totally disabled from June 30, 2010, through April 10, 2011. Section 287.020.6 RSMo defines "total disability" as the "inability to return to any employment and not merely [the] inability to return to the employment in which the employee was engaged at the time of the accident."

Employee began working for Manpower approximately two weeks after he stopped working for employer. Employee effectively represented that he was able to do any work at that time because he did not give his work restrictions to Manpower. Employee may have been given lifting restrictions, but failed to prove he was "totally disabled" from June 30, 2010, through April 10, 2011.

Lastly, with respect to employee's claim for costs under § 287.560 RSMo, employee failed to meet its burden of proving that employer defended this claim without reasonable ground. Costs should only be invoked where the employer offers "absolutely no ground, reasonable or otherwise," for refusing benefits clearly owed to a claimant because his injury was indisputably work-related. Landman v. Ice Cream Specialties, Inc., 107 S.W.3d 240, 250 (Mo. banc 2003). In this case, employer refused employee benefits because it believed, based on its witnesses' testimony, that employee did not suffer a work-related accident. Employer's refusal to provide benefits was not egregious.

Award

We reverse the ALJ's decision and find that employee sustained an accident arising out of and in the course of his employment on June 18, 2010. Employer is ordered to provide all future medical care reasonably required to cure and relieve employee from the effects of the injury.

Employee's claim for temporary total disability benefits for the period June 30, 2010, through April 10, 2011, is denied.

Employee's claim for costs under § 287.560 RSMo is denied.

This award is only temporary or partial. It is subject to further order, and the proceedings are hereby continued and kept open until a final award can be made. All parties should be aware of the provisions of $\S 287.510$ RSMo.

Colleen Joern Vetter, attorney for employee, is allowed a fee of 25 % of all sums awarded under the provisions of this award for necessary legal services rendered to employee. The amount of this attorney's fee shall constitute a lien on the compensation awarded herein.

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

The award and decision of Administrative Law Judge Maureen Tilley issued November 23, 2011, is attached hereto and incorporated herein to the extent it is not inconsistent with this temporary or partial award.

Given at Jefferson City, State of Missouri, this $\qquad 22nd \qquad$ day of June 2012.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

William F. Ringer, Chairman

James Avery, Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

FINAL AWARD

Employee: Ronland Ranson

Injury No. 10-051797

Dependents: N/A

Employer: Cracker Barrel

Additional Party: Left open

Insurer: Indemnity Insurance Company of North America c/o CCMSI

Hearing Date: 8-10-2011

Checked by: MT/rf

SUMMARY OF FINDINGS

  1. Are any benefits awarded herein? No.
  2. Was the injury or occupational disease compensable under Chapter 287? No.
  3. Was there an accident or incident of occupational disease under the Law? Yes.
  4. Date of alleged accident? 6-18-2010.
  5. State location where accide

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

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