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Robert Bollinger v. The Education Institute

Decision date: June 27, 201211 pages

Summary

The Commission modified the administrative law judge's award regarding Second Injury Fund liability for an employee's compensable right knee injury sustained on September 16, 2008. The Commission disagreed with the ALJ's analysis of whether the employee's preexisting diabetes constituted a hindrance or obstacle to employment, clarifying that the relevant inquiry focuses on the potential for a condition to combine with a work-related injury to cause greater disability, not on past manifestations of difficulty.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge)
Employee:Robert Bollinger
Employer:The Education Institute (Settled)
Insurer:Travelers Commercial Casualty (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 § 287.480 RSMo. We have reviewed the evidence, read the briefs, 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.
Discussion On September 16, 2008, employee sustained a compensable right knee injury when he slipped and fell while working for employer. He settled his claim against the employer and proceeded to a hearing before an administrative law judge on his claim against the Second Injury Fund. The administrative law judge found that employee is entitled to 20.24 weeks of enhanced permanent partial disability benefits from the Second Injury Fund. The Second Injury Fund filed a timely Application for Review with the Commission. The Second Injury Fund alleges, among other things, that the administrative law judge erred in including employee's preexisting diabetes in her calculation of Second Injury Fund liability. The Second Injury Fund points out the administrative law judge specifically found that employee's preexisting diabetes was not a hindrance or obstacle to employment at the time of the primary injury on September 16, 2008. The administrative law judge provided the following rationale for so finding:
Although Claimant indicated that his diabetes is now out of control, such was not the case at the time of the last or primary injury. ... The testimony of Claimant and his spouse indicate that any problems with diabetes or diabetic neuropathy were minimal, consisting of an infrequent need to sip some juice to correct Claimant's blood sugar level.
Award, page 7.
We believe the administrative law judge inappropriately analyzed the question whether employee's diabetes constituted a hindrance or obstacle to employment. The courts have consistently instructed that the question whether a preexisting condition constitutes a hindrance or obstacle to employment does not turn on the degree of difficulty which the condition caused the employee in the past:
Many occupations can be ably performed by workers with one eye or one arm. In such cases, the condition may not cause the employee to miss any work or otherwise diminish his earning power. The condition becomes disabling only when combined with a further injury. It is the potential for those more serious combinations of injury and previous condition that gives rise to the employer's

incentive to discriminate in the absence of a Second Injury Fund. Thus, a requirement that the condition be shown to have caused the employee to have missed work or suffer diminished earnings prior to the injury which combines with the condition to render the employee disabled is inconsistent with the purpose of the Fund. In many instances, the effect would be to deny the protection of the Fund to those most in need of it.

If the Second Injury Fund is to fulfill its acknowledged purpose, the proper focus of the inquiry as to the nature of the prior disability 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 work related injury in the future so as to cause a greater degree of disability than would have resulted in the absence of the condition. That potential is what gives rise to prospective employers' incentive to discriminate. Thus, if the Second Injury Fund is to serve its acknowledged purpose, "previous disability" should be interpreted to mean a previously existing condition that a cautious employer could reasonably perceive as having the potential to combine with a work related injury so as to produce a greater degree of disability than would occur in the absence of such condition. A condition satisfying this standard would, in the absence of a Second Injury Fund, constitute a hindrance or obstacle to employment or reemployment if the employee became unemployed.

Wuebbeling v. West County Drywall, 898 S.W.2d 615, 620 (Mo. App. 1995) (emphasis in original).

The foregoing "potential to combine" standard has been consistently cited by the courts to determine whether a preexisting condition constitutes a hindrance or obstacle to employment. See Knisley v. Charleswood Corp., 211 S.W.3d 629, 637 (Mo. App. 2007); Concepcion v. Lear Corp., 173 S.W.3d 368, 371 (Mo. App. 2005); E.W. v. Kan. City Sch. Dist., 89 S.W.3d 527, 538 (Mo. App. 2002); and Carlson v. Plant Farm, 952 S.W.2d 369, 373 (Mo. App. 1997). Nevertheless, the misperception continues that an employee's failure to provide evidence that a preexisting condition caused difficulty in the past means that the employee has failed to prove the condition was a hindrance or obstacle to employment.

Evidence that a preexisting condition affected an employee's earning potential before the work injury is certainly relevant to the question whether employee suffered from a preexisting permanent partial disability; this, of course, is a related but separate requirement for establishing Second Injury Fund liability under § 287.220 RSMo. It appears that much of the confusion in this area stems from the regular conflation of these two distinct concepts. Here, the administrative law judge found that employee's diabetes did amount to a preexisting permanent partial disability to the extent of 10 % of the body as a whole-but then cited the fact employee's diabetes was controlled by sipping some juice as evidence for finding employee's diabetes did not constitute a hindrance or obstacle to employment at the time of the primary injury.

We disagree with the administrative law judge's conclusion that employee's diabetes did not constitute a hindrance or obstacle to employment. When we apply the appropriate standard, as identified in Wuebbeling and consistently reaffirmed by the courts, we conclude that employee's preexisting diabetes amounted to a hindrance or obstacle to employment at the time he sustained the primary injury. This is because we are convinced a cautious employer could reasonably perceive employee's diabetes as having the potential to combine with a work related injury so as to produce a greater degree of disability than would occur in the absence of such condition.

As Dr. Shuter pointed out, employee's diabetes negatively impacted his treatment for the primary injury, leading to delays in December 2008 while treating doctors tried to get his diabetes under control. This case thus fittingly illustrates the concept expressed by the Wuebbeling court: a prospective employer considering whether to hire employee could reasonably anticipate that employee's diabetes, while under control at the date of hire, may-as actually happened herehamper employee's ability to recover from a subsequent work injury, and thus (in the absence of the Second Injury Fund) expose the prospective employer to more liability than otherwise would have resulted from the work injury. It follows that employee's diabetes is precisely the sort of preexisting condition the legislature had in mind when the Second Injury Fund was created.

Accordingly, we modify the analysis of the administrative law judge on the question of Second Injury Fund liability as follows. We conclude employee's preexisting diabetes was a hindrance or obstacle to employment for purposes of $\S 287.220$ RSMo.

Award

We modify the analysis of the administrative law judge on the question of Second Injury Fund liability. We conclude employee's preexisting diabetes was a hindrance or obstacle to employment at the time of the primary injury on September 16, 2008.

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 Victorine R. Mahon, issued February 2, 2012, is attached hereto and incorporated herein to the extent not inconsistent with this decision and award.

Given at Jefferson City, State of Missouri, this $27^{\text {th }}$ day of June 2012.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

NOT SITTING

William F. Ringer, Chairman

James Avery, Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

Employee:Robert BollingerInjury No. 08-120375
Dependents:N/A
Employer:The Education Institute (settled)
Additional Party:Treasurer of the State of Missouri as custodian of The Second Injury Fund
Insurer:Travelers Commercial Casualty (settled)
Hearing Date:December 14, 2011Reviewed by:
VRM/ps
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: September 16, 2008.
5.State location where accident occurred or occupational disease was contracted: Battlefield, 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 slipped on water and sustained an injury to his right knee.
12.Did accident or occupational disease cause death? No
13.Part(s) of body injured by accident or occupational disease: Right knee.
14.Nature and extent of any permanent disability: 39 percent or the right knee and enhanced permanent partial disability as against the Second Injury Fund.
15.Compensation paid to-date for temporary disability: None.
  1. Value necessary medical aid paid to date by employer/insurer? None.
  2. Value necessary medical aid not furnished by employer/insurer? Not Applicable.
  3. Employee's average weekly wages: Sufficient to yield the following rate of compensation.
  4. Weekly compensation rate: $\ 240.44 for all purposes.
  5. Method wages computation: Stipulation.

COMPENSATION PAYABLE

  1. Amount of compensation payable: Settled as to Employer/Insurer.
  2. Second Injury Fund liability: Yes - permanent partial disability.

Disability from the primary injury to the knee $=62.40 weeks

(39 percent x 160 weeks)

Preexisting disability for chronic depression =100$ weeks

(25 percent x 400 weeks)

Preexisting disability for diabetes, including neuropathy $=40 weeks

(10 percent x 400 weeks)

Simple Sum =202.40

Multiplied by 10 percent loading factor (202.40 \times 10)=20.24 weeks

20.24 weeks x weekly benefit rate of \$ 240.44=

TOTAL: \ 4,866.51.

  1. Future requirements awarded: None

The compensation awarded to the claimant shall be subject to a lien in the amount of 25 % of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant: Jerry A. Klein

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

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