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James Gulotta v. Alstom Power/APCOM

Decision date: November 13, 201222 pages

Summary

The Commission affirmed that the employee sustained a compensable injury by accident on July 31, 2008, and modified the administrative law judge's award to clarify medical causation findings. The Commission found Dr. Amundson's opinion most credible regarding the employee's low back injury and disc herniation resulting from the workplace accident.

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Caption

TEMPORARY AWARD ALLOWING COMPENSATION

Injury No.: 08-083316

Employee: James Gulotta

Employer: | Alstom Power/APCOM |

Insurer:

Ace American Insurance Company

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, we issue this temporary award and decision modifying and supplementing 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

Employee pursues two alternative theories of injury and filed two claims in order to advance them. Herein, employee alleges injury by accident on July 31, 2008. In employee's claim designated Injury No. 08-082772, which was heard together with this matter, employee alleges injury by occupational disease through October 13, 2008, his last day working for employer.

The administrative law judge found, in his temporary award issued in this matter, that employee "sustained a compensable injury occurring on July 31, 2008, or an occupational disease through his last date of employment of October 12, 2008." Award, page 10. This finding suggests the administrative law judge avoided an affirmative finding as to whether employee sustained injury by accident or occupational disease. This uncertainty is compounded by the administrative law judge's failure to state which doctors he found most credible on the issue of medical causation of employee's injuries.

In seeming contradiction, the administrative law judge rendered the following finding in his award issued in Injury No. 08-082772: "the more convincing and credible evidence leads me to conclude the Claimant suffered an accidental injury on or about July 31, 2008." Award, Injury No. 08-082772, page 11. We take it from this finding that, despite his comments in the temporary award in this matter suggesting employee met his burden of proving he suffered injury by accident or occupational disease, the administrative law judge ultimately believed employee sustained an injury by accident.

In any event, we are convinced that employee sustained an injury by accident, and affirm the result that employee is entitled to compensation herein. But in order to address the above-identified ambiguities and correct other errors contained in the administrative law judge's temporary award, we issue the following supplemental findings and modifications.

Medical causation - low back and psychiatric injuries

The parties presented conflicting testimony from medical experts on the issue of medical causation of employee's low back and psychiatric injuries. Although the

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administrative law judge quoted certain segments of the medical testimony and seems to have found that Dr. Fevurly was not credible, the administrative law judge ultimately failed to make an affirmative credibility finding, so it is unclear which expert opinions formed the basis of his implied findings on the issue of medical causation.

After careful consideration, we find Dr. Amundson most credible on the issue of causation of employee's low back injury, specifically the disc herniation at L5-S1. We credit Dr. Amundson's opinion that employee's injuries resulted from the specific accident at work, although as the administrative law judge noted, Dr. Amundson identified the wrong date (June 30 rather than July 31) for this event. We find that this trivial discrepancy does not affect the credibility of Dr. Amundson's ultimate opinions. In particular, we find Dr. Amundson more credible than Dr. Fevurly, whose opinion that employee could not have herniated a disc through repetitive heavy lifting combined with bending into awkward positions strikes us as completely unconvincing. We also find Dr. Amundson's theory of injury more credible than that advanced by Dr. Koprivica, who identified a cumulative trauma injury or occupational disease. We do find credible, however, Dr. Koprivica's testimony regarding causation of employee's psychiatric complaints. Finally, we credit Dr. Amundson's testimony that the left-sided herniation at L5-S1 following employee's first surgery was a continuation of the initial work injury.

Having rendered the foregoing credibility determinations, we turn now to the statutory analysis. Section 287.020.3(1) RSMo sets forth the standard for medical causation applicable to this claim and provides, as follows:

> 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.

We have credited employee's expert Dr. Amundson on the issue of causation of employee's low back injury. We find the accident on July 31, 2008, was the prevailing factor causing employee the medical condition of a lumbar disc herniation at L5-S1 with severe low back pain and radiculopathy, and resultant temporary total disability. We have credited Dr. Koprivica on the issue of causation of employee's psychiatric injury. We find the accident on July 31, 2008, was the prevailing factor causing employee to sustain psychiatric injury and resultant temporary total disability.

Notice

As a preliminary matter, we note the administrative law judge's suggestion or implied finding that employer waived its affirmative defense of notice by failing to identify it in its Answer to employee's Claim for Compensation. We disagree. We find instructive the case of *Lawson v. Emerson Electric Co.*, 809 S.W.2d 121 (Mo. App. 1991), overruled on other grounds by *Hampton v. Big Boy Steel Erection*, 121 S.W.3d 220 (Mo. banc 2003). In *Lawson*, the court held that the employer waived the defense of notice where it filed an answer which was silent with regard to notice, and thereafter failed to identify an issue with respect to notice at a hearing before an administrative law judge. *Id.* at 125. Here, employer filed an Answer that did not identify notice as an affirmative defense, but

Enployee: James Gulotta

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at the hearing, the administrative law judge recited that the parties were disputing the issue of notice. Transcript, page 5. The parties then added other issues and employee's counsel informed the administrative law judge that employee was requesting a temporary award. During this exchange, employee made no objection to including notice as an issue, and the record reveals that both parties thereafter presented evidence pertinent to the issue of notice. Employee does not now claim that he was surprised by employer's contesting the issue of notice at the hearing, or that he was prejudiced as a result. Given all of these circumstances, we find *Lawson* distinguishable, and we conclude that the issue of notice is properly before us and that employer did not waive its affirmative defense.

The administrative law judge failed to render any affirmative conclusion as to whether employee provided written notice to employer satisfying each element of the statute, and if not, whether employer was prejudiced by failure to receive the notice. The administrative law judge also appears to have improperly analyzed the notice requirements pertinent to an occupational disease, when he discussed the findings of a diagnostician linking employee's back injury to his work. As a result of these errors and ambiguities, the requisite statutory analysis remains to be accomplished. We turn now to that analysis.

Section 287.420 RSMo sets forth the notice required by injured employees and provides, in pertinent part, as follows:

> No proceedings for compensation for any accident under this chapter shall be maintained unless written notice of the time, place and nature of the injury, and the name and address of the person injured, has been given to the employer no later than thirty days after the accident, unless the employer was not prejudiced by failure to receive the notice.

We find that employee provided notice of his work injury to employer on August 4, 2008, when he informed Victor Wilson, his supervisor, that he'd suffered an accident and hurt his back at work on July 31, 2008. We find that, also on August 4, 2008, employee spoke to employer's safety steward, James King, and filled out a First Aid Report providing his name and the date, location, and nature of his injury. Employee even submitted to a urinalysis on that date.

But because the First Aid Report does not include employee's address, and given that neither party has identified any other written notice from employee to employer within thirty days after the accident, it appears that employee failed to provide a written notice that strictly satisfied each of the elements of the statute. See *Allcorn v. Tap Enters.*, 277 S.W.3d 823, 830 (Mo. App. 2009). Thus, the question is whether employee demonstrated that employer was not prejudiced by failure to receive the notice. "The most common way for an employee to establish lack of prejudice is for the employee to show that the employer had actual knowledge of the accident when it occurred." *Soos v. Mallinckrodt Chem. Co.*, 19 S.W.3d 683, 686 (Mo. App. 2000) (citations omitted), overruled on other grounds by *Hampton v. Big Boy Steel Erection*, 121 S.W.3d 220, 224 (Mo. banc 2003).

We have found that on August 4, 2008, employee told his supervisor, Victor Wilson, as well as employer's safety steward, James King, that he hurt his low back on or about July 31, 2008. "Notice or knowledge is imputed to the employer when it is given to a supervisory employee." Dunn v. Hussman Corp., 892 S.W.2d 676, 681 (Mo. App. 1994) (citation omitted). We conclude that employer had actual knowledge of employee's work injury. Because employer had actual knowledge of employee's work injury, the burden shifts to employer to demonstrate that it was prejudiced by employee's failure to provide written notice. Sell v. Ozarks Med. Ctr., 333 S.W.3d 498, 511 (Mo. App. 2011). After a thorough review of the record, we are convinced that employer failed to meet that burden.

The record reveals that employer had an opportunity to provide medical treatment to minimize employee's back injury and to investigate the circumstances of the accident as soon as employee reported the back injury on August 4, 2008, a mere four days after it occurred. It appears that employer first took advantage of that opportunity in October 2008, when it sent employee to Dr. Tentori, who released employee for full-duty work even while noting his herniated disc at L5-S1 and his pain levels of 7-9 out of 10. Thereafter, employer denied further medical care for employee and told him he was on his own. At any time, employer could have changed course and exercised its right to direct medical treatment, and certainly cannot now reasonably claim to have been hampered in its ability to investigate the circumstances of the accident merely because employee's written notice omitted his address.

We conclude that employer was not prejudiced by employee's failure to provide written notice meeting each of the requirements under § 287.420. We conclude that employee's claim is not barred by that section.

Medical treatment

We agree with the administrative law judge that employee's experts are more credible on the question and that employee met his burden of proving that employer is obligated to provide him with medical treatment for his physical and psychiatric work injuries. However, the administrative law judge went a step further and found that employer "abandoned the ability to direct medical care" and ordered Dr. Amundson as employee's authorized treating physician. See Award, page 13. Employer argues that the administrative law judge was without authority to order employer

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

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