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Donald Payne v. J. B. Hunt Transport, Inc.

Decision date: December 28, 201216 pages

Summary

The Commission reversed the administrative law judge's award finding the Second Injury Fund liable for permanent total disability benefits for an employee who suffered bilateral rotator cuff tendonitis from a fall on ice in a truck stop parking lot on December 24, 2004. The employee had significant preexisting conditions including cardiovascular disability from a prior heart attack, diabetes, and sleep apnea, which complicated the assessment of disability attributable solely to the primary shoulder injury.

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Third-Party Injury Check

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

  • A driver, contractor, property owner, or equipment company may share fault.
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Caption

FINAL AWARD DENYING COMPENSATION

(Reversing Award and Decision of Administrative Law Judge)

Injury No.: 04-142098

Employee: Donald Payne

Employer: J. B. Hunt Transport, Inc. (Settled)

Insurer: Self-Insured (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 reverses the award and decision of the administrative law judge.

Preliminaries

The parties stipulated the sole issue for determination by the administrative law judge was the liability of the Second Injury Fund for permanent disability with employee alleging permanent total disability.

The administrative law judge summarized the evidence and concluded the Second Injury Fund is liable for permanent total disability benefits.

The Second Injury Fund submitted a timely Application for Review with the Commission.

For the reasons set forth below, we reverse the award of the administrative law judge.

Preexisting conditions

Prior to December 24, 2004, the date on which employee sustained the primary injury, employee suffered preexisting cardiovascular disability referable to a 1997 heart attack which necessitated a surgery and placement of two stents.

Employee also suffered preexisting diabetes. Although the condition was not diagnosed until after the work injury, the condition caused swelling and pain in employee's legs for several years prior to the accident of December 24, 2004.

Employee also suffered from sleep apnea prior to December 24, 2004.

Primary injury

On December 24, 2004, employee suffered injury while working for employer when he fell on ice while walking through a truck stop parking lot. Employee suffered injuries to both shoulders as a result of the accident. Treating doctors diagnosed bilateral rotator cuff tendonitis. We must determine the nature and extent of this primary injury.

Employee presents Dr. Bennoch, who rated the primary injury at 40\% "permanent partial impairment" of each shoulder. Dr. Bennoch testified impairment is not the same as disability and that employee's true disability may be "much less" than the impairment ratings he issued. Surprisingly, the parties did not ask Dr. Bennoch to express his opinions in terms of permanent partial disability. We find Dr. Bennoch's impairment ratings to be of little help to us in analyzing this claim.

Dr. Bennoch's restrictions are also somewhat confusing. We note that, in his report of May 18, 2006, Dr. Bennoch initially assigned postural limitations secondary to employee's preexisting weight and cardiovascular conditions. Then, in his report dated May 14, 2010, Dr. Bennoch identified the same restrictions, but this time suggested they were referable to the primary injury. Finally, at his deposition, Dr. Bennoch testified that all the limitations he identified in his first report are for the primary shoulder injuries. We take it that Dr. Bennoch retracts his initial restrictions referable to preexisting conditions and ultimately believes that all of the restrictions he identified are referable to the primary injury.

Accordingly, we find that Dr. Bennoch assigned the following restrictions in reference to the primary injury: no lifting or carrying more than 10 lbs , no push/pull, no repetitive lifting, no work at or above shoulder level, no climbing, no balancing, no reaching with both arms, and no work that involves vibration, hazardous machinery, or heights.

Dr. Bennoch offered the opinion in his report dated May 14, 2010, that employee is permanently and totally disabled owing to the effects of the December 2004 work injury considered alone, if employee does not have surgery. Then, at his deposition, Dr. Bennoch opined that employee is permanently and totally disabled owing to a "collection" of his medical problems. Later, on cross-examination, Dr. Bennoch agreed that, as of his examination of employee on May 12, 2010, "[t]he shoulders-bilateral shoulders alone would have been enough, in that present state, without any further treatment, to be permanently and totally disabled." Transcript, page 394. Dr. Bennoch went on to agree that, to his knowledge, employee had not received any further treatment.

Employee testified he did not elect to undergo the surgery Dr. Bennoch referenced because he decided, based on discussions with his treating doctor, that it wouldn't help. Employee also credibly testified (and we so find) that his shoulders are worse now than before. Accordingly, we find that employee has not received any treatment that would change the impact of Dr. Bennoch's May 12, 2012, opinion that employee is permanently and totally disabled owing to the primary injury if it is considered alone.

Employee also presents Philip Eldred, who opined employee is permanently and totally disabled. Mr. Eldred explained that employee, a truck driver for almost his entire working life, has no transferable skills. Mr. Eldred backed up this assertion with an indepth explanation of his methodology. We credit Mr. Eldred on this point and find that employee has no transferable skills.

Mr. Eldred opined that employee is permanently and totally disabled because he has worked in manual labor all his life, has a GED but no formal training beyond that, and

Improvee: Donald Payne

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because of the physical restrictions imposed by the doctors. We note that Mr. Eldred did not appear to be aware that Dr. Bennoch ultimately opined that all of the restrictions he identified were referable to the primary injury alone. For example, Mr. Eldred incorrectly believed Dr. Bennoch's lifting and similar restrictions were attributable to employee's cardiovascular problems as well as the primary injury. As noted above, Dr. Bennoch did not so testify.

Mr. Eldred was asked whether he believed the work injury alone rendered employee permanently and totally disabled or whether it was a combination of employee's preexisting conditions and the effects of the primary injury. Mr. Eldred provided the conclusory response that it was a combination. Especially in light of Mr. Eldred's failure to appreciate the nature of the restrictions assigned by Dr. Bennoch, we find Mr. Eldred's opinion lacking credibility on the question whether employee is permanently and totally disabled as a result of the effects of the work injury considered alone.

The Second Injury Fund presents Mary Titterington, who opined employee is not permanently and totally disabled. Ms. Titterington believes employee has some skills that would be transferable to light or sedentary work. We have credited Mr. Eldred's testimony that employee does not have any transferrable skills. We find Ms. Titterington's contrary opinion lacking credibility, and in turn we are not persuaded by her testimony that employee is not permanently and totally disabled.

After careful consideration, we find Dr. Bennoch's opinion as stated in his May 14, 2012, report, and as conceded on cross-examination at his deposition, to be the most credible on the question whether employee is permanently and totally disabled owing to the effects of the work injury considered alone.

Second Injury Fund liability

For the Second Injury Fund to be liable for permanent total disability benefits, employee must establish that: (1) he suffered a permanent partial disability as a result of the last compensable injury; and (2) that disability has combined with a prior permanent partial disability to result in total permanent disability. ABB Power T \& D Co. v. Kempker, 236 S.W.3d 43, 50 (Mo. App. 2007). Section 287.220.1 requires us to first determine the compensation liability of the employer for the last injury, considered alone. If employee is permanently and totally disabled due to the last injury considered in isolation, the employer, not the Second Injury Fund, is responsible for the entire amount of compensation.

We have found most credible Dr. Bennoch's opinion, conceded on cross-examination, that employee is permanently and totally disabled owing to the work injury considered alone. Employee certainly suffered some preexisting disability, most notably with respect to his cardiovascular condition, but we are precluded from even considering employee's preexisting conditions until we have determined the nature and extent of the primary injury, because "pre-existing disabilities are irrelevant until the employer's liability for the last injury is determined." Landman v. Ice Cream Specialties, Inc., 107 S.W.3d 240, 248 (Mo. 2003). We conclude employee is permanently and totally disabled as a result of the primary injury considered alone and in isolation.

Employee: Donald Payne

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Employee has failed to meet his burden of proving Second Injury Fund liability for permanent total disability benefits.

Conclusion

Based on the foregoing, the Commission concludes employee is permanently and totally disabled as a result of the primary injury considered alone and in isolation. Accordingly, employee's claim against the Second Injury Fund is denied.

The award and decision of Administrative Law Judge Karen Wells Fisher, issued March 21, 2012, is attached solely for reference.

Given at Jefferson City, State of Missouri, this $28^{\text {th }}$ day of December 2012.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

V A C A N T Chairman

James Avery, Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

Employee:Donald PayneInjury No.: 04-142098
Dependents:N/A
Employer:J. B. Hunt Transport, Inc. (Settled)
Additional Party:Treasurer of the State of Missouri as Custodian of the Second Injury Fund
Insurer:Self-Insured (Settled)
Hearing Date:November 10, 2011
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. December 24, 2004.
  5. State location where accident occurred or occupational disease was contracted. Slightly east of Memphis, Tennessee at a truck stop operated by TA Truck Stops.
  6. Was above employee in the 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 employment? Yes.
  9. Was Claim for Compensation filed within time required by law? Yes.
  10. Was employer insured by above insurer? Self-insured.
  11. Describe work being performed and how accident occurred or occupational disease contracted. The Employee was walking across the parking lot of the TA Truck Stop when he slipped and fell onto his upper back and shoulder blades, injuring both shoulders. Diagnostic imaging indicated tears to the rotator cuffs of both shoulders. The MRI scan to the left shoulder indicated high grade tearing of the distal supraspinatus with a complete pinhole identified. The MRI scan for the right shoulder indicated a 1.8 centimeter complete supraspinatus tendon tear.
  12. Did accident or occupational disease cause death? No.
  13. Parts of body injured by accident or occupational disease. Shoulders and the body as a whole.
  14. Nature and extent of any permanent disability. Permanent Total Disability.
  15. Compensation paid to-date for temporary disability. N/A.
  1. Value necessary medical aid paid to-date by employer/insurer? N/A.
  2. Value necessary medical aid not furnished by employer/insurer? N/A.
  3. Employee's average weekly wages: $\ 480.00.
  4. Weekly compensation rate: $\ 360.00.
  5. Method wages computation: Stipulation.
  6. Compensation payable: N/A. The Claim for Compensation against the employer was settled, and approved by the Division on Decemb

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

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