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Marlene Stewart v. Subway

Decision date: June 14, 201316 pages

Summary

The Commission affirmed the administrative law judge's award of permanent total disability compensation to Marlene Stewart for a February 2009 work injury, finding the Second Injury Fund liable despite her preexisting chronic conditions. The decision established that Stewart's demonstrated ability to compete in the labor market and secure multiple part-time positions before the primary injury negated claims she was permanently and totally disabled beforehand.

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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.
  • The injury involved a vehicle, unsafe premises, defective equipment, or a non-employer vendor.
  • A serious injury or death may need both benefits review and civil-claim analysis.

Caption

FINAL AWARD ALLOWING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge with Supplemental Opinion)

Injury No.: 09-022015

Employee: Marlene Stewart

Employer: Subway (Settled)

Insurer: Zurich American 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 § 287.480 RSMo. Having read the briefs, reviewed the evidence, heard the parties' arguments, and considered the whole record, we find that the award of the administrative law judge allowing compensation is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to § 286.090 RSMo, we affirm the award and decision of the administrative law judge with this supplemental opinion.

Second Injury Fund liability

On appeal before this Commission, the Second Injury Fund argues that employee was permanently and totally disabled before she suffered the February 2009 primary injury in this matter. We disagree. Employee's work history shows that she was able to compete for and obtain a number of part-time positions in the open labor market before the primary injury. Employee did not obtain these positions through the help of family or friends, nor was she relegated to "make-work" while performing these jobs. We are convinced that this evidence demonstrates that employee, although limited to part-time work, was not permanently and totally disabled prior to the work injury. In the case of Laturno v. Carnahan, 640 S.W.2d 470 (Mo. App. 1982), the court rejected a similar argument from the Second Injury Fund by pointing to the inescapable fact of the employee's pre-injury employment:

Ability to compete in the labor market is a test for permanent total disability in that it measures the worker's prospects for returning to employment. But a test for probable future employment cannot change the fact of past employment.

Id. at 473 (citations omitted).

We find the holding of the Laturno court dispositive of the issue herein. We believe it is consistent with the purposes of the Second Injury Fund to award compensation to an employee who, at least up until her last injury, was tenacious enough to compete for and secure a number of part-time positions even though she was suffering from seriously limiting chronic conditions. Also, we note that employee's relatively low

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weekly compensation rate for permanent total disability benefits reflects the fact that she was only able to work part-time jobs at the time of the primary injury.

Given the foregoing supplemental analysis, and because we otherwise agree with the administrative law judge's reasoning, we conclude that the Second Injury Fund is liable for permanent total disability benefits.

Preexisting vs. post-injury limitations

On appeal before this Commission, the Second Injury Fund argues the administrative law judge failed to understand the nature of employee's preexisting versus post-injury limitations. The Second Injury Fund points out that the administrative law judge found that employee had no trouble performing all of her job duties for employer, but that employee actually testified that she had aches and pain performing duties for employer such as kneeling, squatting, and reaching overhead.

We do not adopt the administrative law judge's finding that employee had no trouble performing her job duties for employer. We find, instead, that employee had aches and pains performing her duties. We note, however, that there is no evidence to suggest employee was not working to employer's satisfaction before the work injury.

Conclusion

We affirm and adopt the award of the administrative law judge as supplemented herein.

The award and decision of Administrative Law Judge Victorine R. Mahon is attached and incorporated by this reference.

We approve and affirm 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.

Given at Jefferson City, State of Missouri, this $14^{\text {th }}$ day of June 2013.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

DISSENTING OPINION FILED

James G. Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

DISSENTING OPINION

Based on my review of the evidence as well as my consideration of the relevant provisions of the Missouri Workers' Compensation Law, I am convinced that the decision of the administrative law judge awarding permanent total disability benefits against the Second Injury Fund is in error, and should be reversed.

Section 287.220 RSMo creates the Second Injury Fund and provides when and what compensation shall be paid from the fund in "all cases of permanent disability where there has been previous disability." The Fund is liable for permanent total disability benefits only where the work injury combines 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).

Before the primary injury in this case, this 47-year-old employee was relegated to parttime positions as a result of a preexisting history of seriously disabling chronic pain conditions including Fibromyalgia, arthritis, reflex sympathetic dystrophy, degenerative joint disease, and carpal tunnel syndrome. Employee also suffered from depression. Employee has been on Social Security disability benefits since the late 1990's. Since that time, employee has never worked more than 20 hours per week, and has never worked for any single employer longer than about 6 months. Before the work injury, employee would lie down one to two times per day for relief from her pain conditions. When employee worked, she was in pain. At the end of the day, she would go home, take a pain pill, and lie down for the rest of the night.

All of the foregoing are limitations that employee suffered before the primary injury; all of the foregoing are classic indicators for permanent total disability. I believe the vocational expert Wilbur Swearingin most credibly evaluated employee's preexisting condition when he opined that employee was permanently and totally disabled before the work injury. I believe the majority misreads Mr. Swearingin's opinion when they construe it as supportive of an award of permanent total disability benefits against the Second Injury Fund. I also note that employee's own medical expert opined that her work after 1997 did not represent work in the open labor market.

On a more fundamental level, I believe the majority's conclusion that this employee was not permanently and totally disabled prior to the work injury runs directly contrary to a long history of decisions from administrative law judges, this Commission, and from the courts awarding permanent total disability benefits to employees with similar, or even less limiting, disabilities. Far from dispositive, I consider Laturno v. Carnahan, 640 S.W.2d 470 (Mo. App. 1982) to be a case that speaks to the timing of payments from the Second Injury Fund. The dicta cited by the majority for abandoning the wellestablished test for permanent total disability cannot change the reality that if this employee were pointing to the same limitations and disabling conditions after a work injury, no reasonable person could seriously contend that she was capable of competing for work in the open labor market.

In sum, I find no support in the Missouri Workers' Compensation Law for the proposition that we should throw out the test for permanent total disability simply because the employee was able to eke out an extremely restricted employment history. I disagree with the majority's choice to credit Mr. England. I credit instead Mr. Swearingin and find that employee was permanently and totally disabled before the work injury of February 25, 2009. It follows that there is no Second Injury Fund liability, because there can be no "combination" of disabilities where employee was already permanently and totally disabled at the time of the primary injury. I would reverse the decision of the administrative law judge.

Because the majority has determined otherwise, I respectfully dissent.

James G. Avery, Jr., Member

AWARD

Employee: Marlene Stewart

Injury No. 09-022015

Dependents: Not applicable.

Employer: Subway (settled)

Additional Party: Treasurer of the State of Missouri, as

Custodian of the Second Injury Fund

Insurer: Zurich American Insurance Company (settled)

Hearing Date: January 27, 2012

Before the

DIVISION OF WORKERS' COMPENSATION

Department of Labor and Industrial Relations of Missouri

Jefferson City, Missouri

Checked by: VRM/db

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: February 25, 2009.
  5. State location where accident occurred or occupational disease was contracted: West Plains, Howell County, 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 the 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: Claimant slipped and fell on water at work.
  12. Did accident or occupational disease cause death? No. Date of death? N/A.
  13. Part(s) of body injured by accident or occupational disease: Body as a whole, including shoulder, back, and neck.
  1. Nature and extent of any permanent disability: Settled as to Employer/Insurer; Permanent total disability as against the Second Injury Fund.
  2. Compensation paid to-date for temporary disability: $\ 845.25.
  3. Value necessary medical aid paid to date by employer/insurer? $\ 33,509.88.
  4. Value necessary medical aid not paid by employer/insurer? Not applicable.
  5. Employee's average weekly wages? $\ 180.00.
  6. Weekly compensation rate: $\ 120.75.
  7. Method of computation: By stipulation.

COMPENSATION PAYABLE

  1. Amount of compensation payable: Settled as to Employer/Insurer for 20 percent to the body as a whole.
  2. Second Injury Fund liability: See below.
  3. Future requirements:

For permanent total disability, the Second Injury Fund shall pay the permanent total disability rate of $\ 120.75 per week, beginning November 28, 2011, (which is 80 weeks after the date of maximum medical improvement), and continuing for the remainder of Claimant's lifetime, subject to review and modification as provided by law. Interest shall accrue as provided by law.

The compensation awarded shall be subject to a lien in the amount of 25 percent of all payments in favor of the following attorney for necessary legal services rendered to Claimant: Randy Alberhasky.

FINDINGS OF FACT AND RULINGS OF LAW

Employee: Marlene Stewart

Injury No. 09-022015

Dependents: Not applicable.

Employer: Subway (settled)

Additional Party: Treasurer of the State of Missouri, as

Custodian of the Second Injury Fund

Insurer: Zurich American Insurance Company (settled)

Hearing Date: January 27, 2012

Before the DIVISION OF WORKERS' COMPENSATION

Department of Labor and Industrial Relations of Missouri

Jefferson City, Missouri

INTRODUCTION

The above-referenced Workers' Compensation claim was heard before the undersigned Administrative Law Judge on January 27, 2012. Marlene Stewart (Claimant) appeared with her attorney, Randy Alberhasky. Assistant Attorney General Cara Harris appeared on behalf of the Treasurer of the State of Missouri, as Custodian of the Second Injury Fund. Subway and Zurich American Insurance Company previously settled their liability with Claimant. Claimant proceeds against the Second Injury Fund fo

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

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