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Barbara Simmons v. Mercy Hospital St. Louis

Decision date: June 27, 20139 pages

Summary

The Labor and Industrial Relations Commission affirmed the administrative law judge's temporary or partial award in a workers' compensation case involving Barbara Simmons, a billing specialist at Mercy Hospital St. Louis who suffered a right proximal humerus fracture when she fell on a linoleum floor while walking to an elevator. The case remains open for further proceedings to determine a final award.

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Caption

TEMPORARY OR PARTIAL AWARD

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 12-001723

Employee: Barbara Simmons

Employer: Mercy Hospital St. Louis

Insurer: Mercy Hospitals East Communities

Additional Party: Treasurer of Missouri as Custodian of Second Injury Fund (Open)

The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission for review as provided by $\S 287.480$ RSMo, which provides for review concerning the issue of liability only. Having reviewed the evidence and considered the whole record concerning the issue of liability, the Commission finds that the award of the administrative law judge in this regard is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to § 286.090 RSMo, the Commission affirms and adopts the award and decision of the administrative law judge dated December 20, 2012.

This award is only temporary or partial, 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.

The award and decision of Administrative Law Judge Karla Ogrodnik Boresi, issued December 20, 2012, is attached and incorporated by this reference.

Given at Jefferson City, State of Missouri, this $27^{\text {th }}$ 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 is in error, and should be reversed.

Employee worked for employer as a billing specialist. Her duties included posting payments, receiving payments, filing insurance claims, making deposits, and collecting mail. Employee made deposits and picked up mail once per day, typically near the end of her shift.

On January 13, 2012, employee was walking down a hallway after picking up the office mail from the mailbox area located on the lobby floor of the building where she worked. Employee was on her way to the elevator which would take her to the second floor where her office was located. As employee walked toward the elevator area, she looked up and saw a doctor from her office walking toward the elevators. Employee picked up her pace in order to catch up to the doctor. Employee offered no explanation at the hearing as to why she wanted to catch up with the doctor.

When employee reached the end of the hallway, she slowed her pace to turn a corner to the elevator area. As employee was walking toward the elevators, her feet stuck to the linoleum floor, and she fell forward and landed on her right shoulder. Employee suffered a right proximal humerus fracture as a result of her fall.

Employee was unable to provide any explanation as to why her feet stuck to the floor. Employee testified there was nothing on her shoes that caused her feet to stick to the floor, and that there was nothing about the floor itself that caused her to fall. Employee agreed that there was no sticky substance on the floor, and that there were no defects or uneven spots on the floor that caused her to fall. Employee explained that the shoes she was wearing at the time of her accident were shoes she chose to wear; they were not required by employer.

Employee agreed that she walks on linoleum floor outside of work, and that she also carries items with both of her hands. Employee only walks at work when she is making deposits, picking up mail, or retrieving files. Employee typically picked up the mail only once per shift. Employee did not provide any evidence to show she walks more at work than outside of work, nor that she carries mail at work more often than she does at home.

William Stogner, a security officer who responded to the incident, testified that he inspected the area where employee fell, and did not find any foreign substances, liquids, or defects in the floor.

Given the foregoing facts, I am convinced that employee has failed to demonstrate that her injuries arose out of and in the course of employment. The courts have interpreted § 287.020.3(2)(b) RSMo to involve a "causal connection" test. Johme v. St. John's Mercy Healthcare, 366 S.W.3d 504, 510-11 (Mo. 2012). In specifically contrasting a "work-related risk" versus a "risk to which the employee was equally exposed" outside

Injury No.: 12-001723

Employee: Barbara Simmons

- 2 -

of work, the Johme court made clear that our analysis under § 287.020.3(2)(b) should begin with an identification of the risk or hazard that resulted in the employee's injuries, followed by a quantitative comparison whether this employee was equally exposed to that risk in normal nonemployment life. Id. at 512. Following the court's reasoning, the result of this quantitative comparison should reveal whether employee's injuries resulted from a risk unrelated to the employment.

Here, I find that the risk or hazard that resulted in employee's injuries is that of employee's shoe sticking to a linoleum floor. The next question is whether employee was equally exposed to that risk or hazard in her normal nonemployment life. I am convinced that employee was so exposed. Employee agreed that she walks outside of work, and that she walks on linoleum floors. Employee also agreed that her job does not involve a lot of walking, and that she typically only does so if she is getting the mail or making a deposit, events that happen once per shift, at most. Nothing about employee's work as a billing specialist caused employee to fall down on January 13, 2012. As the Missouri Supreme Court has made unmistakably clear:

An injury will not be deemed to arise out of employment if it merely happened to occur while working but work was not a prevailing factor and the risk involved ... is one to which the worker would have been exposed equally in normal non-employment life.

Johme v. St. John's Mercy Healthcare, 366 S.W.3d 504, 511 (Mo. 2012), quoting Miller v. Mo. Highway \& Transp. Comm'n, 287 S.W.3d 671, 674 (Mo. 2009).

I believe the majority's reasoning imputes liability to employer merely because employee was injured at work, and fails to address the relevant question whether her injuries resulted because of work. I am convinced that employee's injuries came 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.

For the foregoing reasons, I would reverse the award of the administrative law judge and enter a final award denying employee's claim. Because the majority has determined otherwise, I respectfully dissent.

James G. Avery, Jr., Member

PARTIAL AWARD

Employee: Barbara Simmons

Injury No.: 12-001723

Dependents: N/A

Employer: Mercy Hospital St. Louis

Additional Party: Second Injury Fund

Insumer: Mercy Hospitals East Communities

Hearing Date: October 3, 2012

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: KOB

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? No, due to limited nature of the award.
  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: January 13, 2012
  5. State location where accident occurred or occupational disease was contracted: St. Louis County
  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: Claimant was walking on laminate floor in rubber clogs while clutching mail when she fell.
  12. Did accident or occupational disease cause death? No.
  13. Part(s) of body injured by accident or occupational disease: Right shoulder
  14. Nature and extent of any permanent disability: Not determined.
  15. Compensation paid to-date for temporary disability: $\ 0.00
  16. Value necessary medical aid paid to date by employer/insurer? $\ 0.00
  1. Value necessary medical aid not furnished by employer/insurer? To be determined
  2. Employee's average weekly wages: To be determined.
  3. Weekly compensation rate: To be determined.
  4. Method wages computation: To be determined.

COMPENSATION PAYABLE

  1. Amount of compensation payable:

To be determined.

  1. Second Injury Fund liability:

To be determined.

  1. Future requirements awarded:

To be determined.

Each of said payments to begin and be subject to modification and review as provided by law. This award is only temporary or partial, is subject to further order, and the proceedings are hereby continued and the case kept open until a final award can be made.

IF THIS AWARD IS NOT COMPLIED WITH, THE AMOUNT AWARDED HEREIN MAY BE DOUBLED IN THE FINAL AWARD, IF SUCH FINAL AWARD IS IN ACCORDANCE WITH THIS TEMPORARY AWARD.

The compensation awarded to the claimant shall be subject to a lien in the amount of TBD of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant: Christopher Wagner

FINDINGS OF FACT and RULINGS OF LAW:

Employee: Barbara Simmons

Injury No.: 12-001723

Dependents: N/A

Employer: Mercy Hospital St. Louis

Additional Party: Second Injury Fund

Insumer: Mercy Hospitals East Communities

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: KOB

PRELIMINARIES

The matter of Barbara Simmons ("Claimant") proceeded to hearing to determine whether Claimant's accidental injury arose out of her employment. Attorney Christopher Wagner represented Claimant. Attorney Patrick Hinrichs represented Mercy Hospital St. Louis ("Employer") and its Insurer. The Second Injury Fund is a party to the claim, but because the parties submitted this case for hearing on the limited issue of arising out of employment, the Fund did not attend the hearing.

The parties stipulated that on January 13, 2012, Claimant sustained an accidental injury. The parties agreed Claimant was an employee of Employer, venue is proper in the City of St. Louis, Employer received proper notice, and Claimant filed her claim within the time required by law. Employer has denied the claim as not compensable. Because of the limited scope of the hearing, there were no other stipulations.

The limited issue to be determined is whether Claimant sustained an injury that arose out of and in the course of employment. If Employer prevails, the parties have requested a final award. If the issue is resolved in favor of Claimant, a temporary and partial award will result.

FINDINGS OF FACT

The underlying facts are undisputed. Claimant was billing specialist for an office of pulmonologists located on the second floor in Tower A at Mercy Hospital. It was her habit, but not a job requirement, to wear snug fitting, slip resistant rubber clogs that she bought at the Mercy Hospital uniform store. She only wore the clogs at work. Among her duties was making deposits with the hospital cashier and collecting the office mail, which she often combined into one trip. On January 13, 2012, Claimant had made the deposit and collected the mail from the mailboxes located by the Tower B elevators. As she made her way back to the office, Claimant walked down the corridor clutching magazines and envelopes of multiple sizes with both hands pressed to her chest. Looking up, she saw Dr. Paranjothi, one of the pulmonologists from her

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

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