Section 287.220 RSMo creates the Second Injury Fund and provides when and what compensation shall be paid in "all cases of permanent disability where there has been previous disability." As a preliminary matter, the employee must show that he suffers from "a preexisting permanent partial disability whether from compensable injury or otherwise, of such seriousness as to constitute a hindrance or obstacle to employment or to obtaining reemployment if the employee becomes unemployed..." Id. The Missouri courts have articulated the following test for determining whether a preexisting disability constitutes a "hindrance or obstacle to employment":
[T]he proper focus of the inquiry 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.
Knisley v. Charleswood Corp., 211 S.W.3d 629, 637 (Mo. App. 2007)(citation omitted).
We have found that employee suffered from a preexisting permanent partially disabling condition referable to his left shoulder at the time he sustained the work injury. We are convinced this condition was serious enough to constitute a hindrance or obstacle to employment. This is because we are convinced employee's preexisting left upper shoulder condition had the potential to combine with a future work injury to result in worse disability than would have resulted in the absence of the condition. See Wuebbeling v. West County Drywall, 898 S.W.2d 615, 620 (Mo. App. 1995). This, in fact, is what occurred, as we have credited Dr. Poetz's opinion and found that employee was forced, as a result of the primary right shoulder injury, to increase the use of his
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previously compromised left arm, which has rendered employee significantly more disabled than he would be in the absence of the preexisting condition.
Having found that employee suffered from a preexisting permanent partially disabling condition that amounted to a hindrance or obstacle to employment, we turn to the question whether the Second Injury Fund is liable for permanent total disability benefits. In order to prove his entitlement to such an award, 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. "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 have found employee sustained a 50% permanent partial disability of the right shoulder at the 232-week level as a result of the primary injury, and credited the expert opinions from Mr. England and Dr. Poetz that employee's permanent total disability results from a combination of his preexisting left shoulder injury with the effects of the primary injury. We find that employee is not permanently and totally disabled as a result of the last injury considered in isolation.
We conclude employee is permanently and totally disabled owing to a combination of his preexisting disabling conditions in combination with the effects of the work injury. The Second Injury Fund is liable for permanent total disability benefits.
**Conclusion**
We modify the award of the administrative law judge as to the issues of the nature and extent of disability resulting from the primary injury and Second Injury Fund liability.
Employer is liable for permanent partial disability benefits in the amount of $43,679.80.
The Second Injury Fund is liable for weekly permanent total disability benefits beginning March 23, 2010, at the differential rate of $260.51 for 116 weeks. Beginning June 12, 2012, the Second Injury Fund is liable for weekly permanent total disability benefits at the permanent total disability rate of $637.06. The weekly payments shall continue thereafter for employee's lifetime, or until modified by law.
The award and decision of Administrative Law Judge Gary L. Robbins, January 24, 2013, is attached hereto and incorporated herein to the extent not inconsistent with this decision and award.
The Commission further approves and affirms the administrative law judge's allowance of an attorney's fee herein as being fair and reasonable.
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Any past due compensation shall bear interest as provided by law.
Given at Jefferson City, State of Missouri, this $20^{\text {th }}$ day of September 2013.
LABOR AND INDUSTRIAL RELATIONS COMMISSION
John J. Larsen, Jr., Chairman
James G. Avery, Jr., Member
Attest:
Curtis E. Chick, Jr., Member
Secretary