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Steven Crossley v. Southwestern Bell Telephone Co./AT&T Communications

Decision date: December 17, 201310 pages

Summary

The Labor and Industrial Relations Commission affirmed the administrative law judge's award of workers' compensation benefits for Steven Crossley's right knee injury sustained in a slip and fall accident on July 9, 2010. The claimant was awarded compensation for unpaid medical expenses, temporary total disability, and permanent partial disability of 35% of the right knee.

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Caption

FINAL AWARD ALLOWING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 10-053611

Employee: Steven Crossley

Employer: Southwestern Bell Telephone Co./A T \& T Communications

Insurer: Self-Insured/Old Republic Insurance Company

The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. Having reviewed the evidence and considered the whole record, the Commission finds that the award of the administrative law judge 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 the award and decision of the administrative law judge dated May 30, 2013. The award and decision of Administrative Law Judge Karla Ogrodnik Boresi, issued May 30, 2013, is attached and incorporated by this reference.

The Commission further approves and affirms 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 $17^{\text {th }}$ day of December 2013.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

James G. Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

AWARD

Employee:Steven CrossleyInjury No.: 10-053611
Dependents:N/A
Employer:Southwestern Bell Telephone Co.Before the
Additional PartyN/ADivision of Workers' Compensation
Of Missouri
Insurer:Self C/o Sedgwick Claims Mgmt.Jefferson City, Missouri
Hearing Date:February 26, 2013Checked by: KOB

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: July 9, 2010
  5. State location where accident occurred or occupational disease was contracted: Saint 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 slipped and fell, injuring his right knee.
  12. Did accident or occupational disease cause death? No
  13. Part(s) of body injured by accident or occupational disease: Right knee
  14. Nature and extent of any permanent disability: 35 % PPD of the right knee
  15. Compensation paid to-date for temporary disability: $\ 19,738.47
  16. Value necessary medical aid paid to date by employer/insurer? $\ 18,340.97
  1. Value necessary medical aid not furnished by employer/insurer? $\ 39,024.83
  2. Employee's average weekly wages: $\ 970.92
  3. Weekly compensation rate: $\$ 647.26 / \ 422.97
  4. Method wages computation: By Stipulation

COMPENSATION PAYABLE

  1. Amount of compensation payable:

Unpaid medical expenses: $\ 39,024.83

$146 / 7 weeks of temporary total disability: \ 9,616.40

56 weeks of permanent partial disability from Employer: $\ 23,686.32

  1. Second Injury Fund liability: N/A

TOTAL:

  1. Future requirements awarded: None

Said payments to begin immediately and to be payable and be subject to modification and review as provided by law.

The compensation awarded to the claimant shall be subject to a lien in the amount of 25 % of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant: John Winterscheidt

FINDINGS OF FACT and RULINGS OF LAW:

Employee:Steven CrossleyInjury No.: 10-053611
Dependents:N/A
Employer:Southwestern Bell Telephone Co.Before the
Additional PartyN/ADivision of Workers' Compensation
Of Missouri
Insurer:Self C/o Sedgwick Claims Mgmt.Jefferson City, Missouri
Hearing Date:February 26, 2013Checked by: KOB

PRELIMINARIES

The matter of Steve Crossley ("Claimant") proceeded to final hearing on February 26, 2011. Attorney John Winterscheidt represented Claimant. Attorney Sarah Reichert represented Southwestern Bell Telephone Company aka AT\&T Communications ("Employer"), and thirdparty administrator Sedgwick CMS.

The parties stipulated Claimant sustained an accidental injury to the right knee, arising out of and in the course of his employment on July 9, 2010. The St. Louis Division of Workers' Compensation is the proper venue, and notice, timeliness of the claim, and coverage of the Act were not at issue. The parties further stipulated at the relevant time, Claimant was an employee of Employer, who earned an average weekly wage of $\ 970.92, with corresponding rates of compensation of $\ 647.26 for temporary total disability ("TTD") benefits and $\ 422.97 for permanent partial disability ("PPD") benefits. Employer paid \$19,738.47 in TTD benefits from July 10, 2010 to January 25, 2011. Employer also paid medical benefits in the amount of $\ 18,340.97.

The issues for determination are: 1) Medical causation; 2) Employer's liability for past medical expenses of up to $\ 39,024.83; 3) Employer's liability for TTD benefits from April 1, 2011 to July 14, 2911, or \$9,616.40; and 4) Employer's liability for PPD benefits.

Claimant's exhibits A through L, and Employer's exhibits 1 through 3 were offered and admitted without objection.

The dispute in this case is whether Claimant's acknowledged work accident is the prevailing factor and medical cause for the second right knee surgery and associated benefits. Employer accepts responsibility for a once-operated knee, but disputes additional liability. Claimant asserts the work accident was the prevailing factor in both surgeries and resultant disability. The evidence compels an award in favor of Claimant.

Live Testimony and Medical Records

Claimant is a fifty-eight-year-old man who worked for Employer as a "prim tech" from 2008 to July 14, 2011. His job involved installing Employer's "U-Verse" technology in residences and businesses, which required climbing utility poles and ladders, ascending and descending stairs, climbing into and crawling around attics and crawl spaces, frequent bending, stooping, and kneeling, and walking on uneven surfaces. Other than occasional pain and stiffness in his knees and wrists that he attributed to "getting older", Claimant never had any problems with his right knee before July 9, 2010. Likewise, prior to July 9, 2010, Claimant never injured his right knee, received medical treatment or missed time from work due to his right knee.

On July 9, 2010, while performing an installation, Claimant had to pull coaxial cable through a wet, sloped, wooded area. While doing so, he slipped, twisted his right knee and fell to the ground landing on the knee. Claimant felt immediate pain in the knee.

Employer directed Claimant to Concentra Medical Center that day for treatment. Concentra records reflect a history of Claimant's accident as well as a history of swelling in the right knee off and on for the last six months. Claimant explained that he told the Concentra medical personnel about the aches and pains he had experienced in both of his knees and wrists before the accident, but did not recall telling them that his right knee had previously swelled.

Concentra medical personnel diagnosed Claimant with a right knee strain, provided him with an ACE bandage, referred him to physical therapy, and instructed him to ice and exercise the knee. Work restrictions of no squatting, kneeling or ladder climbing were imposed. Employer did not have work available within those restrictions. The July 16, 2010 record of Employee's follow-up visit states, "[a]ccording to the history provided by the patient and the physical exam it is my professional opinion that work was the prevailing factor in the patient's injury."

Physical therapy did not help Claimant's condition. An MRI revealed signal changes in the medical meniscus suggesting the possibility of a radial tear. Concentra personnel diagnosed a meniscal tear, referred Claimant to an orthopedic surgeon, and imposed work restrictions of no climbing and sitting 50 % of the time. Employer could not accommodate those restrictions.

On August 12, 2010, orthopedic surgeon Dr. Christopher Kostman, evaluated Claimant, recorded a history of Claimant's July 9, 2010 accident, and diagnosed a right knee injury with probable medial meniscal tear. Dr. Kostman injected Claimant's knee and recommended surgery. Employer could not accommodate the continued work restrictions.

After obtaining cardiac clearance ${ }^{1}$, on December 10, 2010, Dr. Kostman performed an arthroscopic partial medial meniscectomy and chondroplasty of the patellofemoral joint.

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[^0]: ${ }^{1}$ Claimant has a history of cardiac issues, including heart attacks in 1995 and 2000. He obtained clearance from his cardiologists by undergoing testing at Belleville Memorial Hospital in the Fall of 2010, prior to his first surgery. He incurred medical expenses of $\ 9,666.98. Clearance from his cardiologist was a prerequisite for surgery.

Following surgery, Dr. Kostman excused Claimant from work, referred him for additional physical therapy, and on December 22, 2010, released him to return to work with restrictions of 50 % deskwork, no lifting, pushing or pulling greater than 35 pounds and no ladder climbing. Employer could not accommodate those restrictions.

The January 24, 2011 functional capacity evaluation ("FCE") revealed an overall good effort and determined that Claimant could return to work in the medium work level, but that he did not meet the essential job demands required by his position with Employer. On January 25, 2011, Dr. Kostman released Claimant to return to work without restrictions and declared Claimant to be at maximum medical improvement ("MMI"). Although Dr. Kostman's report indicated full range of motion, almost no swelling and tenderness to palpation, Claimant testified that as of that date, he still experienced knee pain, swelling, occasional popping, and a feeling that his knee would give out while ascending and descending stairs.

Claimant returned to work for Employer with an assigned a helper, and testified that he was able to do his job with difficulty. He purchased an over-the-counter knee brace, but still had significant difficulty performing his job duties of pole and ladder climbing. Sometime in March 2011, Claimant's right knee gave out when he stepped out of his truck. He grabbed a handle on the truck to keep from falling. He testified that the incident did not change the symptoms he felt when he last saw Dr. Kostman.

Employer denied Claimant's request ${ }^{2}$ to return to Dr. Kostman, so Claimant sought medical treatment with his family physician, Dr. Kelly Wood, on April 1, 2011. Dr. Wood recorded symptoms of post-operative pain, buckling, popping, grinding and swelling. She noted Claimant has difficulty performing his job duties, especially climbing poles. Dr. Wood diagnosed post surgery right knee pain, ordered X-rays, prescribed medication, and referred Claimant for another FCE. Dr. Wood also placed work restrictions of no kneeling or climbing, which Employer could not accommodate.

The April 14, 2011 FCE revealed near full levels of physical effort on Claimant's behalf as well as full reliability of Claimant's reports of pain and disability. The FCE determined that Claimant is not capable of performing his job duties as a "communications technician", but was able to work at the "light-medium" level.

At Dr. Wood's referral, orthopedic surgeon Dr. Forbes McMullin saw Claimant on April 5, 2011. Dr. McMullin recorded a history of the

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

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