Mary K. Meyer, the employee, was the only witness to personally testify at trial. All other evidence was presented in the form of written records, medical records or deposition testimony.
Ms. Meyer was 63 years old at the time of her trial. She grew up in Jackson, Missouri. Ms. Meyer graduated from Jackson High School in 1967 and shortly thereafter she completed a nine month program at the Jackson School of Cosmetology. She obtained her license in 1968. Ms. Meyer has not had any other type of vocational training, apprenticeship or formal education since then.
She worked full time as a beautician until she was diagnosed with relapsing remitting multiple sclerosis/MS. She received this diagnosis in 1984. Due to the effects of MS, Ms. Meyer gradually reduced the hours she could work as a beautician and eventually had to quit as she could not perform that job anymore. When she was unable to work as a beautician she tried other work. She quit working as a beautician in about 1984. Other than working for a family restaurant she did not work from 1984 to 1995. She worked part time at Country Mart in the deli
from 1995 to 1998. She had to quit as she could no longer stand on her feet all day and her arms got too tired. Dr. Stahly reduced her work hours and would not allow her to work over 25-30 hours a week as anything more than that was too mentally and physically exhausting. Ms. Meyer testified that with MS you have to avoid stress as stress makes the physical problems worse. She indicated that due to stress problems she had to cut out any stressors in her life.
The employee was awarded social security total disability on June 13, 1988, solely due to her MS. She testified that chronic fatigue has been a major problem for her with this disease. Ms. Meyer testified that social security had a program where she could work part time and she continued to work part time as she was able. Ms. Meyer described MS as a relapsing/remitting kind of disease, it comes and goes. Some days she has good days and some days are bad days. She testified that a major problem with MS is tiredness. She indicated that when she was first diagnosed she was really tired, but also had drop toe which caused her to trip, and tingling. These general problems caused her to change her vocation and reduce the number of hours that she could work.
Dr. Stahly prescribed Betaseron for the employee in 1993. This drug is administered by injection. Ms. Meyer still takes this medication today and injects herself about every other day. Betaseron does not cure MS, it just tries to retard the disease and keep it in check.
Ms. Meyer worked part time at Delmonico's Restaurant from 1998 until she was injured on January 22, 2007. She was employed as a waitress and worked approximately 20 to 30 hours per week. Her duties required her to serve beverages and items from the menu and also take care of a self-service buffet.
On January 22, 2007, she was injured while preparing drinks at the soda fountain. Her foot was stuck to the floor because of a sticky substance. As she tried to walk away her foot would not move and she fell and injured her left hip and left knee.
On January 24, 2007, Dr. Kapp performed a partial left hip replacement. On March 20, 2007, Dr. Kapp performed left knee surgery. Ms. Meyer continued to have treatment for the injury of January 22, 2007, until June 26, 2008, at which time she reached maximum medical improvement. Ms. Meyer settled her primary claim with the employer-insurer for 25 % permanent partial disability of the left hip and 15 % permanent partial disability of the left knee. Ms. Meyer testified that she was unable to work because of the pre-existing chronic fatigue caused by the MS and the problems due to the injury to her left hip and knee of January 22, 2007.
The employee had another work accident on September 1, 2003, that was settled for 12^{1 / 2} % permanent partial disability to the head and body as a whole (Injury Number 03-102426).
Ms. Meyer was evaluated Dr. Escandon, a board certified neurologist who practices in St. Louis. Dr. Escandon provided opinions:
- The employee has a 30 % permanent partial disability of the left hip due to her primary injury.
- The employee had a 15\% permanent partial disability of the left knee due to her primary injury.
- He confirmed the diagnosis of multiple sclerosis of the relapsing remitting type together with chronic fatigue syndrome secondary to MS.
- The employee has a 30\% permanent partial disability to the body as a whole due to the pre-existing MS.
- The multiple sclerosis which pre-existed the accident of January 22, 2007, was and is a hindrance and obstacle to employment and re-employment should she become unemployed.
- The employee is permanently and totally disabled as a result of the combination of the three impa