Larry Voidanoff ("Claimant") was born on September 27, 1958. He is 54 years old and stayed through the $11^{\text {th }}$ grade in high school. He has some difficulty reading and writing and has few computer skills. Claimant's work history is in fast food retail as well as in stocking shelves with produce and hardware. He worked for three employers in the 6 years leading up to his work injury: Walmart, Captain D's and United Samsco, Inc. He worked for United Samsco in two Home Depot stores stocking the shelves. In all positions he worked physically demanding jobs where he was on his feet all shift carrying items. He was a full-time store manager of eight employees at Captain D's. He was the produce manager at Walmart where he stocked shelves and did all aspects the job required. Employee testified he worked for both Walmart and Captain D's at the same time for five years between approximately 2000 and 2005. He began his employment with United Samsco Inc in February 2005.
Claimant testified that while he worked for United Samsco, it was United Samsco which directed and controlled his work; however, he physically worked at two Home Depot stores, one in Osage Beach, Missouri and the other in Columbia, Missouri. The parties stipulated that Claimant was an employee of United Samsco and that United Samsco was subject to the Missouri Workers' Compensation Act.
Claimant testified regarding conditions he had prior to the injury of May 19, 2005. He testified that in 1981 while in the military he suffered a gunshot wound to his left ankle, but he had no permanent disability or ongoing problems from that condition. Claimant testified that in March 1996 he sustained an injury to his left ankle when he fell down some stairs shattering his talus bone. Following a failed fusion Claimant had the option of either living with the pain from his left ankle or having a below knee amputation. Claimant decided on the below knee amputation, which he had done in December 1996. He was fitted with a prosthetic and returned to the work force in 2000, working for both Walmart and Captain D's. Claimant described that with the prosthesis he wore special shoes which had extra grip on them. They gave him a little more stability but looked and performed like normal tennis shoes.
After returning back to the work force in 2000, Claimant worked two full-time jobs. He worked for Walmart as the produce manager, ten hours a day, 5-6 days a week, which Claimant described as a manual job. His shift ended about 12:30 a.m. or 1:00 a.m. He described lifting boxes which were fifty to sixty pounds all day long. During this time he also worked for Captain D's as the daytime manager working 8 hours a day usually about 5:30 a.m. to 1:00 p.m., Monday to Friday. At Captain D's he frequently lifted boxes weighing fifty pounds. In both jobs Claimant was on his feet most of the time. He testified he was able to do everything required of him at these jobs, and needed no accommodations or help to perform his work. Claimant stated at the hearing "Nobody gave any accommodations to help with anything I have done" when referring to his abilities before 2005.
In February 2005 Claimant began working for United Samsco ("Employer") stocking shelves in two Home Depot stores. He quit his jobs at Walmart and Captain D's to work for Employer. He worked 7 am to 3 pm , five days a week, Monday through Friday, two days in Osage Beach and three days in Columbia. He testified he occasionally worked overtime. At the Home Depot stores he was constantly on his feet stocking shelves, carrying items up and down ladders, carrying hardware, tools, lumber, etc. Claimant continued to climb ladders even with his prosthesis and that, indeed, at the time of the May 19, 2005, injury Claimant was on a ladder. Claimant described the ladders he used at Home Depot. They were platform ladders with wide steps, a platform measuring about two feet by three feet on the top, handrails on each side, a railing at the top, and metal grips on the steps and platform. He used these ladders daily while working for United Samsco at the Home Depot stores.
Claimant testified regarding the injury of May 19, 2005. He was on a ladder stocking some shelves. He turned to descend and his left foot caught on the grate at the top of the ladder. In particular he stated it was the special shoe on his prosthesis which caught on the ladder. He turned but his foot did not which caused the muscle to pull from the bone at the site of the amputation, right where the prosthetic met his leg. He reported the injury and went home where he discovered the prosthesis had broken piercing the back of his knee. A posttraumatic popliteal cyst developed, he eventually had an irrigation and debridement and was fitted for a new prosthesis. He had physical therapy for his episodes of low back pain in July 2005. An infection developed and he had a second irrigation and debridement. Continued infection led to an excision of the popliteal cyst in August 2005, and a second excision of the popliteal cyst in September 2005. By this time Claimant had not yet received his new prosthesis and was walking on crutches. Use of crutches led to pain in his low back and left elbow. Claimant eventually was referred to Dr. Matthew Concannon for continuing problems. In April 2006, Dr. Concannon performed an excision at the amputation site and covered it with a material called Integra. Once the Integra became fully incorporated the wound would be covered with a skin graft. Claimant has had no treatment since this procedure.
Claimant testified that since finishing treatment for his 2005 work injury he has ongoing pai