The claimant is 66 years old. She graduated from high school but has no college or post high school training. She is married and lives in Sherwood, Arkansas. She was ambidextrous before August 16, 2008.
After her husband retired, they decided to come to Branson, Missouri and work at Silver Dollar City. They would rent a condo and each worked during the season the park was open. She did this from 1999 to 2008. He worked there longer. Due to some physical difficulties, she went to work for Kritter Tracks, the employer, after leaving Silver Dollar City. The employer has several shops in a complex. She worked in the same position in different shops, mostly the Villages and the Bookstore. Her duties included being a clerk, cashier, and working on the displays. Working on the displays included setting them up, taking them down, replenishing them, periodic cleaning, and special displays of new merchandise.
She said that she had trouble doing these displays because of the condition of her hands. She had trouble handling some of the larger pieces and trouble picking up some of the smaller pieces.
On August 16, 2008, she was working on a display. She had to climb onto a six foot ladder to reach the display. She was putting a piece on the display to her left when she lost her balance and fell backwards onto her left hand, bending it backwards. This injured her left fingers, hand, wrist and elbow.
As a result of her work injury she had a total of five surgeries to her left wrist and injections. She settled her claim with the employer and insurer for 50 % of the left wrist.
Prior to the injury she was ambidextrous and used both hands. Now she cannot use her left hand and mainly uses her right. She has not been able to return to work since the injury.
Prior to the work injury, she had several preexisting conditions, bilateral carpal tunnel syndrome, gout, a thyroid condition, high blood pressure, and rheumatoid arthritis.
The bilateral carpal tunnel problems began in the 1980's. She had bilateral carpal tunnel release surgery to both wrists. This relieved her symptoms somewhat, but she continued to have pain and weakness. This affected her daily activities and changed the way she worked in that she could not lift as much and her hands would get tired. I find that her bilateral carpal tunnel syndrome condition constituted a hindrance or obstacle to employment at the time of the last injuury.
She was diagnosed with gout about 2003. She has taken daily medication since. This does not control her condition all the time and she will have flare ups. When this happens her foot becomes very painful, swollen and red. She cannot stand anything to touch it and she has to elevate it. She cannot wear shoes and socks during these flare ups. There is no set pattern to these flare ups and the frequency varies. Sometimes she will have two to three a year and sometimes more. These flare ups last three days to a week. This affected her ability to do her job in that she would miss work and could not wear shoes during the flare ups. I find that her gout condition constituted a hindrance or obstacle to employment at the time of the last injury.
The thyroid condition developed in the 1970's. She has had surgery and takes daily medication. If her thyroid gets imbalanced she will have to have blood work performed every three months and adjust her medication. When it is out of balance the symptoms vary, depending on whether it is too high or too low. These include hair loss, rapid heart beat, feeling jittery, swelling, and extreme fatigue. Sometimes her fatigue will cause her to fall asleep when she sits down. This affected her employment before August 2008. She would have to work shorter hours and take more breaks when she was tired. She also missed work because of it. I find that her thyroid condition constituted a hindrance or obstacle to employment at the time of the last injury.
She was diagnosed with high blood pressure about ten years ago. She takes three different medications for this condition. Her symptoms are controlled to a point. If she is under stress it will flare up. If she overexerts it will cause her to be short of breath. She was working at Silver Dollar City when she was diagnosed. Walking up the hills or stairs at the park caused her shortness of breath as well as chest pain. She would have to stop and rest until her heart beat slowed. She asked permission to work shorter hours, take extra breaks, and not work every day. I find that her high blood pressure condition constituted a hindrance or obstacle to employment at the time of the last injury.
She was diagnosed with rheumatoid arthritis in the 1990's. This affects her neck, shoulders, elbows, wrists, hands, fingers, hips, both knees, both ankles, and both feet. It has caused her hands to become deformed. She is in constant pain and has trouble getting out of a chair. Also, she cannot stand very long and has trouble walking and climbing stairs. She cannot lift her arms and it is difficult for her to bend. She takes daily medication for this condition. Before August 2008 it affected her employment and it got to the point she could not do her duties at her job. Her doctor gave her restrictions. She had to take shorter hours, be off her feet
every 30 to 45 minutes, and take several breaks. The doctor put her restrictions in a letter to her employer and the employer accomm