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Barbara Fagins v. DolgenCorp., Inc.

Decision date: June 13, 201418 pages

Summary

The Commission affirmed the administrative law judge's denial of workers' compensation benefits to an assistant manager who claimed a psychiatric injury resulting from an armed robbery where a gun was pointed at her head. The court found that the employee failed to present credible expert medical testimony establishing that the robbery was the prevailing factor causing her psychiatric injury, as required under Missouri law.

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Caption

FINAL AWARD DENYING COMPENSATION (Affirming Award and Decision of Administrative Law Judge with Supplemental Opinion)
Injury No.: 09-093079
Employee:Barbara Fagins
Employer:DolgenCorp., Inc.
Insurer:DolgenCorp., LLC
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund

This 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, we find that the award of the administrative law judge denying compensation is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to § 286.090 RSMo, we affirm the award and decision of the administrative law judge with this supplemental opinion.

Medical causation

At issue in this matter is whether employee, an assistant manager at one of employer's retail stores, suffered a compensable psychiatric injury when an assailant pointed a gun at her head during an armed robbery of the store on November 1, 2009. Employee had very serious psychiatric problems before this event, for which she was receiving social security disability benefits. Yet, employee was able to work for employer for about 4.5 years prior to the event on November 1, 2009, advancing from a cashier to an assistant manager position. Two days after the robbery, employee was admitted to Research Psychiatric Center owing to acute anxiety and distress stemming from the event, and she ultimately never returned to work for employer.

The administrative law judge denied employee's claim on the issue of medical causation, crediting the testimony of employer's expert, the psychologist Dr. Keenan, over that of employee's medical expert, the psychiatrist Dr. True. It is well-settled in Missouri that in workers' compensation cases involving injuries that are beyond lay understanding, "the question of causation [is] one for medical testimony, without which a finding for claimant would be based on mere conjecture and speculation and not on substantial evidence." Welker v. MFA Cent. Co-operative, 380 S.W.2d 481, 487 (Mo. App. 1964). We agree that employee's alleged psychiatric injuries are beyond lay understanding, and that in the absence of credible expert medical testimony, a finding for employee in this matter would be based on conjecture and speculation.

We note that the administrative law judge placed considerable emphasis on the fact employee's counsel asked Dr. True whether the accident was "a" prevailing factor resulting in injury, rather than "the" prevailing factor. At least in this case, we perceive this to be a distinction without a difference. Although we do not find Dr. True's testimony in this matter

to be persuasive, his response to counsel's question does not suggest that counsel's use of "a" versus "the" was in any way important to Dr. True, or that it caused Dr. True to misunderstand the applicable standard of medical causation. The problem with employee's case is not the fact her attorney used "a" instead of "the" in posing a question to Dr. True; it's the fact she simply failed to present any credible expert medical testimony.

We note also that the administrative law judge relied on the case of Gordon v. City of Ellisville, 268 S.W.3d 454 (Mo. App. 2008) for the proposition that aggravation of a preexisting condition is not compensable following the 2005 amendments to the Missouri Workers' Compensation Law. The Gordon court used the word "aggravation" as shorthand for "something less than the prevailing factor." Id. at 459-60. Subsequent cases have clarified that aggravation (as a medical condition) is compensable after the 2005 amendments where a medical expert credibly opines that an accident was the prevailing factor resulting in aggravation of a preexisting condition. See, e.g., Maness v. City of De Soto, 421 S.W.3d 532, 540-41 (Mo. App. 2014). If employee had presented a credible medical expert opinion that the event of November 1, 2009, was the prevailing factor causing an aggravation of her preexisting psychiatric conditions and additional permanent partial disability, we are of the opinion that such injuries would be compensable.

Likewise, we wish to make clear that we are not persuaded by the theory from Dr. Keenan that because employee suffered serious preexisting psychiatric problems, she cannot have suffered any additional injury. We fail to see why employee's numerous suicide attempts, psychiatric hospitalizations, and need for psychiatric medications rendered her any less likely to suffer additional permanent partial disability as a result of having a gun pointed at her head; if anything, it would seem that employee's psychiatric fragility rendered her more likely to suffer injury. And where § 287.190.6(2) RSMo requires that "permanent disability ... shall be demonstrated and certified by a physician," we have doubts as to whether testimony from a psychologist is sufficient to demonstrate and certify the absence of permanent disability. For these reasons, we must disclaim the administrative law judge's reliance on the opinions of Dr. Keenan.

On the other hand, the sole expert medical testimony that employee procured and presented in this matter derives from the treating physician Dr. True, and even the most generous reading of his testimony supports the administrative law judge's conclusion that employee has failed to meet her burden of proof. From a lay perspective, it appears obvious to us that employee suffered some permanent injury from having a gun pointed at her head during the course of her work for employer. This is especially so when we consider employee's work history, her hospitalization following the event, and her inability to return to work thereafter. But our lay perspective is not determinative in this matter, and Dr. True's testimony is so uncertain, so ambiguous, and at times so contradictory, that we simply cannot credit it.

Because employee has failed to make her case with the testimony from Dr. True, we must deny the claim for compensation.

Conclusion

We affirm and adopt the award of the administrative law judge with this supplemental opinion.

The award and decision of Administrative Law Judge Kenneth J. Cain, issued September 10, 2013, is attached and incorporated herein to the extent not inconsistent with this supplemental decision.

Given at Jefferson City, State of Missouri, this $13^{\text {th }}$ day of June 2014.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

James G. Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

FINAL AWARD

Employee: Barbara Fagins

Injury No. 09-093079

Dependents: N/A

Employer: DolgenCorp., Inc.

Insurer: DolgenCorp, LLC (Self-Insured)

Additional Party: Missouri State Treasurer as Custodian of the Second Injury Fund

Hearing Date: July 9, 2013; final brief filed September 4, 2013 Checked by: KJC/pd

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? No
  2. Was the injury or occupational disease compensable under Chapter 287? No
  3. Was there an accident or incident of occupational disease under the Law? Employee did not prove an "injury" by accident (See additional findings of fact and rulings of law)
  4. Date of accident or onset of occupational disease: November 1, 2009
  5. State location where accident occurred or occupational disease was contracted: Raytown, Jackson County, Missouri
  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: Employee, while in the course and scope of her employment as a Third Key person at a Dollar General store was the victim of an armed robbery.
  12. Did accident or occupational disease cause death? No. Date of death? N/A
  1. Part(s) of body injured by accident or occupational disease: Alleged psyche
  2. Nature and extent of any permanent disability: None
  3. Compensation paid to date for temporary disability: None
  4. Value necessary medical aid paid to date by employer/insurer? None
  5. Value necessary medical aid not furnished by employer/insurer? None
  6. Employee's average weekly wages: $\ 255.00 per week per stipulation of parties
  7. Weekly compensation rate: $\ 170.00 per week per stipulation of parties
  8. Method wages computation: By agreement

COMPENSATION PAYABLE

  1. Amount of compensation payable:

Unpaid medical expenses: None

Weeks for permanent partial disability: None

Weeks for temporary total and temporary partial disability: None

Weeks for permanent total disability: None

  1. Second Injury Liability: None

TOTAL: None

  1. Future requirements awarded: None

Said payments to begin N/A 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 N/A of all payments hereunder in favor of the following attorney: N/A

FINDINGS OF FACT and RULINGS OF LAW:

Employee: Barbara Fagins

Injury No. 09-093079

Dependents: N/A

Employer: DolgenCorp., Inc.

Insurer: DolgenCorp, LLC (Self-insured)

Additional Party: Missouri State Treasurer as Custodian of the Second Injury Fund

Hearing Date: July 9, 2013; final brief filed September 4, 2013 Checked by: KJC/pd

Prior to the hearing, the parties entered into various admissions and stipulations. The remaining issues were as follows:

  1. Accident;
  2. Liability of the employer for temporary total disability benefits from November 2, 2009 to the date of the hearing;
  3. The nature and extent of the disability sustained by the employee;
  4. Whether all the conditions complained of by the employee resulted from the alleged accident;
  5. Liability of the employer for past medical benefits; and
  6. Liability of the Second Injury Fund for compensation.

At the hearing, Ms. Barbara Wright-Fagins (hereinafter referred to as Claimant) testified that she was born in 1959 and that she was 54 years old. She stated that she had been married about 10 years. She stated that she had an AA degree in business from Platte College.

Claimant testified that she was hired in 2007 or 2008 by Dollar General. She stated that she worked for the company for $4 \frac{1}{2}$ years. She stated that she was hired initially as a cashier. She stated that her job title was later changed to Third Key which was similar to being an assistant manager. She stated that in the Third Key position she opened and closed the store, gave change to the cashiers, did paper work and made sure that the store was clean. She stated that her salary was $\ 5.50 per hour and that she worked a 30 hour week.

Claimant testified that her injury at work occurred on November 1, 2009 during an armed robbery of the store. She stated that the robber had a " 38 snub nosed gun." She stated that the robber initially took money from a clerk's wallet and then told her that he would shoot the clerk unless she opened the safe. She stated that the robber pointed the gun at her head. She stated that while she was bending down trying to open the safe, the robber had the gun at the back of her head.

Claimant admitted that the gun never touched her head. She stated that the incident lasted about 3 or 4 minutes. She stated that the next day at work she was nervous, "jumpy" and scared every time the bell on the store's door rang. She stated that she asked the store's manager for the crisis number, but lost it. She stated that on the following day after she again requested the crisis number, the manager told her to go to the hospital to get evaluated.

Claimant testified that she was admit

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

Related Decisions

The Labor and Industrial Relations Commission modified the October 4, 2010 Final Award finding the employee permanently and totally disabled, supplementing the ALJ's decision with additional analysis of expert depositions regarding the work-relatedness of psychiatric disability. The Commission found that additional significant evidence, including Dr. Wolfgram's contradictory 2010 deposition testimony regarding the employee's adjustment disorder with depressed mood, warranted modification of the prior award.

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