Denise Locklin v. Securitas Security Services USA, Inc.

Decision date: July 25, 201421 pages

Summary

The Labor and Industrial Relations Commission modified the administrative law judge's award, increasing past medical expenses and addressing future medical treatment liability for employee Denise Locklin's workers' compensation case. The Commission found the ALJ inadvertently excluded certain medical charges totaling $1,544.00 that the employee was entitled to recover from the employer.

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FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge)

Employee:	Denise Locklin
Employer:	Securitas Security Services USA, Inc.
Insurer:	Ace American Insurance Company
This workers’ compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by § 287.480 RSMo. We have reviewed the evidence, read the parties’briefs, and considered the whole record. Pursuant to § 286.090 RSMo, we modify the award and decision of the administrative law judge. We adopt the findings, conclusions, decision, and award of the administrative law judge to the extent that they are not inconsistent with the findings, conclusions, decision, and modifications set forth below.
Preliminaries
The parties asked the administrative law judge to resolve the following issues: (1) medical causation; (2) liability for past medical expenses; (3) future medical care; (4) temporary disability; and (5) permanent disability.The administrative law judge rendered the following findings and conclusions: (1) the evidence supports a finding that employee has prevailed on the issue of medical causation; (2) employee is awarded $6,359.99 for past medical expenses subject to a lien for the Missouri Medicaid program for $206.38; (3) the issue of future medical care must be ruled in favor of the defense; (4) the defense prevails on the issue of temporary total disability; and (5) employee is awarded a 15% permanent partial disability.Employer filed a timely Application for Review with the Commission alleging: (1) there was insufficient competent evidence to support a finding that employer is liable for a medical expenses award; and (2) the award of permanent partial disability is excessive.Employee filed a timely Application for Review with the Commission alleging the administrative law judge erred: (1) in awarding 6,359.99 in past medical expenses instead of 10,656.38; (2) in failing to award future medical care; and (3) in awarding only 15% permanent partial disability benefits.For the reasons stated below, we modify the award of the administrative law judge as to the issues of: (1) past medical expenses; and (2) future medical treatment.
Discussion
Past medical expenses
The administrative law judge determined that employee met her burden of proving entitlement under § 287.140 RSMo to her past medical expenses; we agree. Employee argues, however, that the administrative law judge did not award certain expenses reflected in the medical bills employee provided as evidence. Employer has not filed a responsive brief to contest this argument. After a careful review of the bills and the medical treatment record, it does appear to us that the administrative law judge did not award certain past

Date of Service	Provider	Charges
01-04-05	Dr. Khan	$450.00
01-04-05	Dr. Khan	$116.00
01-04-05	Dr. Khan	$70.00
04-19-05	Dr. Khan	$92.00
04-20-05	Dr. Khan	$116.00
04-20-05	Dr. Khan	$33.00
04-20-05	Dr. Khan	$38.00
04-20-05	Dr. Khan	$70.00
05-12-05	Dr. Khan	$176.00
07-26-05	Dr. Khan	$92.00
03-02-06	Dr. Khan	$39.00
09-26-06	Dr. Khan	$39.00
03-27-07	Dr. Khan	$213.00
Total:	$1,544.00

See *Transcript*, pages 554, 556-57.

The administrative law judge did not offer any rationale for excluding the foregoing charges; it thus appears that this was simply an inadvertent error. We conclude, in any event, that employee is entitled to, and employer is liable to pay, the foregoing additional charges.

We note also that the administrative law judge reduced employer's liability for certain charges in connection with payments tendered by employee. Specifically, the administrative law judge reduced employer's liability for a $1,425.80 charge from St. Joseph Hospital West for services on January 3, 2005, in connection with a 427.74 payment by employee, and for a 768.60 charge from St. Joseph Hospital West for services on March 7, 2006, in connection with a $307.44 payment by employee. See *Transcript*, pages 564, 568. Under § 287.270 RSMo, "[n]o savings or insurance of the injured employee, nor any benefits derived from any other source than the employer or the employer's insurer for liability under this chapter, shall be considered in determining the compensation due hereunder." Accordingly, we conclude employee is entitled to an additional $735.18 in connection with these bills.

Finally, we note that the administrative law judge did not award each of the prescription drug charges reflected in the medical bills employee provided as evidence. It appears that the administrative law judge excluded certain unspecified charges under the impression that employee's Exhibit J contains duplicate billing records. We have carefully reviewed the bills in connection with the medical treatment records in evidence. We note that each of the prescription drug charges in Exhibit J are delineated by date, and that the medical treatment record reflects ongoing prescriptions from employee's treating physicians. Although Exhibit J does contain charges for a number of medications unrelated to employee's treatment for the work injury, we deem the record sufficiently clear to support

Date	Provider	Medication	Charges
12-21-04	Dr. Varga	Combivent	$77.32
12-21-04	Dr. Varga	Advair Disku	$228.88
02-03-05	Dr. Khan	Combivent	$84.54
02-03-05	Dr. Khan	Prednisone	$8.36
02-03-05	Dr. Khan	Advair Disku	$228.88
01-11-11	Dr. Khan	Advair Disku	$201.21
01-11-11	Dr. Easterday	Singulair	$116.11
04-07-11	Dr. Easterday	Singulair	$38.24
01-03-12	Dr. Khan	Albuterol	$14.57
02-28-12	Dr. Khan	Albuterol	$14.57
01-23-13	Dr. Khan	Fluticasone	$17.78
02-26-13	Dr. Easterday	Montelukast	$77.59
03-25-13	Dr. Easterday	Montelukast	$12.00
05-28-13	Dr. Easterday	Montelukast	$19.95
07-30-13	Dr. Easterday	Montelukast	$19.95
08-30-13	Dr. Easterday	Montelukast	$19.95
10-10-13	Dr. Easterday	Montelukast	$19.95
Total:	$1,199.85

Employee: Denise Locklin

The administrative law judge awarded only $571.84 of the foregoing charges; we conclude, therefore, that employee is entitled to the additional amount of $628.01 for her prescription drug expenses.

In light of the foregoing considerations, we must modify the administrative law judge’s award of past medical expenses. We conclude that, in addition to the amount of $6,359.99 awarded by the administrative law judge, employee is entitled to an additional total of $2,907.19.

Future medical treatment Section 287.140.1 RSMo provides for an award of future medical treatment where the employee can prove a reasonable probability that she has a need for future medical treatment that flows from the work injury. *Conrad v. Jack Cooper Transp. Co.*, 273 S.W.3d 49, 51-4 (Mo. App. 2008). We are convinced that employee has proven she has a need for future medical treatment flowing from the work injury.

Employee presented expert medical testimony from Dr. Volarich, who opined that employee will need to continue to see her pulmonologist, Dr. Khan, take prescribed

^{1} We do note that employee, in her brief, claims employer is liable for a January 10, 2012, prescription by Dr. Easterday for Triamcinolon, but Dr. Easterday’s corresponding treatment record suggests he ordered this medication to treat swelling and a rash in employee’s lower extremities, i.e., a condition unrelated to the work injury. Accordingly, we conclude that employer is not liable for employee’s expenses in connection with her prescription for Triamcinolon.

Improved health outcomes

Improved health outcomes are defined as the change in the quality of life of an individual or group, or the change in the quality of life of a person or group. Improved health outcomes are defined as the change in the quality of life of a person or group, or the change in the quality of life of a person or group.

Improved health outcomes are defined as the change in the quality of life of an individual or group, or the change in the quality of life of a person or group. Improved health outcomes are defined as the change in the quality of life of an individual or group, or the change in the quality of life of a person or group.

Improved health outcomes are defined as the change in the quality of life of an individual or group, or the change in the quality of life of a person or group.

Improved health outcomes are defined as the change in the quality of life of an individual or group, or th

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