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Larry Abt v. Mississippi Lime Company

Decision date: September 22, 2014Injury #01-07142612 pages

Summary

The Commission modified its prior award in compliance with the Missouri Court of Appeals remand order, establishing that the Second Injury Fund's liability for permanent total disability commenced December 6, 2005, and awarding permanent partial disability benefits of $38,968.24 for 124 weeks plus ongoing permanent total disability benefits. The employee was found to be permanently and totally disabled as a result of his 2001 primary injuries combined with pre-existing conditions.

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Caption

Issued by THE LABOR AND INDUSTRIAL RELATIONS COMMISSION
FINAL AWARD ALLOWING COMPENSATION(Modified in compliance with the August 23, 2014, order of remand issued by the Missouri Court of Appeals for the Eastern District)
Injury No.: 01-071426
Employee:Larry Abt
Employer:Mississippi Lime Company
Insurer:Federal Insurance Company
Additional Party:Treasurer of Missouri as Custodian of Second Injury Fund
Procedural History
On February 18, 2014, the Missouri Court of Appeals for the Eastern District issued an opinion affirming in part, reversing in part, and remanding the March 6, 2013, decision of the Labor and Industrial Relations Commission (Commission). ^{ 1 }
By mandate dated March 12, 2014, the Court confirmed its February 18th opinion and remanded the matter to the Commission with instructions to 1) calculate the liability of the employer and the Second Injury Fund and to award compensation for permanent total disability benefits accordingly, and, 2) award from employer to employee the sum of $10,859.57 as reimbursement for medical expenses.
By its Opinion, the court found that “claimant is permanently and totally disabled as a result of the combination of his 2001 primary injuries and pre-existing conditions.”^{2 } By its mandate, the Court instructed us “to calculate the liability of the employer and the Second Injury Fund and to award compensation for permanent total disability benefits accordingly.” On May 7, 2014, we issued an award we believed to be in accordance with the Court’s mandate. In our award, we awarded permanent total disability benefits against the Second Injury Fund. We found employee reached maximum medical improvement from the effects of his primary injury on May 30, 2001, in accordance with the opinion of Dr. Mirkin. The Second Injury Fund appealed our May 7, 2014, award.
On August 23, 2014, the Court sustained the parties’ joint motion to remand this matter. The Court remanded this matter to us and ordered us to modify our award of May 7, 2014, to make the following modifications:
(a) a finding that, following his return to work after his January 15, 2001, injury, Employee continued in his regular employment with Employer through December 5, 2005;
(b) a finding and conclusion that the Fund’s liability to Employee for permanent total disability accordingly commenced on December 6, 2005; and
(c) an order that from December 6, 2005, and continuing for 124 weeks, the Fund shall pay a differential of $285.70 per week which, when combined with Employer’s weekly permanent partial disability payment of 314.26, equals the full weekly permanent total disability benefit of 599.96 to which Employee is entitled for his lifetime, or until modified by law.
^{ 1 } Abt v. Mississippi Lime Company, 420 S.W.3d 689 (Mo. App. 2014). ^{ 2 } Id., at 705.

Findings and Conclusions

In accordance with the Court's August 23, 2014, remand order, we make the following findings:

Following his return to work after his January 15, 2001, injury, employee continued in his regular employment with employer through December 5, 2005. The Second Injury Fund's liability to employee for permanent total disability commenced December 6, 2005.

Award

We affirm the administrative law judge's finding that, as a result of the primary injury, employee sustained permanent partial disabilities of 30 % of his left lower extremity at the 160-week level ( 48 weeks), 4 % of the body as a whole referable to the ribs ( 16 weeks), and 15 % of the body as a whole referable to the lumbar spine ( 60 weeks). We award from employer to employee permanent partial disability benefits for 124 weeks in the amount of $\ 38,968.24.

We award permanent total disability benefits from the Second Injury Fund to employee. The permanent total disability benefits shall begin December 6, 2005. From December 6, 2005, and continuing for 124 weeks, the Second Injury Fund shall pay a differential of $\ 285.70 per week which, when combined with employer's weekly permanent partial disability payment of $\ 314.26 equals the full weekly permanent total disability benefit of $\ 599.96, to which employee is entitled for his lifetime, or until modified by law.

We award from employer to employee past medical expenses in the amount of $\ 10,859.57.

The award and decision of Administrative Law Judge Carl Strange, is attached and incorporated to the extent it is not inconsistent with the Court's opinions and this award.

The Commission further approves and affirms the administrative law judge's allowance of attorney's fee herein as being fair and reasonable.

Any past due compensation shall bear interest as provided by law.

Given at Jefferson City, State of Missouri, this $19^{\text {th }}$ day of September 2014.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

James G, Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

AWARD

Employee: Larry Abt

Injury No. 01-071426

Dependents: N/A

Employer: Mississippi Lime Company

Additional Party: Second Injury Fund

Insurer: Federal Insurance Company

Hearing Date: March 21, 2011

Checked by: CS/rf

SUMMARY OF FINDINGS

  1. Are any benefits awarded herein? Yes.
  2. Was the injury or occupational disease compensable under Chapter 287? Yes.
  3. Was there an accident or incident of occupational disease under the Law? Yes.
  4. Date of accident or onset of occupational disease? January 16, 2001.
  5. State location where accident occurred or occupational disease contracted: Ste. Genevieve, 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 happened or occupational disease contracted: Employee was injured when he was operating a locomotive and a truck hit the locomotive throwing the employee off of it onto the truck.
  12. Did accident or occupational disease cause death? N/A
Employee: Larry AbtInjury No. 01-071426
13.Parts of body injured by accident or occupational disease:Left lower extremity at the level of the knee, ribs referable to the body as a whole, and lumbar spine referable to the body as a whole. Nature and extent of any permanent disability: 30% of the left lower extremity at the level of the knee, 4% of the body as a whole referable to the ribs, 15% of the body as a whole referable to the lumbar spine, & a pre-existing 15% of the upper left extremity at the level of the wrist (SeeFindings). Compensation paid to date for temporary total disability: 10,199.32 Value necessary medical aid paid to date by employer-insurer: 19,358.59 Value necessary medical aid not furnished by employer-insurer: $3,266.03 (SeeFindings). Employee's average weekly wage: Not calculated. Weekly compensation rate:
16.
17.
18.
19.Weekly compensation rate:
599.96 for temporary total disability and permanent total disability; and 314.26 for permanent partial disability.
20.Method wages computation: By Agreement.
21.Amount of compensation payable:
a.Employee awarded permanent partial disability from the employer-insurer in the amount of $38,968.24 (SeeFindings).
b.Employee awarded previously incurred medical aid of $3,266.03 (SeeFindings).
c.Employee awarded permanent partial disability benefits from Second Injury Fund in the amount of $6,328.41 (SeeFindings).
22.Second Injury Fund liability: Yes (SeeFindings).
22.Future requirements awarded: N/A
Said payments shall be payable as provided in the findings of fact and rulings of law, and shall be subject to modification and review as provided bylaw.
The compensation awarded to the claimant shall be subject to a lien in the amount of 25% of all payments hereunder in favor of the following attorney fornecessary legal services rendered to the claimant: Robert Lenze.

FINDINGS OF FACT AND RULINGS OF LAW

On March 21, 2011, the employee, Larry Abt, appeared in person and by his attorney, Robert Lenze, for a hearing for a final award. The employer-insurer was represented at the hearing by its attorney, Matthew Mocherman. The Second Injury Fund was represented by its attorney, Assistant Attorney General Gregg Johnson. At the time of the hearing, the parties agreed on certain undisputed facts and identified the issues that were in dispute. These undisputed facts and issues, together with the findings of fact and rulings of law, are set forth below as follows.

UNDISPUTED FACTS:

  1. On or about January 16, 2001, Mississippi Lime Company was operating under and subject to the provisions of the Missouri Workers' Compensation Act and its liability was insured by Federal Insurance Company.
  2. On or about January 16, 2001, the employee was an employee of Mississippi Lime Company and was working under and subject to the provisions of the Missouri Workers' Compensation Act.
  3. On or about January 16, 2001, the employee sustained an accident during the course of his employment.
  4. The employer had notice of employee's accident.
  5. The employee's claim was filed within the time allowed by law.
  6. The employee's rate for temporary total disability and permanent total disability is $\ 599.96 and his rate for permanent partial disability is $\ 314.26.
  7. The employee's injury is medically causally related to the work injury on or about January 16, 2001.
  8. The employer has furnished $\ 19,358.59 in medical aid to employee.
  9. The employer has paid temporary total disability benefits for 17 weeks at a rate of $\ 599.96 per week for a total of $\ 10,199.32.

ISSUES:

  1. Previously Incurred Medical Aid.
  2. Nature and Extent of Disability.
  3. Liability of the Fund.

EXHIBITS:

The following exhibits were offered and admitted into evidence:

Employee's Exhibits

A. Medical Records of Ste. Genevieve County Memorial Hospital 05/31/1991 to11/28/2007;

B. Medical Records of Point Basse Family Healthcare/Ste. Genevieve Health Group 05/13/1991 to 04/22/2008;

C. Withdrawn;

D. Medical Records of Dr. Joseph Sharlow 10/25/2004 to 05/31/2001;

E. Medical Records of Dr. Theodore A. Mueller 04/15/1999;

F. Medical Records of Dr. Richard Pearson 05/05/1999 to 10/11/2005;

G. Medical Records of Ste. Genevieve County Memorial Hospital Home Health Agency 01/19/2001 to 01/29/2001;

H. Medical Records of PRO REHAB 04/05/2001 to 04/30/2001;

I. Medical Records of Physicians Health and Rehab 01/14/2002 to 03/31/2004;

J. Medical Records of Bloomsdale Family Health Center 03/18/2004 to 05/16/2005;

K. Medical Records of Mid American Rehab 11/01/2005 to 11/22/2005;

L. Medical Bills of Physicians Health and Rehab 01/14/2002 to 03/31/2004;

M. Withdrawn;

M1. Medical Bills of Ste. Genevieve County Memorial Hospital;

N. Withdrawn;

N1. Medical Bills of Dr. Richard Pearson;

O. Deposition of Wilbur Swearingin dated 10/05/2010; and

P. Deposition of Dr. Robert Poetz dated 10/18/2010.

Employer-Insurer's Exhibits

  1. Medical Records of Ste. Genevieve Medical Group;

a. Office note of $07 / 20 / 1999$;

b. Office note of 08/02/1999;

c. Office note of 08/10/1999;

d. Office note of 09/29/1999;

  1. Medical Records of Ste. Genevieve County Memorial Hospital 09/06/1999 to 09/15/1999;
  2. Medical Records of Ste. Genevieve County Memorial Hospital 03/27/2001;
  3. Medical Records of PRO REHAB - Functional Capacity Exam 04/26/2001;
  4. Medical Records of Dr. Joseph Sharlow 05/29/2001;
  5. Medical Records of Ste. Genevieve County Memorial Hospital Lumbar 05/29/2001;
  6. Report of Dr. Peter Mirkin 05/30/2001;
  7. Medical Records of Ste. Genevi

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