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Joseph Pentridge v. Gayman Construction, Inc.

Decision date: March 18, 2016Injury #11-08058720 pages

Summary

The Commission affirmed the administrative law judge's award of enhanced permanent partial disability benefits to Joseph Pentridge, finding that his primary work injury combined synergistically with preexisting conditions to result in greater disability than the sum of each condition alone. The decision was supported by the employee's expert testimony, significant income loss, and medical treatment records documenting the compounded effects of the injuries.

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This workers' comp decision may point to a separate injury claim.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Affirming Award and Decision of Administrative Law Judge with Supplemental Opinion)
Injury No. 11-080587
Employee:Joseph Pentridge
Employer:Gayman Construction, Inc. (Settled)
Insurer:Guarantee Insurance Company (Settled)
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 read the briefs, reviewed the evidence, and considered the whole record, we find that the award of the administrative law judge allowing 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.
Discussion Second Injury Fund liability – synergistic effectThe administrative law judge awarded enhanced permanent partial disability benefits to employee based on a finding that the effects of the primary work injury combine with the effects of employee’s preexisting conditions of ill-being to result in greater disability than the simple sum of disability. See § 287.220 RSMo. The Second Injury Fund appeals, arguing that the evidence was insufficiently specific or persuasive to satisfy employee’s burden of proof with regard to the issue whether his primary injury and preexisting conditions of ill-being interact synergistically to result in greater disability.The Second Injury Fund makes some valid points in its brief, and we acknowledge that this is a close case. After careful consideration, though, we are not persuaded to disturb the administrative law judge’s findings, for the following reasons.First, although the Second Injury Fund argues that employee’s evaluating expert, Dr. Paul, did not identify any synergy (because he did not use that word in his report), we note that he did rate a separate and additional 15% permanent partial disability of the body as a whole referable to the combination of employee’s disability from the primary injury and his preexisting conditions. Although Dr. Paul did not specifically use the word “synergy,” this rating is—in and of itself—evidence of synergy, because it suggests there is additional disability apart from and above the simple sum of disability referable to all of employee’s conditions of ill-being, and that this additional disability stems from the combination of the primary injury and preexisting conditions. While the Second Injury Fund does correctly note that Dr. Paul’s opinion is conclusory and without elaboration with regard to synergy, his rating of an additional 15% permanent partial disability stands unrebutted by any conflicting expert opinion evidence on this record.Second, employee credibly testified that he now earns less than half what he was able to earn before the primary injury. We find this severe loss in employee’s income to be

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evidence of a synergistic combination between employee's preexisting conditions of ill-being and the primary injury. Employee also testified that his current employer (his neighbor) is aware of his limitations and allows him to "take it easy" when necessary. *Transcript*, page 17. Employee indicated that this arrangement allows him to continue to be gainfully employed despite the combination of limitations resulting from his primary injury and preexisting conditions of ill-being. We deem this credible evidence that the combination of employee's limitations has had a significant impact upon his employability and his earning capacity. We find this sufficient evidence of a synergistic interaction amongst employee's limitations.

Finally, we note that the medical treatment records memorialize employee's difficulty, as a result of his preexisting low back pain, in completing the physical therapy prescribed following the primary injury. Those records also describe the interaction between the pain stemming from employee's preexisting low back radicular symptoms and the effects of his right foot/ankle injury. In our view, these records are further evidence of a magnifying or synergistic interaction between the pain referable to those separate conditions.

In sum, although employee's evidence certainly could be more clear or specific with regard to the issue of synergy, we deem it ultimately sufficient to meet his burden of proof. For this reason, and because we otherwise agree with the administrative law judge's findings, analysis, and conclusions, we affirm and adopt as our own the award allowing permanent partial disability benefits from the Second Injury Fund.

Conclusion

We affirm and adopt the award of the administrative law judge as supplemented herein.

The award and decision of Administrative Law Judge L. Timothy Wilson, issued September 29, 2015, is attached and incorporated herein to the extent not inconsistent with this supplemental decision.

We approve and affirm 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 17th day of March 2016.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

James G. Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

Employee:Joseph PentridgeInjury No. 11-080587
Dependents:N/ABefore the
Division of Workers’
Employer:Gayman Construction, Inc. (Settled)Compensation
Department of Labor and Industrial
Insurer:Guarantee Insurance Company (Settled)Relations of Missouri
Jefferson City, Missouri

**AWARD**

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

**Hearing Date:** August 5, 2015 **Checked by:** LTW

**FINDINGS OF FACT AND RULINGS OF LAW**

  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: 09/29/2011
  5. State location where accident occurred or occupational disease was contracted: Brown County, Kansas
  6. Was the above employee in the employ of the above employer at the time of the alleged accident or occupational disease? Yes
  7. Did the employer receive proper notice? Yes
  8. Did the accident or occupational disease arise out of and in the course of the employment? Yes
  9. Was the claim for compensation filed within time required by Law? Yes
  10. Was the employer insured by the above insurer? Yes
  11. Describe the work employee was doing and how the accident occurred or occupational disease contracted: While engaged in employment with the Employer, and while securing a track plow to his equipment, the Employee fell to the pavement. As a consequence of this work incident, the Employee sustained an injury to his right foot and heel.
  12. Did the accident or occupational disease cause death? No (Date of death? N/A)
  13. Part(s) of body injured by the accident or occupational disease: right foot and heel
  14. Nature and extent of any permanent disability: 30% to right foot/ankle at the 155-week level
  15. Compensation paid to-date for temporary disability: $13,570.32
  16. Value necessary medical aid paid to-date by employer/insurer: $11,015.23
  1. Value necessary medical aid not furnished by employer/insurer? N/A
  2. Employee's average weekly wages: Not Identified
  3. Weekly compensation rate: $\ 425.19 (PPD)
  4. Method wages computation: Stipulation

COMPENSATION PAYABLE

  1. Amount of compensation payable: N/A (Employee and Employer / Insurer entered into a Stipulation for Compromise Settlement.)
  2. Second Injury Fund liability: Yes

23.84 weeks of permanent partial disability from the Second Injury Fund: $\ 10,136.53

Uninsured medical/death benefits: N/A

Permanent total disability benefits from Second Injury Fund: N/A

TOTAL: $\quad \ 10,136.53

  1. Future requirements awarded: None

Said payments to begin immediately 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 25 percent of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant: E. Joseph Hosmer, Esq.

FINDINGS OF FACT and RULINGS OF LAW:

Employee: Joseph Pentridge

Injury No. 11-080587

Dependents: N/A

Employer: Gayman Construction, Inc.

Insurer: Guarantee Insurance Company

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

The above-referenced workers' compensation claim was heard before the undersigned Administrative Law Judge on August 5, 2015.

The employee appeared personally and through his attorney, E. Joseph Hosmer, Esq. The employer and insurer were not part of the evidentiary hearing, having previously entered into a stipulation for compromise settlement with the employee. The Second Injury Fund appeared through its attorney, Skyler Burks, Assistant Attorney General.

The parties entered into a stipulation of facts. The stipulation is as follows:

(1) On or about September 29, 2011, Gayman Construction, Inc. was an employer operating under and subject to the Missouri Workers' Compensation Law, and during this time was fully insured by Guarantee Insurance Company.

(2) On the alleged injury date of September 29, 2011, Joseph Pentridge was an employee of the employer, and was working under and subject to the Missouri Workers' Compensation Law.

(3) On or about September 29, 2011, the employee sustained an accident, which arose out of and in the course of his employment with the employer.

(4) The above-referenced accident occurred in the State of Kansas. However, the contract of employment was made in Missouri. Further, the parties agree to venue lying in Greene County, Missouri. The Missouri Division of Workers' Compensation possesses jurisdiction, and venue is proper.

(5) The employee notified the employer of his injury as required by Section 287.420, RSMo.

(6) The Claim for Compensation was filed within the time prescribed by Section 287.430, RSMo.

(7) At the time of the claimed accident the employee's average weekly wage was sufficient to allow a compensation rate of $\ 425.19 for permanent partial disability compensation.

(8) Temporary disability benefits were provided to the employee in the amount of $\ 13,570.32, which represents $294 / 7$ weeks in disability benefits, payable for the period of September 30, 2011 to April 24, 2012.

(9) The employer and insurer provided medical treatment to the employee, having paid $\ 11,015.23 in medical expenses.

(10) The employee and employer / insurer entered into a stipulation for compromise lump sum settlement for $\ 30,000.00 based upon approximate disability of 30 percent to the right foot/ankle at the 155 week level, and closure of future medical care. An administrative law judge with the Division of Workers' Compensation approved this Stipulation for Compromise Settlement on or about March 11, 2014.

The sole issue to be resolved by hearing is as follows:

(1) Whether the Treasurer of Missouri, as the Custodian of the Second Injury Fund, is liable for payment of additional permanent partial disability compensation?

EVIDENCE PRESENTED

The employee testified at the hearing in support of his claim. In addition, the employee offered for admission the following exhibits:

Exhibit 1.....Stipulation for Compromise Settlement B/T Employee \& Employer / Insurer (Inj. No. 11-080587)

Exhibit 2 Medical Report of Robert Paul, M.D.

(Inclusive of Medical Records \& Attachments)

Exhibit 3.....Stipulation for Compromise Settlement B/T Employee \& Employer / Insurer (Inj. No. 02-087683)

Exhibit 4.....Stipulation for Compromise Settlement B

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

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