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Jeremy Reynolds v. Fulton State Hospital

Decision date: April 15, 2016Injury #11-08036615 pages

Summary

The Commission reversed the administrative law judge's award of permanent partial disability and Second Injury Fund liability, finding that the employee's claim against the Second Injury Fund was barred by the statute of limitations under § 287.430 RSMo. Following the Couch decision, the court determined that a settlement agreement cannot be considered a timely 'claim' where a prior claim for the same injury had already been filed.

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Caption

FINAL AWARD DENYING COMPENSATION (Reversing Award and Decision of Administrative Law Judge)
Employee:Jeremy Reynolds
Employer:Fulton State Hospital (Settled)
Insurer:C A R O (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. We have reviewed the evidence, read the parties’briefs, and considered the whole record. Pursuant to § 286.090 RSMo, the Commission reverses the award and decision of the administrative law judge.
Introduction
The parties asked the administrative law judge to resolve the following issues: (1) statute of limitations; (2) permanent partial disability; and (3) liability of the Second Injury Fund.The administrative law judge determined as follows: (1) employee timely filed his claim against the Second Injury Fund, and it is not barred by the statute of limitations; (2) employee suffered a permanent partial disability of 10% of the body as a whole referable to the groin; and (3) the Second Injury Fund is liable for 12.29 weeks of enhanced permanent partial disability.The Second Injury Fund filed a timely application for review with the Commission alleging the administrative law judge erred in finding that employee timely filed his claim against the Second Injury Fund. The Commission granted a stay of review in this matter pending the court’s issuance of a decision in the case ofTreasurer of Missouri-Custodian of the 2nd Injury Fund v. Couch, 478 S.W.3d 417 (Mo. App. 2015).
On January 26, 2016, the Second Injury Fund filed a “Motion to Reverse Judgment,” arguing that theCouch decision was dispositive and requesting that the Commission reverse the administrative law judge’s award, or alternatively, reinstate the briefing schedule.On March 14, 2016, the parties filed a “Joint Motion to Vacate,” acknowledging the decision inCouch, agreeing that it is dispositive of the sole issue on appeal in this case, and requesting that the Commission vacate the administrative law judge’s award.For the reasons set forth below, we reverse the award and decision of the administrative law judge.
Discussion
Statute of limitations
Section 287.430 RSMo provides, in relevant part, as follows:
A claim against the second injury fund shall be filed within two years after the date of the injury or within one year after a claim is filed against an employer or insurer pursuant to this chapter, whichever is later.

The Missouri courts have recently clarified that the "claim" referenced in the foregoing language cannot be deemed to refer to the approval of a stipulation for compromise settlement where the employee has previously filed one or more claims for compensation for the injury. Treasurer of Missouri-Custodian of the 2nd Injury Fund v. Couch, 478 S.W.3d 417 (Mo. App. 2015).

The Couch court distinguished prior decisions in Grubbs v. Treasurer of Mo. As Custodian of the Second Injury Fund, 298 S.W.3d 907 (Mo. App. 2009), Treasurer of the State - Custodian of the Second Injury Fund v. Cook, 323 S.W.3d 105 (Mo. App. 2010), and Elrod v. Treasurer of Mo., 138 S.W.3d 714 (Mo. 2004), and held that where an employee had previously filed a July 12, 2011, claim for compensation for a June 22, 2011, work injury, her March 28, 2013, settlement with employer could not be considered the relevant "claim" for purposes of $\S 287.430$, and that the employee's filing of a subsequent November 27, 2013, claim for compensation against the Second Injury Fund was therefore untimely.

The facts of this case are comparable to those at issue in Couch. Here, employee filed a claim for compensation against the employer and Second Injury Fund on October 27, 2011, for a work injury he sustained on October 9, 2011. On August 2, 2013, employee settled his claim against the employer. On August 16, 2013, employee voluntarily dismissed his claim against the Second Injury Fund. On July 30, 2014, employee re-filed a claim against the Second Injury Fund.

Pursuant to the holding in Couch, we conclude that employee's claim for compensation is untimely, because it was not filed within two years after the date of injury or one year after filing of the claim for compensation against employer. For this reason, we deny the claim. All other issues are moot.

Conclusion

We reverse the award of the administrative law judge. Employee's claim against the Second Injury Fund is denied because it was not timely filed for purposes of $\S 287.430$ RSMo.

The award and decision of Administrative Law Judge Vicky Ruth, issued February 11, 2015, is attached solely for reference.

Given at Jefferson City, State of Missouri, this $\qquad 15^{\text {th }} \qquad$ day of April 2016.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

James G. Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

AWARD

Employee:Jeremy ReynoldsInjury No. 11-080366
Dependents:N/ABefore the
Employer:Fulton State Hospital (SETTLED)DIVISION OF WORKERS' <br> COMPENSATION <br> Department of Labor and Industrial <br> Relations of Missouri <br> Jefferson City, Missouri
Additional Party:Second Injury Fund
Insurer:State of Missouri c/o CARO (SETTLED)
Hearing Date:November 5, 2014Checked by: VR/cs

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: October 9, 2011.
  5. State location where accident occurred or occupational disease was contracted: Fulton, Callaway County, Missouri.
  6. Was above employee in the employ of above employer at the time of the 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: Claimant was attacked by a client and sustained an injury to his groin.
  12. Did accident or occupational disease cause death? No. Date of death? N/A.
  13. $\operatorname{Part}(\mathrm{s})$ of body injured by accident or occupational disease: body as a whole referable to the groin.
  14. Nature and extent of any permanent disability: 10 % of the body as a whole referable to the groin.
  15. Compensation paid to-date for temporary disability: N/A.

Employee: Jeremy Reynolds

  1. Value necessary medical aid paid to date by employer/insurer? N/A.
  2. Value necessary medical aid not furnished by employer/insurer? N/A.
  3. Employee's average weekly wages: N/A.
  4. Weekly compensation rate: $\ 425.19.
  5. Method of wages computation: By agreement.

COMPENSATION PAYABLE

  1. Amount of compensation payable from employer: Previously settled.
  2. Second Injury Fund liability: $\ 5,225.59.

12.29 weeks $\mathrm{x} \ 425.19 compensation rate $=\ 5,225.59.

  1. Future medical awarded: N/A.

Said payments to begin immediately and to be payable and subject to modification and review as provided by law.

The compensation awarded to claimant shall be subject to a lien in the amount of 25 % of all payments hereunder in favor of the following attorney for necessary legal services rendered to the claimant: the Van Camp Law Firm.

FINDINGS OF FACT and RULINGS OF LAW:

Employee:Jeremy ReynoldsInjury No: 11-080366
Dependents:N/ABefore the
DIVISION OF WORKERS'
Employer:Fulton State Hospital (SETTLED)COMPENSATION <br> Department of Labor and Industrial <br> Relations of Missouri
Additional Party:Second Injury FundJefferson City, Missouri
Insurer:State of Missouri c/o CARO (SETTLED)

PRELIMINARIES

On November 5, 2014, Jeremy Reynolds (the claimant) and the Second Injury Fund appeared in Jefferson City, Missouri, for a final award hearing regarding the Second Injury Fund claim in Injury Numbers 08-041325, 11-080366, 12-000434, 12-019268, and 13-048443. Claimant was represented by attorney Christine Kiefer. The Second Injury Fund was represented by attorney Maggie Ahrens. Claimant testified in person at the hearing. The parties submitted brief position statements on or about November 21, 2014, and the record closed at that time.

STIPULATIONS

The parties stipulated to the following:

Injury No. 08-041325

  1. On or about May 16, 2008, Jeremy Reynolds (the claimant) was an employee of Fulton State Hospital (the employer) when he sustained an injury by accident to his left ankle. This accident occurred while claimant was working in the course and scope of his employment with employer.
  2. The employer was operating subject to the provisions of Missouri Workers' Compensation Law.
  3. The employer's liability for workers' compensation was self-insured by State of Missouri, in care of CARO.
  4. The Missouri Division of Workers' Compensation has jurisdiction and venue in Callaway County is proper. For trial purposes, venue is also proper in Jefferson City, Missouri.
  5. Notice is not an issue.
  6. Claimant filed a Claim for Compensation within the time prescribed by law.
  7. Claimant's compensation rate of for permanent partial disability benefits was $\ 359.74.
  8. Medical aid was provided.

Injury No. 11-080366

  1. On or about October 9, 2011, claimant was an employee of Fulton State Hospital (the employer) when he sustained an injury by accident to his body as a whole referable to the groin. This accident occurred while claimant was working in the course and scope of his employment with employer.
  2. The employer was operating subject to the provisions of Missouri Workers' Compensation Law.
  3. The employer's liability for workers' compensation was self-insured by State of Missouri, in care of CARO.
  4. The Missouri Division of Workers' Compensation has jurisdiction and venue in Callaway County is proper. For trial purposes, venue is also proper in Jefferson City, Missouri.
  5. Notice is not an issue.
  6. Claimant's compensation rate of for permanent partial disability benefits was $\ 425.19.
  7. Medical aid was provided.

Injury No. 12-000434

  1. On or about January 7, 2012, the claimant was an employee of Fulton State Hospital (the employer) when he sustained an injury by accident to his left ankle. This accident occurred while claimant was working in the course and scope of his employment with employer.
  2. The employer was operating subject to the provisions of Missouri Workers' Compensation Law.
  3. The employer's liability for workers' compensation was self-insured by State of Missouri, in care of CARO.
  4. The Missouri Division of Workers' Compensation has jurisdiction and venue in Callaway County is proper. For trial purposes, venue is also proper in Jefferson City, Missouri.
  5. Notice is not an issue.
  6. Claimant filed a Claim for Compensation within the time prescribed by law.
  7. Claimant's average weekly compensation rate for permanent partial disability benefits was $\ 421.17.
  8. Medical aid was provided.

Injury No. 12-019268

  1. On or about March 23, 2012, the claimant was an employee of Fulton State Hospital (the employer) when he sustained an injury by accident to his left hand/wrist. This accident occurred while claimant was working in the course and scope of his employment with employer.
  2. The employer was operating subject to the provisions of Missouri Workers' Compensation Law.
  3. The employer's liability for workers' compensation was self-insured by the State of Missouri, in care of CARO.
  4. The Missouri Division of Workers' Compensation has jurisdiction and venue in Callaway County is proper. For trial purposes, venue is also proper in Jefferson City, Missouri.
  5. Notice is

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

Related Decisions

The Labor and Industrial Relations Commission affirmed the Administrative Law Judge's award allowing workers' compensation benefits for Joseph Becherer's right groin injury sustained on September 16, 2002 while using a pipe wrench. The Commission found the injury compensable under Missouri law with permanent disability rated at 20% body as a whole for the groin injury and 4% for aggravation of pre-existing psychiatric condition.

groin8,425 words