Skip to content
Ott Law Firm

Mila Swearingin v. Hickory County R-I School District

Decision date: September 14, 2016Injury #06-08807325 pages

Summary

The Commission modified the administrative law judge's award regarding the nature and extent of disability in a lumbar spine injury case. The employee sustained a work-related acute disk herniation at L5-S1 on August 28, 2006, with the Commission finding 50% permanent partial disability and addressing disputed issues of permanent total disability and Second Injury Fund liability.

Archive Notice

This archive contains published Missouri Labor and Industrial Relations Commission workers' compensation decisions reproduced for research convenience. Official source links remain authoritative where provided. Joseph Ott, Attorney 67889, Ott Law Firm - Constant Victory - Personal Injury and Litigation maintains these public legal archives to support Missouri case research and to help prospective clients connect that research to the firm's courtroom practice.

Related Legal Help

Practical guidance for this decision

Third-Party Injury Check

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

  • A driver, contractor, property owner, or equipment company may share fault.
  • The injury involved a vehicle, unsafe premises, defective equipment, or a non-employer vendor.
  • A serious injury or death may need both benefits review and civil-claim analysis.

Caption

FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge)
Employee:Mila Swearingin
Employer:Hickory County R-I School District
Insurer:Missouri United School Insurance
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, heard the parties’ arguments, 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 determine the following issues: (1) whether the injury was medically and causally related to the work for the employer; (2) nature and extent of disability; (3) temporary total disability from August 13, 2007, through November 8, 2007; (4) past medical expenses in the amount of $155,581.24; (5) future medical treatment; and (6) Second Injury Fund liability.

The administrative law judge determined as follows: (1) the injury of August 28, 2006, was the prevailing factor in employee’s development of an acute disk herniation at L5-S1 with resultant development of a left greater than right S1 radiculopathy on an ongoing basis; (2) employee is entitled to reimbursement of her accrued, but previously unauthorized medical bills totaling $155,581.24; (3) employee is entitled to 12 and 3/7 weeks of temporary total disability benefits; (4) employee suffered 50% permanent partial disability of the body as a whole referable to the 2006 injury; (5) employee has demonstrated the need for ongoing treatment to relieve the effects of the August 28, 2006, work injury; and (6) the Second Injury Fund has no liability for permanent total or permanent partial disability benefits.

Employee filed a timely application for review with the Commission alleging the administrative law judge erred: (1) in concluding employee is able to find gainful employment; and (2) in disregarding employee’s testimony regarding her need to lie down and recline unpredictably.

For the reasons stated below, we modify the award of the administrative law judge referable to the issues of: (1) the nature and extent of disability; and (2) the liability of the Second Injury Fund.

Nature and extent of disability

After careful consideration, we deem reasonable, and hereby adopt as our own, the administrative law judge’s determination that employee sustained 50% permanent partial disability of the body as a whole referable to the lumbar spine as a result of the work injury of August 28, 2006. The administrative law judge also determined that employee is not permanently and totally disabled. Although we acknowledge that this is a close case, and there

is considerable evidence on this record to support the administrative law judge's determination in this regard, we ultimately disagree, for the following reasons.

The administrative law judge expressly found employee to be a credible witness. However, she rejected employee's testimony that she has a need to lie down during the day to relieve her low back pain; based upon a legal conclusion that employee provided insufficient evidence establishing such need "within a reasonable degree of medical certainty." Award, page 14. The administrative law judge reached this conclusion based on a perceived failure on the part of employee's medical expert, Dr. Koprivica, to assign a medical "restriction" upon employee's activities in line with such complaint. ${ }^{1}$

First, we disagree that there is a material distinction, for our purposes, between Dr. Koprivica's explicit endorsement (albeit phrased as a "limitation") of employee's complaint that she needs to lie down during the day to relieve her symptoms, versus a "restriction" that employee must do so for purely safety reasons. ${ }^{2}$ Second, although evidence with regard to whether an accident caused any degree of permanent disability may, in some cases, be susceptible to the reasonable degree of medical certainty standard, see § 287.190.6(2) RSMo, we must disclaim any suggestion that issues regarding the nature and extent of disability must be so proven.

This is because, as the courts of this state have long held, the "degree of disability is not solely a medical question," and "[d]eciding the percentage or degree of disability to award a claimant is a finding of fact within the unique province of the Commission." ABB Power T \& D Co. v. Kempker, 236 S.W.3d 43, 52 (Mo. App. 2007). Stated another way, if the administrative law judge generally believed (as appears to be the case) employee's testimony, she was not precluded as a matter of law from crediting her testimony regarding a need to lie down during the day merely because employee did not provide expert medical testimony describing such need as a "restriction." We adopt the administrative law judge's finding that employee's testimony is credible, as we discern no basis to determine otherwise. We find that employee has a need to lie down unpredictably throughout the day to control her low back pain.

Second, we note that the administrative law judge relied on a determination that employer's vocational expert, James England, provided the most persuasive opinion with regard to the issue of permanent total disability, because his was "the only vocational opinion setting forth the jobs [employee] is physically capable of doing, per the medical restrictions set forth." Award, page 19. But the question of permanent total disability does not turn solely on an analysis of what jobs employee might physically be capable of performing within the restrictions from her doctors, instead, as our courts have consistently declared:

The test for permanent total disability is whether the worker is able to compete in the open labor market. The critical question is whether, in the ordinary course of business, any employer reasonably would be expected to hire the injured worker, given his present physical condition.

Molder v. Mo. State Treasurer, 342 S.W.3d 406, 411 (Mo. App. 2011).

[^0]

[^0]: ${ }^{1}$ Dr. Koprivica, notably, did endorse employee's need to lie down in his report, when he agreed that such is consistent with employee's presentation; however, at his deposition, he suggested this was perhaps better termed a "limitation" referable to employee's subjective complaints, rather than a "restriction" assigned from a purely safety standpoint. See Transcript, pages 200-01.

${ }^{2}$ It would seem that an injured worker's need to unpredictably lie down during the day would nearly always correlate to the relief of subjective symptoms, rather than some safety precaution.

An employee may be, strictly speaking, capable of performing a particular job's duties without violating her doctors' restrictions, but this does not alone establish that the employee is capable of successfully competing for and securing such job in the open labor market. Accordingly, we look at the persuasive evidence as a whole, and ask whether a hypothetical employer might have been likely to hire employee as of July 22, 2010, the date she reached maximum medical improvement from the effects of the work injury. ${ }^{3}$

After a thorough review of the entire record, we find most persuasive the testimony from the vocational expert Terry Cordray with regard to this issue. Mr. Cordray believes it is unreasonable to expect any employer in the normal course of business to hire employee, given her age, history of back injuries requiring multiple surgeries, use of narcotics and other pain medications that affect her cognitive abilities, lack of transferable skills, and lack of education beyond securing her GED in 1983. Mr. Cordray also pointed out that employee lives in rural Hickory County, and that the potential labor market there is extremely limited in terms of the jobs employee might potentially qualify for given her vocational background and physical restrictions.

We acknowledge that employee continued to work for employer for several years after suffering the August 2006 work injury, which would tend to suggest that employer, at least, found her to be reasonably capable of performing her work duties. On the other hand, employee credibly testified that during her continued work for employer after the last injury, she had to take breaks to lie down on the floor or go sit in her car, and that she went home at night crying because of the extent of her pain. We are also mindful that employee was working for employer under the influence of multiple prescription pain medications, including narcotics. Employer's willingness to permit this longtime employee to remain employed after suffering a workers' compensation injury does not necessarily demonstrate that another employer would be willing to accept employee as a new hire, if she were forced to compete on the open labor market.

Especially when we examine the totality of the circumstances surrounding employee's leaving her work for employer, we are persuaded that, as Mr. Cordray credibly opined, employee would not be an attractive hire. The administrative law judge, in her findings, suggested employee left her work solely because she was personally offended when another coworker complained to supervisors that employee wasn't doing her fair share of the work. We view the evidence somewhat differently. Employee explained that she quit after her supervisor, Mr. Beam, called her into his office and asked if she was taking prescription medications at work. When employee admitted that she was, Mr. Beam told her that she probably shouldn't be "working under the influence," and advised her to apply for disability. Transcript, page 65. This evidence, in our view, critically undermines any argument that employee's continued work for employer demonstrates an ability to compete in the open labor market.

In sum, we find Mr. Cordray's vocational analysis most persuasive with respect to this issue. We find that employee is permanently and totally disabled. Mr. Cordray expressly found the combination of employee's 2006 and 2005 low back work injuries to result in her inability to compete for work in the open labor market. We credit that opinion. We find that employee is permanently and totally disabled owing to the combination of the primary injury and employee's preexisting disability referable to the low back.

[^0]

[^0]: ${ }^{3}$ At the hearing in this matter, the parties placed in dispute the issue when employee reached maximum medical improvement. The administrative law judge did not make a specific finding, in her award, with regard to this issue. We find that employee reached maximum medical improvement on July 22, 2010, the last date that employee saw Dr. Salim Rahman for follow-up treatment in connection with his June 30, 2010, T9-10 laminotomy with implantation of a dorsal column stimulator.

Second Injury Fund liability

Section 287.220 RSMo creates the Second Injury Fund and provides when and what compensation shall be paid in "all cases of permanent disability where there has been previous disability." As a preliminary matter, the employee must show that she suffers from "a preexisting permanent partial disability whether from compensable injury or otherwise, of such seriousness as to constitute a hindrance or obstacle to employment or to obtaining reemployment if the employee becomes unemployed..." Id. The Missouri courts have articulated the following test for determining whether a preexisting disability constitutes a "hindrance or obstacle to employment":

[T]he proper focus of the inquiry is not on the extent to which the condition has

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

Related Decisions

affirmed

The Labor and Industrial Relations Commission affirmed the Administrative Law Judge's award allowing workers' compensation benefits to Theresa Thompson for a low back injury sustained on July 20, 2010 while lifting and shelving copper coils. The claimant was entitled to temporary total disability benefits, permanent partial disability compensation, and medical aid totaling over $223,000, with additional underpayment and back pay amounts owed.

back12,259 words

Brown v. Noranda Aluminum, Inc.(2023)

February 3, 2023#16-027102

affirmed

The Labor and Industrial Relations Commission affirmed the administrative law judge's award granting permanent total disability compensation to Donald Brown for his work-related injuries to his back and left elbow. The Commission rejected the Second Injury Fund's argument that an anxiety disability should be considered in the PTD determination, finding that non-qualifying psychiatric disabilities need not be factored into the analysis.

back7,339 words

The Commission modified the ALJ's award to allow compensation for unpaid past medical expenses for employee Rodney Battles, who sustained a work-related back injury on October 5, 2016, requiring two back surgeries. The decision clarifies that an employer's duty to provide statutorily-required medical aid is absolute and unqualified under Missouri workers' compensation law.

back6,444 words

Gourley v. Cox Medical Center(2021)

December 15, 2021#07-031701

affirmed

The Labor and Industrial Relations Commission affirmed the administrative law judge's award allowing workers' compensation benefits for Carol Gourley's injury sustained on January 13, 2007 at Cox Medical Center. One commissioner dissented, arguing the ALJ erred in denying payment for unpaid medical bills ($173,896.25) and temporary total disability benefits ($109,574.64) related to the compensable 2007 injury.

back12,971 words

Comer v. Central Programs, Inc.(2021)

August 11, 2021#16-085212

affirmed

The Commission affirmed the Administrative Law Judge's award of permanent total disability compensation, finding the employee's November 1, 2016 back injury combined with qualifying preexisting disabilities met statutory requirements for Second Injury Fund liability. The employee's preexisting lower left extremity and thoracic disabilities, each exceeding fifty weeks of permanent partial disability, directly aggravated and accelerated the primary work-related back injury resulting in permanent total disability.

back14,532 words