Skip to content
Ott Law Firm

Larry Thilmony v. Schwan's Foods

Decision date: December 15, 2016Injury #09-06279712 pages

Summary

The Commission modified the administrative law judge's award regarding the Second Injury Fund's liability for permanent total disability benefits, affirming that the employee is permanently and totally disabled but changing the commencement date of benefits. The employee, a delivery driver injured in a 2009 workplace fall, was entitled to permanent total disability benefits based on the combination of his primary work injury and preexisting disabling conditions affecting multiple body parts.

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

Employee:Larry Thilmony
Employer:Schwan’s Foods (Settled)
Insurer:Hartford Accident & Indemnity (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, 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.

Introduction

The parties asked the administrative law judge to resolve the sole issue of the liability of the Second Injury Fund.

The administrative law judge determined that the Second Injury Fund is liable for permanent total disability benefits beginning July 1, 2015.

Employee filed a timely application for review with the Commission alleging the administrative law judge erred in determining that employee was not permanently and totally disabled until July 1, 2015, and that the administrative law judge should have instead determined that employee’s permanent and total disability began on his last date of employment with employer.

The Second Injury Fund filed a timely application for review with the Commission alleging the administrative law judge erred in determining that employee is permanently and totally disabled based upon a combination of his primary injury and preexisting disabilities.

For the reasons set forth in our decision herein, we modify the administrative law judge’s award with respect to the date of commencement of the Second Injury Fund’s liability for permanent total disability benefits.

*Commencement of permanent total disability benefits*

On July 21, 2009, this delivery driver of over 20 years slipped and fell on a wet flight of stairs at work, suffering injuries affecting his right knee and right shoulder. He seeks an award of permanent total disability benefits from the Second Injury Fund based on a combination of the effects of this injury and his preexisting permanent partially disabling

Employee: Larry Thilmony

-2 -

conditions affecting the left hip, left shoulder, left knee, and body as a whole in the form of a cardiovascular disorder. Employee stopped working for employer during the summer of 2010. Thereafter, he provided some assistance to his wife with a daycare business that she operated from their home through the summer of 2015. The Second Injury Fund argues that this latter activity shows that employee is not permanently and totally disabled, and that it amounted to employment in the open labor market.

In her findings, the administrative law judge expressly credited the testimony from the employee describing his limitations stemming from the combination of his primary 2009 work injury and his preexisting disabling conditions. We are mindful that the administrative law judge was able to observe employee as he testified at the hearing, and we are reluctant to reverse her express credibility call in this regard absent a compelling reason to do so. After careful consideration, we do not find a reason to do so here. Accordingly, we defer to her finding and adopt it as our own. For this reason, and because we otherwise agree that the combination of employee's work injuries and his preexisting disabling conditions render him unable to compete in the open labor market in light of his age, education, and work history, we affirm the award of permanent total disability benefits.

However, we note that the administrative law judge determined that employee was not permanently and totally disabled until July 1, 2015, based on an implicit finding that employee's actions in helping his wife with her in-home daycare business demonstrated employee had an ability to compete for work in the open labor market until that business closed at some point in the summer of 2015. We disagree, for the following reasons.

Courts have used various terms to determine when an employee's condition has reached the point where further progress is not expected, including the term maximum medical improvement. Vinson v. Curators of the University of Missouri, 822 S.W.2d 504, 508 (Mo. App. E.D. 1991)(interpreting a doctor's testimony of employee's maximum treatment potential to mean maximum medical improvement); Cooper, 955 S.W.2d at 575 (using the term maximum medical progress to define the point where no further progress is expected for an employee's condition).

After reaching the point where no further progress is expected, it can be determined whether there is either permanent partial or permanent total disability and benefits may be awarded based on that determination. One cannot determine the level of permanent disability associated with an injury until it reaches a point where it will no longer improve with medical treatment. ...

Although the term maximum medical improvement is not included in the statute, the issue of whether any further medical progress can be reached is essential in determining when a disability becomes permanent and thus, when payments for permanent partial or permanent total disability should be calculated.

As the foregoing language from the Cardwell decision makes clear, the appropriate date for assigning liability for the payment of permanent total disability benefits will generally coincide with the date upon which an employee reaches maximum medical improvement from the effects of the work injury. This is because, at that point, the nature and extent of any permanent disability referable to the effects of the work injury may be calculated. By the same token, the fact-finder is then able to assess the nature and extent of any permanent disability that results from the combination of the primary injury with employee's preexisting conditions of ill-being. Stated another way, if employee was not permanently and totally disabled owing to his continued work for his wife's daycare, he did not suddenly become so disabled when she closed that business during the summer of 2015, as this event did not change employee's medical status, physical condition, or overall ability to compete for work.

As an aside, with regard to employee assisting his wife with her in-home daycare business, we are not persuaded by the contention from the Second Injury Fund that such represented gainful employment in the open labor market. First, as we have noted, the administrative law judge expressly credited employee's testimony with regard to his physical limitations; consequently, she implicitly determined that employee's physical activities for the daycare, such as sitting and watching children, holding infants, and walking children $1 / 2$ block to and from the bus stop, did not ultimately undermine his credible testimony with regard to the issue of permanent total disability. We have deferred to her determination in this regard. Second, the Missouri courts have never required that a disabled employee remain "completely inactive or inert" to receive an award of permanent total disability benefits, Grgic v. P \& G Constr., 904 S.W.2d 464, 466 (Mo. App. 1995), and have consistently held that post-injury work obtained through means other than competition in the open labor market (such as from a friend or family member) does not preclude an award of benefits. Minnick v. South Metro Fire Protection Dist., 926 S.W.2d 906, 910 (Mo. App. 1996).

Turning back to the issue when employee reached maximum medical improvement, we note that employee's treating surgeon for the primary right shoulder injury, Dr. John Havey, released employee from his care on April 5, 2010. This appears to be the date upon which employee reached maximum medical improvement from the effects of the work injury; the parties, in any event, do not argue otherwise. Consequently, it would appear that the Second Injury Fund's liability for permanent partial disability benefits began on April 5, 2010.

However, we note that employee, in his brief, requests an award of permanent total disability benefits beginning on August 7, 2010. We will not second-guess employee where he is willing to stipulate that he is not entitled to permanent total disability benefits until August 7, 2010. Accordingly, we modify the award of the administrative law judge regarding the date of commencement of permanent total disability benefits. The Second Injury Fund is liable for permanent total disability benefits beginning August 7, 2010.

Injury No.: 09-062797

**Employee: Larry Thilmony**

- 4 -

Conclusion

We modify the award of the administrative law judge as to the issue of the date that the Second Injury Fund became liable for permanent total disability benefits.

The Second Injury Fund is liable for permanent total disability benefits beginning August 7, 2010, at the differential rate of $62.69 for 52.6 weeks, and thereafter at the stipulated weekly permanent total disability benefit rate of $485.66. The weekly payments shall continue for employee's lifetime, or until modified by law.

The award and decision of administrative law judge Hannelore D. Fischer, issued February 25, 2016, is attached hereto and incorporated by this reference to the extent not inconsistent with our findings, conclusions, decision, and modifications herein.

The Commission further approves and affirms the administrative law judge's allowance of attorney's fees 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 15th day of December 2016.

**LABOR AND INDUSTRIAL RELATIONS COMMISSION**

John J. Larsen, Jr., Chairman

James G. Avery, Jr., Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

AWARD

Employee:Larry ThilmonyInjury No.: 09-062797
Dependents:N/ABefore the <br> DIVISION OF WORKERS' <br> COMPENSATION <br> Department of Labor and Industrial <br> Relations of Missouri <br> Jefferson City, Missouri
Employer:Schwan's Foods (previously settled)
Additional Party:Treasurer of the State of Missouri <br> Custodian of the Second Injury Fund
Insurer:N/A
Hearing Date:February 2, 2016Checked by: HDF/scb

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: July 21, 2009
  5. State location where accident occurred or occupational disease was contracted: Miller County, 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? N/A
  11. Describe work employee was doing and how accident occurred or occupational disease contracted: See Award
  12. Did accident or occupational disease cause death? No. Date of death? N/A
  13. Part(s) of body injured by accident or occupational disease: Right shoulder; Right knee
  14. Nature and extent of any permanent disability: 17.5 % right shoulder; 7.5 % right knee
  15. Compensation paid to-date for temporary disability: N/A
  16. Value necessary medical aid paid to date by employer/insurer? N/A

Employee: Larry Thilmony Injury No. 09-062797

  1. Value necessary medical aid not furnished by employer/insurer? N/A
  2. Employee's average weekly wages: ---
  3. Weekly compensation rate: $\ 485.66 TTD, PTD/ \$422.97 PPD
  4. Method wages computation: By agreement

COMPENSATION PAYABLE

  1. Amount of compensation payable: Employer previously settled.
  2. Se

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

Related Decisions

modified

The Labor and Industrial Relations Commission modified the administrative law judge's award, finding the employer and Second Injury Fund liable for permanent total disability benefits to employee Helen Baker for multiple work-related injuries sustained on February 14, 2011. The Commission adjusted the liability allocation between the employer and Second Injury Fund while maintaining the finding that employee is permanently and totally disabled.

multiple injuries9,208 words

The LIRC reversed the administrative law judge's denial of Second Injury Fund liability, finding that the employee's work-related injuries to the lumbar spine, cervical spine, and right shoulder combined synergistically with preexisting conditions (right knee patellofemoral syndrome, bilateral carpal tunnel syndrome, and headaches) to cause greater disability than the sum of individual disabilities. The Commission determined the ALJ erred in failing to properly consider medical testimony and evidence regarding the synergistic interaction of the employee's multiple conditions.

multiple injuries5,472 words

The Labor and Industrial Relations Commission affirmed the Administrative Law Judge's award finding the employee's April 21, 2014 workplace injury compensable with permanent partial disability ratings of 25% left shoulder, 10% neck, 5% right knee, and 2.5% left ankle. Total compensation of $190,117.96 was awarded for medical treatment and temporary disability benefits already paid, with no future requirements awarded.

multiple injuries6,297 words

Houchen v. Trimmasters(2018)

January 23, 2018#06-022626

affirmed

The Commission affirmed the administrative law judge's award of permanent total disability benefits to employee Candace Houchen for injuries sustained on January 13, 2006, when she was struck by plywood caught by wind while lifting at work. The employee is entitled to ongoing weekly compensation of $696.97 for life, along with medical expenses and mileage reimbursement.

multiple injuries7,547 words
affirmed

The Labor and Industrial Relations Commission affirmed the administrative law judge's award of permanent total disability benefits to James Hood against the Second Injury Fund based on the combination of his primary injury from February 21, 2014, and preexisting disabling conditions from multiple prior work-related injuries. The Commission found that the 2014 amendments to § 287.220.3 RSMo did not apply because some preexisting injuries predated January 1, 2014, and the claim satisfied the statutory requirements under § 287.220.2 RSMo.

multiple injuries6,215 words