The administrative law judge determined that there is not a reasonable probability that employee has a need for future medical treatment that flows from the effects of the work injury. In so ruling, he relied on the following considerations: employee has not sought treatment for his left knee since November 8, 2011; employee will likely require bilateral knee replacements in the future owing to his arthritis and obesity, regardless whether
the work injury had occurred; employee sought some treatment for his left knee before the occurrence of the work injury, and so the pattern of waxing and waning symptoms referable to arthritis was established before the injury and continues thereafter; and employee currently takes only ibuprofen to manage his symptoms referable to the work injury.
After a careful review of the conflicting evidence with regard to this issue, we disagree. First, we must note that where, as here, it is uncontested that a compensable injury has occurred, "the question of whether or not [employee] may have needed future treatment even if the injury did not occur is irrelevant to the analysis of whether the future medical care flows from the injury that actually occurred." Stevens v. Citizens Mem'l Healthcare Found., 244 S.W.3d 234, 238 (Mo. App. 2008). In the context of this case, we must conclude that it is wholly irrelevant to our analysis that employee may, at some point in the future, have developed a need for a total knee replacement even if the work injury had not occurred.
Second, we do not find it particularly relevant that employee has not sought additional medical treatment for his left knee during the several years that have elapsed since he reached maximum medical improvement. Obviously, there are many reasons an injured employee might delay or refrain altogether from seeking treatment, especially in the context of a disputed workers' compensation claim. In this case, we do not perceive employee's refraining from seeking additional treatment as undercutting, in any fashion, the otherwise persuasive evidence regarding the severity of the work injury. As we noted above, employee was essentially forced to change jobs as a result of the work injury, and now enjoys a position where he is very rarely on his feet for any extended period of time. Employee also credibly testified (and we so find) that he plans to hold off on undergoing a knee replacement surgery until his symptoms are unbearable. We will not fault employee for this eminently reasonable decision.
Third, the fact that employee is, for the time being at least, able to manage his symptoms referable to the work injury utilizing only ibuprofen does not, in our view, defeat the claim for future medical treatment. Relief under § 287.140 RSMo is not limited to prescription medications, but instead specifically includes all "medicines" that may relieve from the effects of the work injury. An employer's duty to provide statutorilyrequired medical aid to an employee is absolute and unqualified. Downing v. McDonald's Sirloin Stockade, 418 S.W.3d 526, 529 (Mo. App. 2014).
Of course, the administrative law judge noted employee's use of ibuprofen as support for his finding that the effects of the work injury are not very serious, and thus employee does not now need a total knee replacement. The premise appears to be that if an employee cannot prove, at the time of hearing, that a specific treatment modality is imminently required, the claim for future medical care is defeated. We cannot endorse this view. As recently made clear in the case of State ex rel. ISP Minerals, Inc. v. Labor \& Indus. Rels. Comm'n, 465 S.W.3d 471 (Mo. 2015), the Commission retains jurisdiction to hear and resolve disputes arising from questions of future medical treatment. Consequently, in a case such as this where the doctors are in agreement that employee will likely require a left total knee replacement at some point in the future;