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Suzanne Gwin v. Southeast Missouri Mental Health Center

Decision date: April 5, 2017Injury #10-01114434 pages

Summary

The Commission modified the administrative law judge's decision regarding the nature and extent of disability, finding the employee credible and her complaints substantially corroborated by medical records. The employee sustained work-related injuries to her lumbar spine, left hip, and left lower extremity from a February 17, 2010 accident, with the Commission reconsidering the determination of permanent total disability based on the employee's documented daily pain and functional limitations.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Modifying Award and Decision of Administrative Law Judge)
Employee:Suzanne Gwin
Employer:Southeast Missouri Mental Health Center
Insurer:Missouri Office of Administration-CARO
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, 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) medical causation with regard to the lumbar spine, left hip, and left lower extremity; (2) past medical expenses; (3) future medical aid; and (4) nature and extent of permanent disability.The administrative law judge determined as follows:(1) the February 17, 2010, accident was the prevailing factor in causing employee’s resulting lumbar spine, left hip and left lower extremity injuries, and resulting symptoms, medical conditions, disability, and need for treatment; (2) employee’s claim for past medical bills is denied; (3) employee is in need of future medical treatment to cure and relieve her from the effects of her February 17, 2010, work-related injury and employer is liable to provide same; and (4) employee has sustained permanent partial disability as a result of the February 17, 2010, accident as follows: 25% of the body as a whole referable to the lumbar spine and left hip, and 30% of the right shoulder at the 232-week level.Employee filed a timely application for review with the Commission alleging the administrative law judge erred in determining that employee failed to meet her burden of proving that she is permanently and totally disabled as a result of the work injury.For the reasons stated below, we modify the award and decision of the administrative law judge referable to the issue of the nature and extent of disability.
Discussion
Nature and extent of disability
After a thorough review of the conflicting expert medical and vocational opinions, the administrative law judge determined that employee is not permanently and totally disabled. We acknowledge that the record of evidence in this matter provides substantial and competent evidence to support the administrative law judge’s findings. However, after our own careful review of the evidence, we are persuaded to find otherwise, for the following reasons.

In his award, the administrative law judge specifically indicated that he found employee's testimony at the hearing to be credible. We discern no basis on this record to disagree with the administrative law judge's finding in this regard. We note that employee's own description of her complaints referable to the work injury is substantially corroborated by the medical records in evidence. Consequently, we credit employee's testimony and find as follows with regard to the effects of the work injury upon her.

Employee suffers right arm numbness and tingling on a daily basis, which limits her use of her dominant right hand, and causes her to drop things. Employee also experiences ongoing, daily back pain that radiates into her lower left extremity, as well as a dull, achy pain in her left hip. On a good day, employee's back pain is a $4 / 10 in severity, but this may increase to 7 / 10$ on a bad day. Activities such as climbing stairs, pushing/pulling, and bending exacerbate employee's low back pain. Owing to back pain, employee is unable to walk for more than 15 to 20 minutes, is unable to stand longer than 30 minutes, and sometimes has to lie down to relieve her pain. Prolonged sitting also causes problems with pain and stiffness. Employee takes narcotic pain medications and muscle relaxers to manage her symptoms.

Turning to employee's attempt to return to work following her injury, we note the uncontested evidence that, following her release by Dr. Wayne from active treatment as of November 23, 2010, employee missed a considerable amount of work, even though she was performing essentially sedentary work tasks. Specifically, from November 23, 2010, through March 18, 2011, when employer fired her, employee missed a total of 61 hours of scheduled work. Employer argues, in its brief, that employee did not provide testimony to specifically delineate whether she missed work during this time period solely because of her own pain complaints or because she was attending medical appointments, but this strikes us as a distinction without a difference. From our own careful review of the leave slips themselves, we find that, in any event, all of this missed work was owing to the permanent and ongoing effects of the work injury.

We note also that, during this timeframe, employee applied to work for employer as a front desk receptionist, a light duty position that would have permitted her to work within her restrictions and alternate sitting and standing as needed. Employer, however, rejected employee's application for this position, and instead terminated her employment when she ran out of leave. In our view, employer's unwillingness to provide this employee of seven years with work within her restrictions casts considerable doubt on the prospect that some other employer will be willing to do so.

Employee's sporadic work history between November 2010 and March 2011 also, in our view, strongly corroborates the opinion from employee's vocational expert, Gary Weimholt, that employee lacks the ability to compete for even sedentary work in the open labor market. Ultimately, after careful consideration, we find the analysis from Dr. Musich and Mr. Weimholt most persuasive with regard to this issue. We find that employee is unable to compete for work in the open labor market as a result of the multiple disabling effects of the primary injury. We conclude, therefore, that employer is liable for permanent total disability benefits pursuant to § 287.200 RSMo.

Conclusion

We modify the award of the administrative law judge as to the issue of the nature and extent of disability.

Employee is entitled to, and employer is hereby ordered to pay, weekly permanent total disability benefits beginning on the stipulated date of maximum medical improvement, March 18, 2011, at the rate of $\ 265.69. The weekly payments shall continue for employee's lifetime, or until modified by law.

The award and decision of Administrative Law Judge Lawrence C. Kasten, issued August 9, 2016, is attached hereto and incorporated herein to the extent not inconsistent with this decision and award.

The Commission approves and affirms the administrative law judge's allowance of an 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 5th day of April 2017.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

VACANT

Member

Curtis E. Chick, Jr., Member

Attest:

FINAL AWARD

Employee: Suzanne Gwin

Injury No. 10-011144

Dependents: N/A

Employer: State of Missouri, Southeast Missouri Mental Health Center

Additional Party: Second Injury Fund (Dismissed)

Insurer: Missouri Office of Administration-CARO

Appearances: Mark Moreland, attorney for the employee.

Jackson Otto and Keyla Rhoades, attorneys for the employer-insurer.

Hearing Date: March 21, 2016 (commenced)

Checked by: LCK/kg May 6, 2016 (completed)

SUMMARY OF FINDINGS

  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? February 17, 2010.
  5. State location where accident occurred or occupational disease contracted: St. Francois County.
  6. Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes.
  7. Did the 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.
Employee:Suzanne GwinInjury No. 10-011144
  1. Describe work the employee was doing and how accident happened or occupational disease contracted: The employee was carrying a client on a litter when she fell down and twisted her back.
  2. Did accident or occupational disease cause death? No.
  3. Parts of body injured by accident or occupational disease: Right shoulder, left hip, left lower extremity, and body as a whole referable to the lumbar spine.
  4. Nature and extent of any permanent disability: 30% permanent partial disability of the right shoulder and 25% permanent partial disability of the body as whole referable to lumbar spine and left hip.
  5. Compensation paid to date for temporary total disability: 2,694.95
  6. Value necessary medical aid paid to date by the employer-insurer: 39,786.06
  7. Value necessary medical aid not furnished by the employer-insurer: None.
  8. Employee’s average weekly wage: 398.54
  9. Weekly compensation rate: 265.69 for temporary total disability, permanent total disability and permanent partial disability.
  10. Method wages computation: By agreement.
  11. Amount of compensation payable: $45,061.02 for permanent partial disability.
  12. Second Injury Fund liability: N/A.
  13. Future requirements awarded: Future medical. See Rulings of Law.

Said payments shall be payable as provided in the findings of fact and rulings of law, and shall be subject to modification and review as provided by law.

The Compensation awarded to the employee 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 employee: Mark Moreland.

STATEMENT OF THE FINDINGS OF FACT AND RULINGS OF LAW

On March 21, 2016, the employee, Suzanne Gwin, appeared in person and with her attorney, Mark Moreland for a hearing for a final award. The employer was represented at the hearing by Assistant Attorney General Jackson Otto and Assistant Attorney General Keyla Rhoades. The parties agreed on certain undisputed facts and identified the issues that were in dispute. These undisputed facts and issues, together with a statement of the findings of fact and rulings of law, are set forth below as follows:

UNDISPUTED FACTS:

  1. The State of Missouri, Southeast Missouri Mental Health Center was operating under and subject to the provisions of the Missouri Workers' Compensation Act, and was duly qualified as a self insured employer through the Missouri Office of Administration/CARO.
  2. On or about February 17, 2010, Suzanne Gwin was an employee of the State of Missouri, Southeast Missouri Mental Health Center, and was working under the Workers' Compensation Act.
  3. On or about February 17, 2010, the employee sustained an accident arising out of and in the course of her employment.
  4. The employer had notice of the employee's accident.
  5. The employee's claim was filed within the time allowed by law.
  6. The employee's average weekly wage was $\ 398.54. The rate of compensation for temporary total, permanent total, and permanent partial disability is $\ 265.69 per week.
  7. The employee's injury to the right shoulder was medically causally related to the accident.
  8. The employer-insurer paid $\ 39,786.06 in medical aid.
  9. The employer-insurer paid $\ 2,694.95 in temporary disability benefits. The first time period paid began on February 18, 2010 and continued through April 21, 2010. The second period paid began on May 10, 2010 and continued through June 2, 20

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

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