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Kenneth Jones v. Harley Davidson Motor Company

Decision date: September 15, 2017Injury #11-06210233 pages

Summary

The Labor and Industrial Relations Commission affirmed the administrative law judge's award allowing workers' compensation for Kenneth Jones's low back injury that occurred in the course of his employment with Harley Davidson Motor Company. The employee was found to be permanently and totally disabled as a result of the accident, with liability established for past medical expenses and future medical care.

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Caption

FINAL AWARD ALLOWING COMPENSATION (Affirming Award and Decision of Administrative Law Judge with Supplemental Opinion)
Injury No.: 11-062102
Employee:Kenneth Jones
Employer:Harley Davidson Motor Company
Insurer:American Casualty Company of Reading PA
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. Having reviewed the evidence, read the parties’briefs, heard the parties’ arguments, and considered the whole record, we find that the award of the administrative law judge allowing compensation is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to § 286.090 RSMo, we affirm the award and decision of the administrative law judge with this supplemental opinion.
Preliminaries
The parties asked the administrative law judge to resolve the following issues: (1) whether there was an accident to employee’s low back; (2) whether notice was provided of an injury to the low back; (3) whether the injury to the back arose out of and in the course of the employment; (4) medical causation for any injuries alleged to the back; (5) liability for past medical expenses; (6) the need for future medical care; (7) the nature and extent of temporary total disability; (8) the nature and extent of permanent disability; and (9) the liability of the Second Injury Fund.The administrative law judge determined as follows: (1) employee proved that an accident occurred in the course and scope of his employment; (2) notice was given to the employer as required by statute; (3) employee was temporarily disabled from September 12, 2011, through October 4, 2012; (4) employee met his burden of proof regarding past medical expenses; (5) employee is permanently and totally disabled as a result of the last accident considered in isolation; (6) employee has satisfied his burden of proof on the issue of future medical aid; and (7) the Second Injury Fund has no liability.Employer filed a timely application for review alleging the administrative law judge erred as follows: (1) in misstating the notice provision of § 287.420 RSMo as not requiring the exact nature of an employee’s injury, because strict construction of statutory language requires specific notice of the nature of the injury; (2) in ignoring all cross-examination questions and answers, or the inconsistencies of employee’s testimony revealed by the same, because the administrative law judge adopted, nearly verbatim, the employee’s proposed award; and (3) in misinterpreting the burden of proof under § 287.808 imposing the burden on employee to prove every essential basis for any entitlement to compensation.

The Commission also received a timely application for review filed by Darren Fulcher, Attorney at Law, alleging the Division of Workers' Compensation (Division) failed to notify him of the hearing or issuance of a final award in this case, despite his assertion of a fee lien in his request for withdrawal filed with the Division. ${ }^{1}$

On July 24, 2017, the Commission invited employee's present counsel, Kristi Pittman, and Mr. Fulcher to advise, in writing, whether they were able to reach an agreement with regard to the issue of Mr. Fulcher's assertion of a lien in this case.

On August 14, 2017, the Commission received correspondence from Mr. Fulcher indicating he had reached an agreement with Ms. Pittman, and that the agreed total amount of the lien in favor of the Fulcher Law Firm, P.C., was agreed to be $\ 12,500.00.

On August 30, 2017, the Commission received correspondence from Ms. Pittman indicating her agreement to the amount of Mr. Fulcher's fee lien as indicated in his correspondence of August 14, 2017.

Accident

The parties asked the administrative law judge to resolve the issue whether employee sustained an accident for purposes of the Missouri Workers' Compensation Law. The administrative law judge determined this issue in employee's favor, but we note that he did not, in his award, cite or apply the controlling statutory provision. Consequently, we must provide the appropriate analysis herein.

Section 287.020.2 RSMo provides, in relevant part, as follows:

The word "accident" as used in this chapter shall mean an unexpected traumatic event or unusual strain identifiable by time and place of occurrence and producing at the time objective symptoms of an injury caused by a specific event during a single work shift.

In adopting employee's testimony with regard to what happened during his work shift on July 13, 2011, the administrative law judge implicitly found that employee made a credible witness. After careful consideration, we do not discern a compelling basis to second-guess the administrative law judge's credibility determination in this regard. ${ }^{2}$ Consequently, we adopt the administrative law judge's findings that on July 13, 2011, while engaged in his work shift for employer, employee was using a large pneumatic gun in an attempt to loosen a bolt that had become stuck; that the gun jerked suddenly and caused employee to twist at the waist; and that employee suffered right elbow and low back pain in connection with this event.

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[^0]: ${ }^{1}$ Taking administrative notice of the records of the Division in connection with this case, we note that Mr. Fulcher was employee's attorney of record from May 17, 2013, through June 4, 2014.

${ }^{2}$ We acknowledge that employer vehemently attacks employee's credibility. However, employer's substantive arguments regarding employee's credibility are, in our view, largely undermined by the discourteous, hyperbolic, and inflammatory tone and tenor of employer's briefing in this matter.

Employee: Kenneth Jones

- 3 -

Employer argues that because employee did not notice immediate pain in his low back on the date of the accident, but instead first noticed these symptoms two or three days later, employee cannot meet his burden of proving he sustained an accident. We are not persuaded. We are required, pursuant to § 287.800.1 RSMo to strictly construe the definition of accident set forth above. Section 287.020.2 requires an employee to demonstrate only that he experienced "symptoms of an injury" to prove that an accident occurred. Employer asks us to read the definition as if it required employee to demonstrate that he experienced "symptoms referable to each and every injury ultimately claimed" at the time of the accident. This we cannot do, because "a strict construction of a statute presumes nothing that is not expressed." *Allcorn v. Tap Enters.*, 277 S.W.3d 823, 828 (Mo. App. 2009).

The fact that employee did not immediately notice low back pain is certainly pertinent to the issue of medical causation, but is not, in our view, particularly relevant to the issue of accident, where employee credibly testified that he suffered symptoms of an injury at the time of the event in question. As further discussed below, we believe this to be a case where it falls within the expertise of the medical witnesses to thereafter determine the exact nature of the injury (or injuries) employee sustained as a result of the accident, including any sequelae affecting the low back.

We conclude that the facts we have summarized above, as found by the administrative law judge and as we have adopted, satisfy the statutory definition of accident, in that they unquestionably involve an unexpected traumatic event or unusual strain that is identifiable by time and place of occurrence, and that produced at the time objective symptoms of an injury caused by a specific event. Consequently, we conclude that employee suffered an accident for purposes of § 287.020.2.

**Medical causation**

The parties asked the administrative law judge to resolve the issue of medical causation of employee's injuries. The administrative law judge determined this issue in employee's favor, but did not, in his award, cite or apply the controlling statutory provision. Consequently, we must provide the appropriate analysis herein.

Section 287.020.3(1) RSMo provides, in relevant part, as follows:

> An injury by accident is compensable only if the accident was the prevailing factor in causing both the resulting medical condition and disability. "The prevailing factor" is defined to be the primary factor, in relation to any other factor, causing both the resulting medical condition and disability.

Employer argues that the accident cannot be deemed the prevailing factor causing employee to suffer any low back injury, because employee suffered from preexisting low back pain prior to the accident, and because the August 8, 2011, records from employee's chiropractor, Dr. Michael Emery, suggest employee reported that these preexisting complaints were unchanged.

Arter careful consideration, we are not persuaded. Employee's testifying medical expert, Dr. P. Brent Koprivica, specifically acknowledged and discussed these treatment records, and ultimately opined that the accident was the prevailing factor causing employee to suffer permanent and disabling injury to the lumbar spine with new structural change with resultant destabilization of the spondylolisthesis associated with an annular injury and resulting in the development of symptomatic stenosis.

Dr. Koprivica explained that employee's history to him was that although he had preexisting ongoing low back pain, this was a tolerable situation prior to the accident of July 13, 2011. Dr. Koprivica also addressed the fact that employee did not immediately notice low back pain on the date of accident as follows:

My understanding from [employee] is that over time, the issues regarding his low back following this injury became much more significant. ... [H]e is clear that there were new and increased pain complaints in his low back that actually progressed following the injury sustained on July 13, 2011.

Transcript, page 340.

Again, we have deferred to the administrative law judge's implicit finding that employee's testimony at the hearing was credible. Consequently, we likewise discern no compelling reason to overturn the administrative law judge's implicit determination that Dr. Koprivica's causation opinions relying on employee's history are persuasive. Instead, we find that Dr. Koprivica provided the more persuasive medical causation testimony in this case. We conclude that the accident of July 13, 2011, was the prevailing factor causing employee to suffer the resulting medical conditions of permanent and disabling injury to the lumbar spine with new structural change with resultant destabilization of the spondylolisthesis associated with an annular injury and resulting in the development of symptomatic stenosis, as well as a right elbow injury that resolved without permanent disability.

Injury arising out of and in the course of the employment

The parties asked the administrative law judge to resolve the issue whether employee sustained an injury arising out of and in the course of the employment. The administrative law judge did not specifically address this issue or apply the controlling statutory test. Consequently, we must provide the appropriate analysis herein. ${ }^{3}$

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[^0]: ${ }^{3}$ Because employer did not file a request that we consider additional evidence in this matter, and because the proposed awards submitted by the parties to the administrative law judge were not made a part of the transcript or legal file provided to us by the Division, we decline to address employer's allegation that the administrative law judge adopted, nearly verbatim, employee's proposed award. We would be remiss, however, if we failed to caution that one of the primary risks attendant to a fact-finder's policy of adopting proposed awards would appear to be

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

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