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Otis Saine v. Pepsi Beverages Company

Decision date: October 23, 2017Injury #15-06988618 pages

Summary

The Labor and Industrial Relations Commission affirmed the administrative law judge's denial of workers' compensation benefits, finding that the employee failed to establish an identifiable traumatic event or accident as required by Missouri law. The employee's credibility was undermined by multiple inconsistent statements regarding how the alleged neck injury occurred, with varying accounts including lifting, twisting, swerving, and backing up incidents.

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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 DENYING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge)

Injury No.: 15-069886

Employee: Otis Saine

Employer: Pepsi Beverages Company

Insurer: Indemnity Insurance Company of North America

This workers' compensation case is submitted to the Labor and Industrial Relations Commission (Commission) for review as provided by $\S 287.480$ RSMo. We have reviewed the evidence, read the briefs, and considered the whole record. We find that the award of the administrative law judge denying compensation is supported by competent and substantial evidence and was made in accordance with the Missouri Workers' Compensation Law. Pursuant to § 286.090 RSMo, the Commission affirms the Award and Decision of the administrative law judge for the reasons set forth below, and as supplemented or corrected herein.

Accident

The parties asked the administrative law judge to determine whether employee sustained an "accident"1 as that term is defined by the Missouri Workers' Compensation Law. Section 287.020 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.

The administrative law judge concluded that employee did not show a single, identifiable traumatic event or unusual strain occurred during any single work shift. Specifically, the administrative law judge found employee's evidence of the alleged accident, as lacking in credibility. The administrative law judge found claimant gave several diverse and distinguishable versions of how the alleged incident occurred. This conclusion is supported by the record.

Objective symptoms of injury

The administrative law judge's finding that: "the claimant's evidence of an accident lacks credibility based on varying inconsistent statements from the claimant, and because the evidence supports a finding that the claimant's neck injury manifest (sic) months after the alleged occurrence;" is supported by the record. (Decision, page 11) Furthermore, the mechanism of injury was described differently throughout. ${ }^{2}$

Employee asserts that the administrative law judge erred in relying on employee's purported inconsistent statement regarding the nature and onset of his pain from his

[^0]

[^0]: ${ }^{1}$ The parties stipulated that proper notice was given to the employer of the alleged accident on August 31, 2015. The parties' stipulation did not include acknowledgement that an accident occurred on that date.

${ }^{2}$ At various times, claimant reported a lifting injury, a turning or twisting injury, swerving to avoid a car, an injury caused by repeatedly backing up and hitting the loading dock, stacking, and hard steering.

Improve: Otis Saine

- 2 -

deposition. During questioning of the employee at the hearing on October 26, 2016, by employer's attorney, statements from the employee's deposition on December 2, 2015, were referenced. Employee's deposition was not in evidence and employer's attorney did not read the testimony into the record. (Tr. 50) We conclude that the reference to an alleged date of injury from employee's deposition testimony as August 25, 2015, is not supported by the record because it is based on a deposition transcript not in evidence. (Decision, page 6) However, we note this was only one thread of the administrative law judge's analysis. The administrative law judge found ample instances of inconsistencies in the information claimant reported to the medical providers. The finding that "claimant's evidence of an accident lacks credibility based on the varying inconsistent statements from the claimant..." is supported. (Decision, page 11)

Employee testified in person before the administrative law judge. The administrative law judge recounted and substantially relied upon his firsthand observations of employee's testimony regarding the issue of employee's credibility. After careful consideration, we are not persuaded to disturb the administrative law judge's credibility determination as to the nature and onset of injury. As pointed out in the administrative law judge's decision, employee identified the nature of the injury (as well as the date), differently in various incarnations of his Claim for Compensation.³ Furthermore, although the initial incident was reported to be in August 2015, employee did not report neck pain until January 5, 2016. Prior to that time, he only referred to right shoulder/arm pain.

Expert medical opinion evidence

The administrative law judge's finding was that the opinion of Dr. Kevin Rutz⁴ was generally more credible, and his causation opinion more persuasive in this matter. After careful consideration, we conclude this finding was supported by the record. Dr. Rutz's examination of employee and his medical records appears to have been more comprehensive than the other physicians, including X-rays in the office on his visit of May 3, 2016; review of MRI scans from 2008, and January 2016,⁵ range of motion-oriented testing; a patient history; review of many of the past examining physician reports relative to this claim; employee's deposition; and a physical examination. Dr. Rutz notes that the delayed onset of the neck symptoms first raised in January 2016, suggest this was not caused by any alleged incident in August 2015. Dr. Rutz further opines that one single incident as described would not cause a disk herniation at C5-C6, as shown on employee's scans, but rather it was more consistent with continuing degenerative changes.

Corrections

The administrative law judge found that "at hearing, claimant testified that on August 15, 2015, his pain began immediately following an incident in which he had to jerk his

³ Employee's initial Claim for Compensation form on September 29, 2015, alleged injury due to heavy and repetitive activities, to his shoulder and right arm. Amended claim forms were filed on December 4, 2015, January 25, 2016, and March 29, 2016. The subsequent claim forms did not add a reference to the neck until January 2016 (second amendment). Dates of injury were reported in the Claims as August 31, 2015 and August 25, 2015.

⁴ Within the record, there are inaccurate references to a Dr. Ruiz. These references should reflect Dr. Rutz. There was no consulting physician by the name of Dr. Ruiz in this proceeding.

⁵ The Decision at page 7 refers to an MRI taken on January 15, 2015. This is a typographical error. The date of the MRI was January 15, 2016.

steering wheel to the right and slam on his brakes to avoid a collision." (Decision page 11, emphasis ours) Upon review of the transcript of hearing, we find no reference in claimant's testimony identifying the date of August 15, 2015. ${ }^{6}

Employee's testimony was generally that he did not recall the exact date. { }^{7}$ We therefore correct the Administrative Law Judge's Findings at page 11, as follows:

... at hearing, claimant testified that his pain began immediately following an incident in which he had to jerk his steering wheel to the right and slam on his brakes to avoid a collision.

This minor correction to the Decision does not affect our confidence in the administrative law judge's conclusion that claimant did not establish that he suffered an unexpected traumatic event or unusual strain identifiable by time and place of occurrence.

All other issues are moot

Because employee has not shown a compensable injury by accident, all other issues are moot.

Decision

We affirm the decision of the administrative law judge as supplemented herein. The decision of Administrative Law Judge Edwin J. Kohner, issued December 14, 2016, is attached and incorporated herein to the extent not inconsistent with this supplemental decision.

Given at Jefferson City, State of Missouri, this 23rd day of October 2017.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

John J. Larsen, Jr., Chairman

VACANT

Member

Curtis E. Chick, Jr., Member

Attest:

Secretary

[^0]

[^0]: ${ }^{6}$ The date of August 15, 2015, as date of injury, is referenced in the February 9, 2016, report of Dr. David G. Kennedy, as the date of a motor vehicle accident. It is not clear where the doctor obtained that date. (Pet. Exhibit 2, at 83)

${ }^{7}$ Employee asserts that the Time and Place of Injury were stipulated by parties at the hearing. The extent of the stipulation was that Employee was employed by Employer on August 31, 2015.

AWARD

Employee:Otis SaineInjury No.: 15-069886
Dependents:N/ABefore the <br> Division of Workers' <br> Compensation
Employer:Pepsi Beverages CompanyDepartment of Labor and Industrial <br> Relations of Missouri
Additional Party:N/AJefferson City, Missouri
Insurer:Indemnity Insurance Company of North America
Hearing Date:October 26, 2016Checked by: EJK

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? No
  2. Was the injury or occupational disease compensable under Chapter 287? No
  3. Was there an accident or incident of occupational disease under the Law? No
  4. Date of accident or onset of occupational disease: August 31, 2015 (Alleged)
  5. State location where accident occurred or occupational disease was contracted: City of St. Louis, 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? No
  9. Was claim for compensation filed within time required by Law? Yes
  10. Was employer insured by above insurer? Yes
  11. Describe work employee was doing and how accident occurred or occupational disease contracted: Employee alleged that he was operating a truck with difficult steering and thereby sustained injury.
  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: Neck, right shoulder, and right arm (Alleged)
  14. Nature and extent of any permanent disability: None
  15. Compensation paid to-date for temporary disability: None
  16. Value necessary medical aid paid to date by employer/insurer: None
  1. Value necessary medical aid not furnished by employer/insurer? $\ 579.00
  2. Employee's average weekly wages: $\ 1,171.13
  3. Weekly compensation rate: $\$ 780.78 / \ 464.58
  4. Method wages computation: By agreement

COMPENSATION PAYABLE

  1. Amount of compensation payable:

None

  1. Second Injury Fund liability: No

TOTAL:

None

  1. Future requirements awarded: None

Said payments to begin immediately and to be payable and be subject to modification and review as provided by law.

The compensation awarded to the claimant 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 claimant: Dean L. Christianson, Esq.

FINDINGS OF FACT and RULINGS OF LAW:

Employee: Otis Saine

Injury No.: 15-069886

Dependents: N/A

Employer: Pepsi Beverages Company

Additional Party: N/A

Insurer: Indemnity Insurance Company of North America

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: EJK/

This workers' compensation case raises several issues arising out of an alleged workrelated injury in which the claimant, a truck driver, alleges that he sustained accidental injury caused by an incident where he was trying to drive his truck after the steering became very difficult. The issues for determination are: (1) Accident or occupational disease arising out of and in the course of employment, (2) Liability for Past Medical Expenses, (3) Future medical care, and (4) Temporary disability. The evidence compels an award for the defense.

At the hearing, the claimant testified in person and offered a deposition of David G. Kennedy, M.D., records from the Division of Workers' Compensation,

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

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