Richard Peeler v. Missouri Department of Corrections

Issued by THE LABOR AND INDUSTRIAL RELATIONS COMMISSION

(Affirming Award and Decision of Administrative Law Judge)

**Injury No. 16-003861**

**Employee:** Richard E. Peeler

**Employer:** Missouri Department of Corrections

**Insurer:** Central Accident Reporting Office

**Additional Party:** Treasurer of Missouri as Custodian of Second Injury Fund (Open)

The above-entitled 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 and considered the whole record, the Commission finds that the award of the administrative law judge 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 dated May 24, 2018, and awards no compensation in the above-captioned case.

The award and decision of Administrative Law Judge Kevin A. Elmer, issued May 24, 2018, is attached and incorporated by this reference.

Given at Jefferson City, State of Missouri, this **4th** day of January 2019.

**LABOR AND INDUSTRIAL RELATIONS COMMISSION**

Robert W. Cornejo, Chairman

Reid K. Forrester, Member

**DISSENTING OPINION FILED**

Curtis E. Chick, Jr., Member

Attest:

Secretary

Injury No.: 16-003861

Employee: Richard E. Peeler

I have reviewed and considered all of the competent and substantial evidence on the whole record. Based on my review of the evidence as well as my consideration of the relevant provisions of the Missouri Workers' Compensation Law, I believe the decision of the administrative law judge should be reversed.

I found Dr. Schlafly's opinion persuasive that employee's carpal tunnel syndrome is not due to diabetes because employee does not have issues with his legs (peripheral neuropathy), which typically occurs with diabetic individuals in their legs prior to their hands. *Transcript*, page 144-45. Dr. Schlafly also testified that it would be "most unusual" for employee's degree of issues in his hands to be related to his diabetes without issues in employee's legs. *Transcript*, page 156. Dr. Schlafly further opined that employee's carpal tunnel syndrome could continue to worsen, even while in a non-hand-intensive position, due to the severity of the carpal tunnel syndrome. *Transcript*, page 163.

Dr. Brown's opinion, on the other hand, is based on limited and inaccurate information. For example, Dr. Brown thought that employee worked four 10-hour days during his entire tenure, instead of only during a short period of time. *Transcript*, page 303. Dr. Brown thought that employee opened doors electronically, instead of physically. *Transcript*, page 331. Also, Dr. Brown reviewed only a portion of the over 600 pages of medical records that Dr. Schlafly reviewed. *Transcript*, page 303. There is insufficient evidence to show that Dr. Brown's review of medical records included records from the Department of Veterans Affairs that showed that employee's diabetes was controlled and, therefore, not likely the cause of his carpal tunnel syndrome.

For these reasons, I find that employee established that his carpal tunnel syndrome was not due to his diabetes, but arose out of and in the course of his employment with employer. Therefore, employee's injury was compensable pursuant to the workers' compensation law.

I would reverse the administrative law judge's award denying benefits. Because the Commission majority has decided otherwise, I respectfully dissent.

Curtis E. Chick, Jr., Member

Issued by DIVISION OF WORKERS' COMPENSATION

**Employee:** Richard Peeler

**Dependents:** N/A

**Employer:** Missouri Department of Corrections

**Insurer:** Central Accident Reporting Office

**Additional Party:** Treasurer of Missouri, as the Custodian of the Second Injury Fund

**Hearing Date:** February 26, 2018

**Checked by:** KAE

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: January 25, 2016
5. State location where accident occurred or occupational disease was contracted: Texas 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? No
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: Claimant alleged repetitive nature of turning keys, opening doors/locks, writing, performing pat-downs and cell searches resulted in injuries to wrists and hands.
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: both wrists and hands.
14. Nature and extent of any permanent disability: 0.00
15. Compensation paid to-date for temporary disability: 0.00
16. Value necessary medical aid paid to date by employer/insurer? $0.00
17. Value necessary medical aid not furnished by employer/insurer? 0.00
18. Employee's average weekly wages: 633.64

Page 1

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

1. Weekly compensation rate: $422.43 TTD/PTD/PPD
2. Method wages computation: Stipulation by the parties

COMPENSATION PAYABLE

1. Amount of compensation payable: $\ 0.00

TOTAL: $\ 0.00

1. Future requirements awarded: None

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

**Employee:** Richard Peeler

**Injury No. 16-003861**

**Dependents:** N/A

**Employer:** Missouri Department of Corrections

**Insurer:** Central Accident Reporting Office

**Additional Party:** Treasurer of Missouri, as the Custodian of the Second Injury Fund

**Hearing Date:** February 26, 2018

**Checked by:** KAE

The above-referenced workers' compensation claim was heard before the undersigned Administrative Law Judge on February 26, 2018. The parties were afforded an opportunity to submit briefs or proposed awards, resulting in the record being completed and submitted to the undersigned on or about March 12, 2018.

The employee appeared personally and through his attorney Kevin Spear. The Employer appeared through its attorneys, Catherine Goodnight, Assistant Attorney General, and Cara Harris, Assistant Attorney General. This matter was requested as a Hardship Hearing, and as a result, the Second Injury Fund did not appear. However, after hearing evidence, this matter is decided as a final hearing award.

The parties entered into a stipulation of facts. The stipulation is as follows:

1. On or about January 25, 2016, the Missouri Department of Corrections was an employer operating under and subject to The Missouri Workers' Compensation Law and during this time was fully insured by the Central Accident Reporting Office.

1. On the alleged injury date of January 25, 2016, Richard Peeler was an employee of the employer and was working under and subject to The Missouri Workers' Compensation Law.

1. The above-referenced employment and accident occurred in Texas County, Missouri. The parties agree to venue lying in Greene County, Missouri. Venue is proper.

1. The Claim for Compensation was filed within the time prescribed by Section 287.430, RSMo.

Page 3

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

(5) At the time of the alleged accident of January 25, 2016, the employee's average weekly wage was 633.64, which is sufficient to allow a compensation rate of 422.43 for temporary total disability compensation/permanent total disability compensation, and a compensation rate of $422.43 for permanent partial disability compensation.

(6) No temporary total disability compensation has been provided to the employee.

(7) The employer and insurer have not provided any medical treatment to the employee or paid any medical expenses.

(8) The attorney fee being sought by Attorney Kevin Spear is 25 percent of the amounts recovered.

ISSUES

The issues to be resolved by hearing include:

(1) Whether the employee sustained an accident or incident of occupational disease on or about January 25, 2016; and, if so, whether the accident or occupational disease arose out of and in the course of his employment with the employer.

(2) Whether the employee notified the alleged employer of his injury as required by Section 287.420, RSMo.

(3) Whether the employee has sustained injuries that will require additional or future medical care in order to cure and relieve the employee from the effects of the injuries.

EVIDENCE PRESENTED

The employee testified at the hearing in support of his claim. In addition, the employee offered for admission the following exhibits:

Exhibit 1........................ Deposition of Dr. Bruce Schlafly with reports and CV

Exhibit 2.................................................................................VCLF Expenses

Exhibit 3.................................................................................VCLF Contingent Fee Agreement

The exhibits were received and admitted into evidence.

The employer and insurer presented two witnesses at the hearing of this case - David Pershing and David Southard. In addition, the employer and insurer offered for admission the following exhibits:

Page 4

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

Exhibit A............................................................................ Protective Order

Exhibit B........................................................................ Deposition of Claimant taken August 22, 2016

Exhibit C........................................................................ Deposition of Dr. David Brown with reports and CV

Exhibit D........................................................................ Department of Veterans' Affairs records, 276 pages

Exhibit E........................................................................ Harry S. Truman Veterans' Hospital records, 352 pages

Exhibit F........................................................................ 57 numbered photos taken at South Central Correctional Center

Exhibit G........................................................................ Offender Movement Pass

The exhibits were received and admitted into evidence.

In addition, the parties identified several documents filed with the Division of Workers' Compensation, which were made part of a single exhibit identified as the Legal File. The undersigned took administrative or judicial notice of the documents contained in the Legal File, which include:

- Notice of Hearing

- Answer of Employer/Insurer to Claim for Compensation

- Answer of Second Injury Fund to Claim for Compensation

- Claim for Compensation

- Report of Injury

All exhibits appear as the exhibits were received and admitted into evidence at the evidentiary hearing. There has been no alteration (including highlighting or underscoring) of any exhibit by the undersigned judge.

DISCUSSION

A hardship hearing was held in this matter on February 26, 2018 in Springfield. The parties agreed to have the trial in Springfield, though venue lies in West Plains. The issues to be decided at this hardship hearing included causation, need for treatment, and if proper notice of the claim was given to the employer. At issue is an alleged occupational disease to Claimant's bilateral upper extremities.

Mr. Peeler's Testimony

Richard Peeler testified on his own behalf that he has been a long-time employee of the Department of Corrections for the State of Missouri. During his employment, he has held three different positions at South Central Correctional Center ("SCCC") in Licking, Missouri. At the time of the hearing, Claimant was employed by the employer and assigned to work in the Education Unit of the SCCC.

The claimant started working for the State of Missouri sometime around 1997 or 1998. During the first three years of employment with the State, the claimant worked in the Jefferson City penitentiary. After that time, he transferred to the SCCC. Mr. Peeler began his career with SCCC as a wing officer in Housing Unit 6. He would occasionally work in the "bubble" to monitor the floor, but his main jobs were observing the population of inmates, cuffing inmates, conducting cell searches, performing pat-downs, and opening cell doors for inmate movement.

Page 5

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

The door activities and cuffs required the use of various keys. He worked in this position from 2000 to sometime in 2003.

Claimant testified that his hands first began to bother him some time in 2003. At that time, he started noticing that his hands felt tired and had some numbness and tingling in them at the end of the day. About this same time period, he was diagnosed as a Type II diabetic by the Veteran Affairs office (VA), where he treated as a Navy veteran. At this point, Claimant did not suspect that his hand issues were as a result of his employment or diabetes.

In 2003, the Claimant transferred to the Education Unit in order to work Monday through Friday and be off work during the weekends. His duties changed in the Education Unit from those performed in Housing Unit 6. In this new position there was less use of the keys and his hands in general. His duties in the Education Unit included: monitoring inmates in classes, searching the computer for information regarding inmates who were absent from class, approving hall passes for inmates leaving classes, occasionally typing violation reports, occasionally searching classrooms, and occasionally opening classroom doors. Claimant testified he types with just one finger in a hunt-and-peck manner. Claimant was not required to do cuffing or pat-downs of inmates in this area. The largest part of his job in the Education Unit is monitoring the inmates. After first going to the Education Unit, he worked there for approximately one and a half to two years, and then due to staffing changes, he was assigned to Housing Unit 1.

Housing Unit 1 is the Administrative Segregation Unit ("AdSeg") where Claimant worked again as a wing officer as he did in Housing Unit 6. In AdSeg there are higher security measures due to the type of inmates being held. Also in AdSeg, there is the need to feed inmates by opening and closing the food port on the cell doors with a skeleton key. Claimant's shift always included having to help serve at least one meal and sometimes two meals. Two officers would assist in the feeding process. He would also have to use the food port to distribute supplies and mail to inmates, which would require keying the port doors both open and closed.

In 2006, as his hand symptoms continued to worsen and got to the point that he was having more trouble at night, Claimant described being given a test at the VA that was similar to a nerve conduction study. Following the test, the VA doctor gave him wrist splints to wear. He found the splints to be uncomfortable and did not wear them much. During this time period he still did not associate his hand issues with either work or his diabetes. As a result, he did not report to anyone at work that he was having hand or wrist issues. Claimant believes the VA gave him a second set of wrist splints in 2007. As with the first set of splints, he did not wear them much and did not report to the VA that they did not help with his problems. He continued to not report to the employer that he was having problems with his hands.

Sometime in 2014 or 2015 he transferred back to the Education Unit. Claimant stated that the reasons for the transfer were so he could be off work for the weekends and he thought that working in the Education Unit was a better job. Mr. Peeler's current job duties are the same as when he worked in the Education Unit from 2003-2005.

Claimant agreed in his deposition and at trial that his diabetes is not controlled by diet or medication. Claimant does take metformin and is insulin dependent. He admitted that he consistently has high blood sugar levels, but he does not monitor his levels daily as directed by his doctor. He also denied following the dietary recommendations of the doctors. Claimant

Page 6

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

stated that he does not notice a difference in how he feels when his blood sugar is high and only on a rare occasion when his blood sugar is low does he feel a difference. He is unaware of any complications he has experienced from his diabetes. He has had no issues with his feet or eyes.

Claimant testified that no matter what job he held at SCCC, his symptoms in his hands and wrists, and now elbows, have continued to worsen in nature. He now has locking fingers and cramps in his left hand and constant numbness in his right hand. Claimant agreed that the multiple jobs he has held at SCCC were varied in nature with regard to his day-to-day duties. He also agreed that his job in the Education Unit is much less hand-intensive than either of the positions he held in the housing units. Claimant testified that he never fully put together that his hand issues could be related to his work until after he felt a pop in his hand on January 25, 2016, when he turned a key and his hand swelled. The swelling has since resolved, but his symptoms continue as before. After being evaluated by Dr. Schlafly, at the request of his attorney in this case, was when Claimant realized that he may have work-related carpal tunnel syndrome.

Dr. Bruce Schlafly

At the hearing, Claimant's counsel presented Dr. Schlafly as an expert in this matter through deposition testimony and records. Dr. Schlafly saw Claimant once and issued two reports dated August 2, 2016 and April 25, 2017. Dr. Schlafly was deposed on April 5, 2017. In Dr. Schlafly's deposition, he stated that though he has never seen any of the keys or doors at SCCC or visited the facility, he believes that: the keys require forearm pronation to operate them, the keys and doors are heavy, and that Claimant has to use these large skeleton keys at least 100 times per day. Dr. Schlafly agreed that the position in the Education Unit would be less hand-intensive than the positions Claimant held in the housing units. Dr. Schlafly was not sure if Claimant's symptoms worsened or stayed the same since moving back to his position with the Education Unit four years ago.

When Dr. Schlafly met with Claimant, he was under the impression that Claimant's diabetes was controlled with medication and that he had no complications resulting from this condition. Dr. Schlafly was then provided with Claimant's deposition and further records and subsequently issued his April 25, 2017 report in which he noted that Claimant's diabetes was not controlled, but disagreed that Claimant's diabetes would be the prevailing factor causing his hand symptoms. He further opined that diabetic neuropathy normally starts in the feet, not the hands. Dr. Schlafly agreed, however, it is a possibility that diabetes could be causing Claimant's problems with his hands. While he agreed with Dr. Brown that carpal tunnel syndrome is a known complication of diabetes, it remained Dr. Schlafly's opinion that Claimant was exposed to enough repetitive work with his hands that his work is the prevailing factor in causing his current condition.

Dr. David Brown

Employer/Insurer presented Dr. Brown as an expert in this matter. Dr. Brown saw Claimant at the request of CARO on April 5, 2016. He opined that the likely prevailing factor for Claimant's bilateral carpal tunnel syndrome is his long history of uncontrolled diabetes dating back to 2002. The VA records reviewed by Dr. Brown documented Claimant's history of uncontrolled diabetes, which is consistent with Claimant's deposition and hearing testimony. Dr. Brown testified that diabetes is a known risk factor for carpal tunnel syndrome. He also stated that the work activities as described in Claimant's deposition are intermittent and varied and do

Page 7

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

not rise to a level of repetitiveness or hand-intensiveness which could cause Claimant's continually-worsening symptoms. Dr. Brown noted that Claimant described being in the Education Unit for the last four years and that this was not a hand-intensive job. The job duties in this role primarily required observing and monitoring inmates and would occasionally involve locking and unlocking doors, writing in a logbook, or typing in a computer log. Overall, the doctor noted this job was less hand intensive than prior positions Claimant held at the prison. Dr. Brown noted that this created an inverse relationship between Claimant's less hand-intensive duties over the past four years, while his symptoms have increased. It would be expected that less exposure to hand-intensive activities would result in decreased symptoms.

David Pershing, Education Unit Supervisor

David Pershing, the Education Supervisor at SCCC, testified that Claimant's duties in the Education Unit are varied and that there was not a lot of typing, cuffing, door opening, or handwriting. The primary job requirement in this Unit is that the Claimant monitor the inmates entering and leaving the classrooms. It was Mr. Pershing's personal experience and observation that a DOC officer would be using his hands and keys much less in the Education Unit than in one of the Housing Units.

David Southard, Investigator

David Southard, an investigator at the Attorney General's Office, testified regarding his inspection of the keys, locks, and doors at the SCCC. He presented pictures he had taken at SCCC showing the keys used by correction officers (Exhibit F). He also photographed three different key rings that weighed between 5.6 ounces and 1 pound 5.0 ounces. The pictures also showed the locks, doors, and overall conditions in Claimant's work environment.

FINDINGS AND CONCLUSIONS

The burden of establishing any affirmative defense is on the employer. The burden of proving an entitlement to compensation is on the employee, Section 287.808 RSMo. Administrative Law Judges and the Labor and Industrial Relations Commission shall weigh the evidence impartially without giving the benefit of the doubt to any party when weighing evidence and resolving factual conflicts, and are to construe strictly the provisions, Section 287.800 RSMo.

1. The employee did not sustain an incident of occupational disease on or about January 25, 2016, which arose out of and in the course of his employment with the employer.

"An occupational disease due to repetitive motion is compensable only if the occupational exposure is the prevailing factor in causing both the resulting medical condition and disability." Section 287.067.3 RSMo. Prevailing factor means the primary factor in relation to any other causative factor. 287.067.3 RSMo. Ordinary or gradual deterioration caused by aging or normal day-to-day activities is not compensable. 287.067.3 RSMo.

Appellate courts have interpreted these statutes to mean that employees are required to provide substantial and competent evidence that the claimant "has contracted an occupationally induced disease rather than an ordinary disease of life." Kelly v. Banta & Studc Const. Co., 1 S.W.3d 43, 48 (Mo.App. E.D.1999). "The inquiry involves two considerations: (1) whether there was an exposure to the disease which is greater than or different from that which affects the public

Page 8

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

generally, and (2) whether there was a recognizable link between the disease and some distinctive feature of the employee's job which is common to all jobs of that sort." *Id.* (internal citations omitted).

To establish this link, "there must be evidence of a direct causal connection between the conditions under which the work is performed and the occupational disease." *Smith v. Capital Region Med. Ctr.*, 412 S.W.3d 252, 259 (Mo.App. W.D. 2013) (quoting *Vickers v. Mo. Dept. of Public Safety*, 283 S.W.3d 287, 292 (Mo.App. W.D. 2009)). The causal link must be established with medical evidence. When an employee "seeks compensation for carpal tunnel syndrome, he or she must submit a medical expert who can establish a probability that working conditions caused the disease." *Cook v. Missouri Highway & Transportation Comm'n*, 500 S.W.3d 917, 926 (Mo.App. S.D. 2016) (quoting *Decker v. Square D Co.*, 974 S.W.2d 667, 669 (Mo.App. 1998)).

"Sufficient competent evidence is 'evidence which has probative force on the issues and from which the trier of facts can reasonably decide the case.'" *Nichols v. Belleview R-III School District*, 528 S.W.3d 918, 922 (Mo.App. S.D. 2017), (quoting *Morris v. Glenridge Children's Center, Inc.*, 436 S.W.3d 732, 735 (Mo.App. E.D. 2014), (internal quotation and citation omitted).

"Sufficient competent evidence is a minimum threshold: '[t]he testimony of one witness, even if contradicted by the testimony of other witnesses, may be sufficient competent evidence to support an administrative decision.'" *Id.*

When evaluating such medical opinions, appellate courts have noted that an expert's opinion may be less credible if it summarily dismisses other possible causes of an injury without being aware of the circumstances regarding such other possible causes. *Bond v. Site Line Surveying*, 322 S.W.3d 165, 172 (Mo.App. W.D. 2010). Moreover, though a medical opinion is required, testimony from a "claimant or other lay witness as to the facts within the realm of lay understanding can constitute substantial evidence of the nature, cause, and extent of the disability, especially when taken in connection with or where supported by, some medical evidence." *Dudley v. City of Des Peres*, 72 S.W.3d 134, 137 (Mo.App. E.D. 2002) (citing *Ford v. Bi-State Dev. Agency*, 677 S.W.2d 899, 903-904 (Mo.App. E.D. 1984)).

Claimant agreed with four key things at trial that are pivotal to the outcome of this case. First, Claimant agreed that the biggest part of his job for the last four years is monitoring inmates; secondly, that his duties have always been varied at all of his positions at SCCC; third, no matter the position he has held or the level of work that called for hand-usage, his symptoms have continued to progress and worsen; and lastly, he does not properly treat or control his diabetes as recommended by his doctors.

Claimant did a lot of different things with his hands at various jobs, but he never worked in a single position doing the same thing over and over and over again, like an assembly line worker. Most of his time has been spent monitoring inmates. Even at his current job, where he has been for the last four years, his typing is not done in a normal fashion, but rather done with his "typing finger." Even then, his computer usage is minimal. In the Education Unit, he is not cuffing inmates, the door is electronically opened, and he does classroom searches or uses his other keys to open doors only occasionally as needed.

Dr. Schlafly's opinions rely heavily on the information the claimant provided to him. As a result, the doctor believed the Claimant's diabetes to be well controlled at the time of his initial report dated August 2, 2016, and deposition on April 5, 2017. After being provided additional

Page 9

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

information, he issued a report on April 25, 2017 (Exhibit 1 to Claimant's Exhibit 2). The subsequent report notes VA Medical Center treatment concerning the claimant's wrists and concerns with neuropathy in his feet. However, it fails to mention any of the records noting that the claimant is not properly treating his diabetes.

At the hearing, the claimant testified he takes his medicine daily, but does not adhere to dietary recommendations or test his blood sugar levels. In short, there is clear and convincing evidence that the claimant's diabetes has been uncontrolled for years. Dr. Schlafly simply dismisses the issue of causation due to the diabetes based on a statement of general statistics, while also remaining silent on the issue of the claimant's failure to adhere to the treatment recommendations of his treating physician.

Dr. Schlafly testified that the claimant started having symptoms in his wrists in 2002 and was diagnosed with diabetes in 2004. The VA records introduced into evidence are dated back through 2006. Without the definitive diagnosis date, this court is left with the testimony provided by the claimant. At the hearing and during Claimant's deposition, he testified that he was diagnosed with diabetes in 2003 (Exhibit B, Page 32). He also claimed that symptoms with his wrists began some time in 2003. Dr. Brown reported a history of symptoms in 2003 that is consistent with the claimant's testimony. However, Dr. Brown's history of a diagnosis of diabetes in 2002 versus 2003 as presented by Claimant.

As a result of the evidence present, I find that the diagnosis of diabetes occurred in 2002 or 2003. I further find that the claimant's wrist symptoms began some time in 2003. These findings differ from the facts Dr. Schlafly relied upon in his report.

Dr. Brown testified due to the lack of repetitiveness in the claimant's job duties he could not find that the work was the prevailing factor in causing the carpal tunnel symptoms. Dr. Brown's information about Claimant's job duties is consistent with those described by the claimant and Mr. Pershing. This evidence supports a finding that the claimant was not required to do the same thing over and over again for an extended or captured period of time at any of the positions he held during his employment.

Both experts agree that the expectation would be for the carpal tunnel symptoms to level off or improve once the repetitive activity allegedly causing the problem is removed. Mr. Peeler and Mr. Pershing testified that Claimant's duties in the Education Unit over the last four years are even less "hand-intensive" than when he was working in a housing unit. However, Claimant was clear in his deposition and trial testimony that his symptoms in both hands have continued to increase in severity no matter what position he has held at SCCC. Dr. Brown relies on those facts in rendering his opinion that Claimant's work is not the cause of his hand issues since moving to a less hand-intensive job did not reduce his symptoms.

The one risk factor for carpal tunnel that has been a constant problem for the same duration as Claimant's hand and arm issues is his uncontrolled diabetes. Dr. Schlafly and Dr. Brown agree that diabetes is a risk factor for carpal tunnel and that uncontrolled diabetes can cause carpal tunnel symptoms.

Given all evidence in this case, I find Dr. Brown's opinion is the most reasonable, persuasive, and credible. Therefore, I do not find Claimant's work to be the cause of Claimant's upper extremity complaints. I agree with Dr. Brown's opinion that Claimant's diabetes is the

Page 10

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Richard Peeler

Injury No. 16-003861

prevailing factor in causing his upper extremities problems and do not award Claimant treatment or benefits in this matter. I find Claimant failed to prove that his work for Employer is the prevailing cause of his condition; therefore, he is entitled to no benefits pursuant to Chapter 287.

Having found that Claimant failed to prove his injuries result from his employment, all other issues are moot.

I certify that on May 24, 2018, I delivered a copy of the foregoing award to the parties to the case. A complete record of the method of delivery and date of service upon each party is retained with the executed award in the Division's case file.

By __________________________

By __________________________

Made by: __________________________

Kevin A. Elmer

Administrative Law Judge

Division of Workers' Compensation

Page 11

.