(Affirming Award and Decision of Administrative Law Judge)
**Injury No. 17-086815**
**Employee:** Brenda L. Britz
**Employer:** Harley-Davidson Motor Company
**Insurer:** Hartford Casualty Insurance Company
The above-entitled workers' compensation case is submitted to the Labor and Industrial Relations Commission for review as provided by § 287.480 RSMo, which provides for review concerning the issue of liability only. Having reviewed the evidence and considered the whole record concerning the issue of liability, the Commission finds that the award of the administrative law judge in this regard 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 and adopts the award and decision of the administrative law judge dated October 3, 2018.
This award is only temporary or partial, is subject to further order and the proceedings are hereby continued and kept open until a final award can be made. All parties should be aware of the provisions of § 287.510 RSMo.
The award and decision of Administrative Law Judge Mark Siedlik, issued October 3, 2018, is attached and incorporated by this reference.
Given at Jefferson City, State of Missouri, this **14th** day of February 2019.
**LABOR AND INDUSTRIAL RELATIONS COMMISSION**
**Attest:**
Robert W. Cornejo, Chairman
Reid K. Forrester, Member
Curtis E. Chick, Jr., Member
**Secretary**
Issued by DIVISION OF WORKERS' COMPENSATION
Employee: Brenda L. Britz
**Injury No. 17-086815**
**TEMPORARY AWARD**
Employee: Brenda L. Britz
**Injury No. 17-086815**
**Dependents:** N/A
**Employer:** Harley-Davidson Motor Co.
**Insurer:** Trumbull Insurance Company c/o Gallagher Bassett Services
**Hearing Date:** July 31, 2018
**Record Closed:** August 21, 2018
**Checked by:** MSS/pd
**FINDINGS OF FACT AND RULINGS OF LAW**
- Are any benefits awarded herein? Yes
- Was the injury or occupational disease compensable under Chapter 287? Yes
- Was there an accident or incident of occupational disease under the Law? Yes
- Date of accident or onset of occupational disease: July 6, 2017
- State location where accident occurred or occupational disease was contracted: Kansas City, Platte County, Missouri
- Was above Employee in employ of above employer at time of alleged accident or occupational disease? Yes
- Did employer receive proper notice? Yes
- Did accident or occupational disease arise out of and in the course of the employment? Yes
- Was Claim for Compensation filed within time required by Law? Yes
- Was employer insured by above insurer? Yes
- Describe work employee was doing and how accident occurred or occupational disease contracted: Employee sustained injury to her left shoulder/arm while installing a gas tank that did not fit properly and while forcefully pushing and shoving down on the tank, her arm began to hurt.
- Did accident or occupational disease cause death? No. Date of death? N/A
- Part(s) of body injured by accident or occupational disease: Left shoulder/arm.
WC-32-R1 (6-81)
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Issued by DIVISION OF WORKERS' COMPENSATION
Employee: Brenda L. Britz
Injury No. 17-086815
- Nature and extent of any permanent disability: N/A
- Compensation paid to date for temporary disability: None
- Value necessary medical aid paid to date by employer/insurer? $700.00
- Value necessary medical aid not furnished by employer/insurer? To be determined
- Employee's average weekly wages: 733.45
- Weekly compensation rate: 488.96/$483.48
- Method wages computation: By stipulation.
COMPENSATION PAYABLE
- Amount of compensation payable:
- Second Injury Liability: No.
- Future requirements awarded: Employer/Insurer are ordered to provide medical treatment necessary to cure and relieve Claimant from injuries sustained to her left shoulder/arm on July 6, 2017.
The compensation awarded to the Claimant shall be subject to a lien in the amount of 25 percent of all payments hereunder in favor of William C. Spooner, Claimant's attorney, for necessary legal services rendered.
* This case to return to general docket pending final disposition.
WC-32-R1 (6-81)
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