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Cherisse Williams v. Gate Gourmet, Inc.

Decision date: September 11, 2019Injury #08-10846726 pages

Summary

The Commission affirmed the administrative law judge's award of permanent partial disability compensation for cervical spine injury from a November 30, 2008 work injury, finding insufficient medical evidence to support the employee's claim of permanent total disability. The single medical expert in the case explicitly avoided certifying permanent total disability, and the Commission determined that self-reported limitations and vocational expert opinion alone do not constitute competent and substantial evidence for permanent total disability status.

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Caption

Issued by THE LABOR AND INDUSTRIAL RELATIONS COMMISSION

FINAL AWARD ALLOWING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge with Supplemental Opinion)

**Injury No. 08-108467**

**Employee:** Cherisse Williams

**Employer:** Gate Gourmet, Inc. (Settled)

**Insurer:** Liberty Insurance Corporation (Settled)

**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 read the briefs, reviewed the evidence, and considered the whole record, we find that the award of the administrative law judge awarding 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.

Discussion

The administrative law judge found that employee failed to meet her burden of proving permanent total disability as a result of permanent partial disability to her cervical spine attributable to her November 30, 2008, work injury in combination with preexisting permanent partial disability to her cervical spine and right wrist because she failed to provide sufficient medical evidence demonstrating that she is permanently and totally disabled.

Section 287.190.6(2) provides, in pertinent part, "Permanent partial disability or permanent total disability shall be demonstrated and certified by a physician." While a medical expert need not use "magic words" to satisfy the requirements of this section, we find that the record in this case lacks sufficient competent and substantial evidence to support the conclusion that the employee is permanently and totally disabled. We note that Dr. Shawn Berkin, the only medical expert produced in this case, explicitly avoided finding employee permanently totally disabled and rather assessed only permanent partial disability.¹ Moss v. Treasurer of Mo. - Custodian of the Second Injury Fund, 570 S.W.3d 110 (Mo. App. 2018) permits the Commission to consider non-medical expert opinions in conjunction with medical evidence in determining if an employee is permanently and totally disabled. Moss instructs:

> Consistent with the definition of "total disability," we interpret § 287.190.6(2)'s mandate that permanent total disability "be demonstrated and certified by a physician" to require that a physician show clearly and attest as being true the employee's medical condition and resulting work-related restrictions post injury. Once a physician does that, the requirement of § 287.190.6(2) is satisfied, and it is within the Commission's expertise to determine whether the employee, with the medical conditions and physical limitations confirmed by the physician, is employable. See Patterson, 452 S.W.3d at 767. ("[U]ltimately, the employability of an individual is a technical matter within the Commission's expertise."). Id. at 116.

¹ See Transcript, 453.

TI11980031

Imployee: Cherisse Williams

- 2 -

Moss does not require the Commission to award permanent total disability where the record includes no medical opinion that supports such a conclusion. Based on our experience in reviewing workers' compensation disability claims, we find that employee's self-reported limitations, in conjunction with the opinion of a single vocational expert retained by her attorney, does not constitute competent and substantial evidence upon which to base a finding of permanent total disability. As a result, we hereby use our expertise, as outlined in Moss, to determine that this employee is permanently partially disabled.

The above clarifications of the administrative law judge's award do not detract from his legal reasoning or his correct analysis of the evidence in the record.

Award

We affirm and adopt the award of the administrative law judge as supplemented herein.

We approve and affirm the administrative law judge's allowance of attorney's fee here in as being fair and reasonable.

The award and decision of Administrative Law Judge John K. Ottenad, issued April 5, 2019, is attached and incorporated by this reference.

Given at Jefferson City, State of Missouri, this 11th day of September 2019.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

Robert W. Correio, Chairman

Reid K. Forrester, Member

DISSENTING OPINION FILED

Curtis E. Chick, Jr., Member

Attest:

Secretary

Injury No. 08-108467

Employee: Cherisse Williams

DISSENTING OPINION

The majority finds that employee credibly testified concerning ongoing pain and functional limitations that attributable to various disabilities clearly enumerated in her medical treatment records. The majority notes that vocational rehabilitation expert Mr. J. Stephen Dolan relied on work restrictions imposed by medical expert Dr. Shawn Berkin as the basis for his opinion that employee is unable to obtain employment in the open labor market. The majority does not take issue with the work restrictions Dr. Berkin imposed nor does it discredit the opinion of vocational expert Mr. Dolan.

Section 287.190.6(2) provides, in pertinent part, "Permanent partial disability or permanent total disability shall be demonstrated and certified by a physician." Citing the strict construction mandate of 287.800, the administrative law judge concluded that employee failed to meet her burden of proof on the issue of permanent total disability. The Commission majority endorses the administrative law judge's finding that employee failed to meet her burden of proof on the issue of permanent total disability because no medical doctor expressly "echoed, endorsed or ratified" Mr. Dolan's opinion that employee is unable to obtain employment in the open labor market.

Three days before the administrative law judge's April 5, 2019, Award, the Supreme Court denied transfer in the Western District case of *Moss v. Treasurer of Mo. - Custodian of the Second Injury Fund*, 570 S.W.3d 110 (Mo. App. 2018). *Moss* specifically rejected the contention that 287.190.6(2) implies or mandates any requirement that a medical expert specifically address or attempt to resolve the question whether the test for permanent total disability under Chapter 287 has been satisfied. *Moss* holds that in determining if an employee is permanently and totally disabled "the Commission may rely on both evidence provided by a physician demonstrating and certifying the claimant's medical condition and functional abilities and evidence provided by other non-medical experts assessing whether, in light of his medical condition and functional ability, the claimant is employable."

*Moss* holds that § 287.190.6(2)'s mandate that permanent total disability "be demonstrated and certified by a physician" requires only "that a physician show clearly and attest as being true the employee's medical condition and resulting work-related restrictions post injury." Once a physician does that, "it is within the Commission's expertise to determine whether the employee, with the medial conditions and physical limitations confirmed by the physician, is employable." *Moss* expressly rejected the Second Injury Fund's contention that a finding of permanent and total disability can only be made in cases where the employee presents an opinion from a physician specifically stating that the employee is unable to perform any work.

Dr. Berkin's opinion complies with the criteria set out in *Moss* by attesting to employee's medical condition and imposing the following work-related restrictions:

- Avoiding rapid and extreme movements of her neck and maintaining her neck fixed for extended period of time.

- Limiting lifting to 20-25 pounds on an occasional basis and 15 pounds on a frequent basis.

- Avoiding lifting with her arm extended from her body, lifting, or working with her arm above shoulder level.

2 *Moss v. Treasurer of Mo. - Custodian of the Second Injury Fund*, 570 S.W.3d 110, 117. (Mo. App. 2018).

3 *Id.* at 116.

4 *Id.*

MNKOI 0000811646

Injury No. 08-108467

Employee: Cherisse Williams

- 2 -

- Limiting pushing and pulling to 35 pounds.

- Avoiding forceful gripping, squeezing, pinching, pulling, twisting, turning and reaching with her right hand for extended period of time and limiting exposure to operating power tools or vibratory equipment.

The majority mischaracterizes Dr. Berkin's testimony as concluding that employee is not permanently and totally disabled. A close reading of Dr. Berkin's deposition testimony and reports reveals that Dr. Berkin confined his assessment of employee to his evaluation of permanent disability relating to her November 30, 2008, injury (42.5 percent of the body as a whole referable to the cervical spine) and a separate determination of employee's preexisting industrial disability (30 percent of the body as a whole of the cervical spine and 30 percent of the right wrist). Dr. Berkin noted that disability from employee's November 30, 2008, injury combined synergistically with her preexisting disabilities to result in overall disability greater than the amounts assessed individually. However, Dr. Berkin never opined on the subject of whether the total sum of employee's disabilities rendered employee permanently and totally disabled from employment in the open labor market. Dr. Berkin's reluctance to make such a determination was entirely reasonable, considering that evaluation of employee's employment prospects in the context of her educational level, vocational history, and Dr. Berkin's physical limitations, is the sort of determination better made by a vocational expert rather than a medical doctor.

Dr. Berkin simply confined his assessment of employee's disability to matters within his expertise.

The only evidence in the record regarding whether employee is unemployable due to the medical conditions and physical limitations demonstrated and certified by Dr. Berkin is the opinion of vocational expert Mr. Dolan. After vocational testing of employee and a review of her vocation profile, Mr. Dolan concluded, "Based on Mrs. Williams' education, work experience, academic skills, [and] work skills, and Dr. Berkin's permanent restrictions, Mrs. Williams is unable to perform any employment for which a reasonably stable market exists."5

Given Dr. Berkin's certification of employee's medical condition and work restrictions, and vocational expert Mr. Dolan's uncontroverted opinion regarding her employability in the open labor market, the majority's conclusion that employee is not permanently and totally disabled is against the weight of the evidence in this case. The majority's endorsement of the administrative law judge's finding that only a medical expert can establish that employee is unable to perform any work for purposes of a permanent total disability award is incorrect as a matter of law.

On this basis, I respectfully dissent.

Curtis E. Chick, Jr., Member

5 Transcript 553, 554.

AWARD

Employee: Cherisse Williams

Dependents: $\quad \mathrm{N} / \mathrm{A}$

Employer: Gate Gourmet, Inc. (Settled)

Additional Party: Second Injury Fund

Insurer: Liberty Insurance Corporation (Settled)

Hearing Date: January 10, 2019

Injury No.: 08-108467

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: JKO

FINDINGS OF FACT AND RULINGS OF LAW

  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: November 30, 2008
  5. State location where accident occurred or occupational disease was contracted: St. Louis County
  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

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

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