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David King v. Sheraton Clayton Plaza Hotel

Decision date: July 23, 2020Injury #13-06331812 pages

Summary

The Labor and Industrial Relations Commission affirmed the administrative law judge's award allowing workers' compensation benefits for David King's low back injury sustained on August 10, 2013, when he slipped and fell on grease at the hotel. The employee was awarded 120 weeks of PPD benefits plus permanent total disability benefits from the Second Injury Fund.

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This archive contains published Missouri Labor and Industrial Relations Commission workers' compensation decisions reproduced for research convenience. Official source links remain authoritative where provided. Joseph Ott, Attorney 67889, Ott Law Firm - Constant Victory - Personal Injury and Litigation maintains these public legal archives to support Missouri case research and to help prospective clients connect that research to the firm's courtroom practice.

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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.
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Caption

FINAL AWARD ALLOWING COMPENSATION

(Affirming Award and Decision of Administrative Law Judge)

**Injury No.:** 13-063318

**Employee:** David King

**Employer:** Sheraton Clayton Plaza Hotel (settled)

**Insurer:** Sunz Insurance Company (settled)

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

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 October 2, 2019. The award and decision of Administrative Law Judge Joseph E. Denigan, issued October 2, 2019, is attached and incorporated by this reference.

The Commission further approves and affirms the administrative law judge's allowance of attorney's fee herein as being fair and reasonable.

Any past due compensation shall bear interest as provided by law.

Given at Jefferson City, State of Missouri, this **23rd** day of July 2020.

**LABOR AND INDUSTRIAL RELATIONS COMMISSION**

**Robert W. Cornejo, Chairman**

**Reid K. Forrester, Member**

**Shalonn K. Curls, Member**

Attest:

**Secretary**

AWARD

Employee: David King

Dependents: N/A

Employer: Sheraton Clayton Plaza Hotel

Additional Party: Second Injury Fund

Insurer: Sunz Insurance Co.

Hearing Date: June 17, 2019

Injury No.: 13-063318

Before the

Division of Workers'

Compensation

Department of Labor and Industrial

Relations of Missouri

Jefferson City, Missouri

Checked by: JED

FINDINGS OF FACT AND RULINGS OF LAW

  1. Are any benefits awarded herein? Yes
  1. Was the injury or occupational disease compensable under Chapter 287? Yes
  1. Was there an accident or incident of occupational disease under the Law? Yes
  1. Date of accident or onset of occupational disease: August 10, 2013 (second case)
  1. State location where accident occurred or occupational disease was contracted: St. Louis County
  1. Was above employee in employ of above employer at time of alleged accident or occupational disease? Yes
  1. Did employer receive proper notice? Yes
  1. Did accident or occupational disease arise out of and in the course of the employment? Yes
  1. Was claim for compensation filed within time required by Law? Yes
  1. Was employer insured by above insurer? Yes
  1. Describe work employee was doing and how accident occurred or occupational disease contracted: Employee injured his low back when he slipped and fell on grease in doorway.
  1. Did accident or occupational disease cause death? No Date of death? N/A
  1. Part(s) of body injured by accident or occupational disease: low back
  1. Nature and extent of any permanent disability: 30% PPD of the low back; PTD from SIF
  1. Compensation paid to-date for temporary disability: $81,286.42
  1. Value necessary medical aid paid to date by employer/insurer? $21,907.24

Revised Form 31 (3/97)

Page 1

  1. Value necessary medical aid not furnished by employer/insurer? None
  2. Employee's average weekly wages: N/A
  3. Weekly compensation rate: $\$ 853.08 / \ 446.85
  4. Method wages computation: Stipulation

COMPENSATION PAYABLE

  1. Amount of compensation payable:

120 weeks PPD from Employer

(settled)

  1. Second Injury Fund liability:

Permanent total disability benefits from Second Injury Fund:

weekly differential (\$406.23) payable by SIF for 120 weeks beginning

February 17, 2016 and, thereafter, $\ 853.08 for Claimant's lifetime

Indeterminate

TOTAL:

INDETERMINANT

  1. Future requirements awarded: Unknown

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:

Daniel Keefe

FINDINGS OF FACT and RULINGS OF LAW:

Employee:David King
Dependents:N/A
Employer:Sheraton Clayton Plaza Hotel
Additional Party:Second Injury Fund
Insurer:Sunz Insurance Co.
Hearing Date:June 17, 2019

This case involves two separate Claims for Compensation alleged by Claimant, against two different employers, with the reported accident dates of February 21, 2013 (\#13-013408; Big Sky/Remy's Kitchen) and August 10, 2013 (\#13-063318; Sheraton). These cases may be referred to hereafter as the "first" and "second" cases, respectively. Employer/Insurer tendered benefits in each case and previously settled their risk of liability. A Temporary Award, issued (in the second case) in 2014, was not placed in the record of evidence. The single issue for trial in each case is the liability of the Second Injury Fund.

The SIF admits Claimant was employed on said dates and that each injury arose out of and in the course of employment. Both parties are represented by counsel. Claimant alleges permanent total disability in the second case. The testimony and exhibits in this record shall constitute the evidence in each Claim. Separate Awards issue on each Claim.

FINDINGS OF FACT

Claimant offered extensive testimony much of which was unnecessary given the unchallenged treatment record and unrebutted expert medical testimony. He testified about the accidents and treatment underlying each Claim. The SIF demonstrated some inconsistency between his direct testimony at trial and his prior hearing testimony. This coupled with several instances of inexactness elsewhere render his testimony unreliable. (Exhibit Roman Numeral I.) In all events, the nature and extent of his disabilities, current and pre-existing, was necessarily the subject of expert testimony.

Issued by DIVISION OF WORKERS' COMPENSATION

Injury Number: 13-063318

First Case - Hand Cut

Claimant lacerated the lateral aspect of his left hand on February 21, 2013. Claimant lost no time from work. He subsequently settled that case for 2.5 percent PPD of the left hand.

Second Case - Low back Injury

Claimant slipped and fell injuring his low back on August 10, 2013. Claimant testified he treated with Dr. James Coyle. Medical expenses in the amount of $21,907.29 are reflected on the face of Employer's CLSS for the low back, settled at 17.5 percent PPD of the body (Exhibit 1-13).

Significant Pre-Existing Disabilities

In 1994, claimant sustained a low back injury causing him to fall to the ground. His symptoms improved with chiropractic care. He treated low back symptoms in 2008 at Grace Hill and was diagnosed with a lumbar strain and sciatica. In 2011, he was diagnosed with fibromyalgia-like symptoms. By 2013, but pre-accident herein, he was treating low back pain with left leg radicular symptoms into his toes at Logan Chiropractic (see below).

In, 1997, Claimant testified he sustained blunt trauma to the face resulting in surgery with orbital implant. He stated he experiences a severe headache about once a month. He feels pain in severe cold from the implant. The medical records from East Jefferson General Hospital show an admission on May 29, 1997 for "blunt trauma" with surgery with wire to reconstruct the infraorbital rim by Dr. Joseph Creely, Jr. on May 30, 1997, with discharge that same date. (Exhibit 1-12.)

In 2011, Claimant was apparently admitted to hospital with right-sided weakness and foot dragging for a "stroke." A CT scan was reportedly negative.

Claimant had used drugs for decades and continues to fight addiction.

In 2005, Claimant developed a staph infection, subsequently diagnosed as MRSA. Relative to the low back accident herein, both Dr. James Kennedy and Dr. James Coyle considered surgical treatment. However, Dr. Coyle ultimately stated the because of his past MRSA infection, Claimant was at "very high risk for discitis or osteomyelitis if he did have surgery." No surgery was performed to relieve Claimant's symptoms. Dr. Coyle's notes include four other reasons why surgery was contraindicated, including status as a smoker.

Revised Form 31 (3/97)

Page 4

Issued by DIVISION OF WORKERS' COMPENSATION

Injury Number: 13-063318

Exhibit - Objections

At the outset, objections to the admissibility of narrative opinions from two surgeons is discussed. Claimant proffered the opinions of two orthopedic surgeons, Dr. David Kennedy and Dr. James Coyle (Group Exhibits 1-6 and 1-7, respectively). Dr. Kennedy's opinion is comprised of a two and one-half page report dated February 25, 2014 which is described by him as an "Independent Medical Evaluation." In contrast, Dr. Coyle's ongoing opinions are comprised in the 31 page exhibit so identified above. Specifically, the notes and impressions of each visit are memorialized in letter format to the Insurer's adjustor. This is a recognized expedient utilized by many surgeon providers to avoid duplicate dictations of notes and status reports. (See Exhibit 1-7.)

The SIF objected to the admissibility of each of these proffers:

The Second Injury Fund objects to the admission of Group Exhibit 1-6 and Group Exhibit 1-7 and to the extent that they are independent medical evaluations made in specific purpose for trial and under Section 287.210.7 these are not able to be admitted into evidence and overcome the objection of hearsay.

Claimant's attorney defended the admissibility of Dr. Coyle's opinions as certified records. Dr. Kennedy's opinion report was never characterized by Claimant as a certified record.

Further, regarding the opinions of both doctors, response to objection sought to predicate the SIF's proffer of the 2014 trial transcript (Exhibit Roman Numeral I) of the prior hearing (on Temporary Award), at which hearing Claimant asserts "those IME reports were both exhibits properly admitted ...," as a basis to assert the SIF "opened the door to the conclusions contained therein."

As described, the Exhibit is a series of letter reports to the adjustor over a two-year period supplemented with radiological reports, all three of which were ordered by Dr. Coyle. Only the two initial letters, dated November 19, 2013 and December 17, 2013 are expressly characterized as IMEs; neither makes a treatment prescription or treatment recommendation. However, subsequent letters included referral to aquatic therapy, a myelogram, Dr. Doll for injections, and finally, a discussion with Claimant about why surgery was contraindicated. Such interaction is clearly treatment as contemplated by Section 287.140.1 RSMo (2005). These first two letters, less important, are easily redacted, if necessary. The SIF did not request such precise relief. Separately, Dr. Coyle's personal characterization of a letter is not determinative of the legal significance of its content, i.e. "Thank you for referring [Claimant] for an independent medical evaluation."

More importantly, Dr. Coyle's records and Dr. Kennedy's report were reviewed by all experts herein, including SIF's vocational expert, Mr. Benjamin Hughes, without objection on these grounds. Specifically, Mr. Hughes characterized Dr. Coyle as a

Revised Form 31 (3/97)

Page 5

Issued by DIVISION OF WORKERS' COMPENSATION

Injury Number: 13-063318

"treating physician" and his ultimate opinion depends squarely on Dr. Coyle's "Discharge Instructions." The SIF objection to Exhibits 1-6 and 1-7 is deemed waived.

***

Separately, the SIF sought to offer Claimant's 62-page deposition in its entirety, as Exhibit *Roman Numeral II*, even though Claimant testified live at trial. By regular practice the court excluded the deposition but invited the SIF to identify pages/lines to be marked in the exhibit. [Excluded exhibits are, nevertheless, kept part of the record.] Unprepared to do so at trial, the court further allowed the SIF to withdraw the proffered Exhibit in order to identify suc

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

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