The Second Injury Fund urges that employee's testimony regarding her physical limitations after the November 1, 2016, primary injury supports a finding that employee's PTD is attributable solely to her primary injury. No medical or vocational expert opined that Ms. Comer is PTD because of the November 2016 injury in isolation. We affirm the ALJ's factual finding, based on the expert medical opinions and other evidence in the record as discussed in his award, that employee sustained 25\% PPD BAW related to her November 1, 2016, primary low back injury.
Consideration of Multiple Qualifying Preexisting Disabilities to Determine Second Injury Fund Liability Pursuant to § 287.220.3(2)(a)
In Treasurer of the State As Custodian of the Second Injury Fund v. Parker, (622 S.W. 3d 178 (Mo. banc 2021) the Supreme Court of Missouri held, "[A]n employee satisfies [§ 287.220.3(2)(b)] by showing the primary injury resulted in PTD when combined with all preexisting disabilities that qualify under one of the four eligibility criteria listed in the first condition [§ 287.220.3(2)(a)]." Id. at 182. Because Parker clearly allows consideration of multiple qualified preexisting disabilities to meet the criteria set out in § 287.220.3(2)(a), its holding is dispositive of the Second Injury Fund's second point on appeal. The ALJ did not err in considering two qualifying preexisting disabilities in combination with disability from employee's primary injury to determine Second Injury Fund liability pursuant to $\S 287.220 .3(2)(a)$.
Qualification of Employee's Prior Left Hip Injury as a Preexisting Disability Pursuant to § 287.220.3(2)(a)a(iv)
The Second Injury Fund argues that employee's preexisting left hip injury of 25 % of the left lower extremity ( 51.75 weeks) is not a "qualified" preexisting disability pursuant to § 287.220.3.2(a)a(iv) because it was not the result of a work injury and did not constitute an injury to an opposite extremity. The Second Injury Fund argues that because employee's primary low back injury was rated at the body as a whole, a nonscheduled loss, an injury to employee's left hip does not constitute an "opposite extremity."
Based on his review of employee's medical records and her December 14, 2017, MRI, Dr. Koprivica's opined that disability flowing from employee's primary injury of November 1, 2016, resulted in radiculopathy involving her right lower extremity that manifested as a deficit to her opposite lower extremity. ${ }^{1}$ An evaluation of employee's total physical impairment resultant from the primary injury in the context of PPD to the body as a whole does not preclude this more specific finding.
Based on Dr. Koprivica's opinion, we find that employee's November 1, 2016, work related back injury included disability that involved her right lower extremity. We find that employee's right lower extremity meets the MERRIAM-WEBSTER DICTIONARY
[^0]
[^0]: ${ }^{1}$ Claimant's Exhibit 3, Transcript, 511.
Improve: Brenda Comer
f/k/a Brenda Colvin
definition of "opposite" as "being the other of a pair that are corresponding to complementary in position, function, or nature" consistent with the holding of Phelps vs. Missouri State Treasurer, at 15-16 (No. SD36998, June 25, 2021).
As noted by employer/insurer:
[Employee's] preexisting leg pain has combined with the current radicular symptoms to create a more significant disability than either considered in isolation. Further, Ms. Comer testified that the limp she has had since the 1987 injury has gotten worse and more painful since November 1, 2016. Her back and left hip hurt in conjunction with each other, which is why Dr. Koprivica opined her back pain is worse than it would have been if she did not have left hip pain and an altered gait. The hip shattered in the 1987 injury is directly adjacent to the lumbar spine where the 2016 work injury occurred. Thus, this is not an unrelated accident location but one that actively aggravates the subsequent work injury in numerous ways. ${ }^{2}$
The Second Injury Fund submitted no expert medical evidence that contradicted the opinions cited by and relied upon by the administrative law judge, including the medical opinion set out in Dr. Koprivica's November 13, 2019, addendum report.
Based on the above-described expert medical evidence in the record and the employee's credible testimony, we affirm the ALJ's finding that the employee's preexisting 25\% PPD of the lower left extremity at the 207 week-level constituted a qualified preexisting disability under $\S 287.220 .3 .2$. because: 1) it exceeded fifty weeks of disability; 2) employee's primary back injury involved disability to her opposite, right lower extremity; and 3) employee's preexisting left hip disability directly and significantly aggravated or accelerated her subsequent work-related back injury.