Nivian Mazariegos Hernandez v. ** Butterball, LLC
Decision date: October 21, 2021Injury #17-10588317-10700019-05653091 pages
Summary
The LIRC affirmed the ALJ's findings that the employer unreasonably denied the employee's workers' compensation claim for work injuries sustained on September 19, 2017, and ordered provision of additional medical treatments including MRI imaging, physical therapy, and EMG/NCS testing. The LIRC modified the award only regarding attorney's fees and costs, finding that issue not yet ripe for consideration at the temporary award stage and remanding for future resolution once the case is fully developed.
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Caption
| Injury Nos. | 17-105883 |
| 17-107000 | |
| 19-056530 | |
| Employee: | Nivian Mazariegos Hernandez |
| bilateral hand injuries. The ALJ found that the employee required additional medical treatment for her work injuries of September 19, 2017. She ordered employer to provide treatment prescribed by Dr. Lennard, to include: | |
| 1. | MR imaging of the lumbar spine and both knees |
| 2. | Physical therapy directed at the knees and low back |
| 3. | An EMG/NCS of both upper extremities |
| The ALJ found that employer denied employee's claim related to her September 19, 2017, work injury and asserted a notice defense until the August 29, 2019, hardship hearing despite having completed an internal incident report. The ALJ further found that the employer/insurer never filed a Report of Injury, denied employee's request for medical treatment, and did not authorize medical treatment for employee's September 19, 2017, work injury, which forced the employee to seek medical treatment on her own, at her own expense. The ALJ concluded that employer/insurer defended employee's claim in Inj. No. 17-105883 upon an unreasonable ground under § 287.560 and awarded costs and attorney's fees to employee's attorney in the amount of $18,788.85. | |
| We affirm and adopt the administrative law judge's findings, conclusions, and award relating to all issues, except as modified below. | |
| We modify the administrative law judge's award only with respect to her findings relating to the award of fees and costs, in the amount of $18,788.85, based on employer's unreasonable defense under § 287.560. We find that issue is not yet ripe for consideration and decline to rule on the issue in this temporary award. | |
| The extent of our review of a temporary award of an administrative law judge is limited to a challenge by a party aggrieved by the finding that the applicant is liable for the payment of any compensation. 8 CSR 20-3.040 (1) - Temporary or Partial Awards. | |
| At this juncture, the matter is not fully litigated, and the employee was not at maximum medical improvement at the time this record was submitted for our review. The legislature has recognized the need for a hardship procedure under § 287.510 in order to obtain a temporary award in appropriate circumstances. This necessitates that the evidence that is presented is limited to what has been developed at that stage of the case, and the treatment course pursued to date. Because the record is not yet complete, we conclude the award of fees and costs is best reviewed at the time that the case has been fully developed. The award of fees and costs in the amount of $18,788.85, pursuant to § 287.560, is not properly resolved at this time. Our ruling is without prejudice to either party raising this issue in the future. |
Injury Nos. 17-105883
17-107000
19-056530
Employee: Nivian Mazariegos Hernandez
- 3 -
Order
We modify the award of the administrative law judge only as to the issue of the award of
fees and costs relating to Injury Claim No. 17-105883 pursuant to § 287.560.
The amended temporary award and decision of Administrative Law Judge Karen Fisher,
issued January 13, 2020, is attached hereto and incorporated herein to the extent not
inconsistent with this decision and award.
This award is only temporary or partial. It is subject to further order, and the
proceedings are hereby remanded to the Division of Workers' Compensation to be kept
open until a final award can be made. All parties should be aware of the provisions of
§ 287.510 RSMo.
Any past due compensation shall bear interest as provided by law.
Given at Jefferson City, State of Missouri this 21st day of October 2021.
LABOR AND INDUSTRIAL RELATIONS COMMISSION
Robert W. Cornejo, Chairman
Reid K. Forrester, Member
SEPARATE OPINION AND DISSENT FILED
Shalonn K. Curls, Member
Attest:
Secretary
| Injury Nos. | 17-105883 |
| 17-107000 | |
| 19-056530 |
Employee: Nivian Mazariegos Hernandez
SEPARATE OPINION CONCURRING IN PART AND DISSENTING IN PART
I concur with the majority's award to the extent that it affirms the administrative law judge's January 13, 2020, Temporary Award after a hardship hearing of the employee's three related claims.
I dissent from the majority's reversal of the administrative law judge's award of attorney's fees and costs against the employer/insurer. As discussed in the award, the employer/insurer's refusal to provide employee with medical care related to her September 19, 2017, work injury recommended by its chosen physicians has put employee's physical condition in peril. "The employee was, and is, continuing to experience unresolved symptomology and severe pain, which has significantly impacted her life."1 Under these circumstances, I would uphold the administrative law judge's decision to penalize employer/insurer by an award of attorney's fees and expenses, prior to the issuance of a final award.
Because the majority finds otherwise, I respectfully dissent.
*Shalonn K. Curls* Shalonn K. Curls, Member
[^0] [^0]: 1 *Award*, p. 26.
DIVISION OF WORKERS' COMPENSATION
3315 WEST TRUMAN BLVD, P.O. BOX 58 JEFFERSON CITY, MO 65102 PHONE: (573) 751-4231 FAX: (573) 751-2012
www.labor.mo.gov/DWC
JANUARY 13, 2020
17-105883 #MATTHEW J BARNHART 8000 MARYLAND AVE STE 550 ST LOUIS, MO 63105
17105883S1WC36100020200113INAT002002
Injury No : 17-105883 Injury Date : 09-19-2017 Insurance No. :
| *Employee | : NIVIAN MAZARIEGOS HERNANDEZ |
| 08777326 0 | 1211 PINE ST |
| CARTHAGE, MO 64836 | |
| *Employer | : BUTTERBALL |
| 08777327 7 | 411 N MAIN STREET |
| CARTHAGE, MO 64836 |
Employee Attorney: JENNIFER L NEWMAN 415 A E CHESTNUT EXPY SPRINGFIELD, MO 65802
| *Insurer | : ACE AMERICAN INSURANCE CO |
| 08777328 4 | c/o SEDGWICK CLAIMS MANAGEMENT SER |
| PO BOX 14562 | |
| LEXINGTON, KY 40512 |
Denotes that the Division sent a copy of the Award by electronic mail to the email address that the party provided. The Certificate of Service for this document is maintained in the Division's records.
Enclosed is a copy of the Temporary or Partial Award made in the above case.
This award is not a final determination of the issues and the case will be reset to allow an Administrative Law Judge to make a final determination in the case. Any party to the case who feels they are not liable for the payment of any compensation as determined by this award may make an Application for Review of the award to the Missouri Labor and Industrial Relations Commission within twenty (20) days of the above date. If you wish to request a review by the Commission, application may be made by completing an Application for Review Form (MOIC-2567). The Application for Review should be sent directly to the Commission at the following address:
Labor and Industrial Relations Commission PO Box 599 Jefferson City, MO 65102-0599
If an Application for Review (MOIC-2567) is not postmarked or received within twenty (20) days of the above date, the enclosed award becomes final and no appeal may be made to the Commission or to the courts.
Please reference the above Injury Number in any correspondence with the Division or the Commission.
DIVISION OF WORKERS' COMPENSATION
Please visit our website at www.labor.mo.gov/DWC
MISSOURI DEPARTMENT OF LABOR & INDUSTRIAL RELATIONS
MISSOURI DEPARTMENT OF LABOR
WIC-181 (06-15) TEMPORARY AWARD APPROVAL NLP Relay Missouri: 800-735-2966
Issued by DIVISION OF WORKERS' COMPENSATION
Employee: Nivian Mazariegos Hernandez
Injury Nos. 17-105883, 17-107000 & 19-056530
AMENDED TEMPORARY AWARD
**Employee:** Nivian Mazariegos Hernandez
**Injury No.:** 17-105883
**Injury No.:** 17-107000
**Injury No.:** 19-056530
**Employer:** Butterball, LLC
**Additional Party:** Second Injury Fund
**Insurer:** Ace American Insurance Company, c/o Sedgwick Claims, Management Services, Inc.
**Hearing Date:** August 29, 2019, and September 19, 2019
FINDINGS OF FACT AND RULINGS OF LAW
- Are any benefits awarded herein? YES
- Were the injuries compensable under Chapter 287? YES
- Was there an accident under the Law? YES
- Date of injury: September 19, 2017/July 15, 2019
- Location where accident(s) occurred: Carthage, Jasper County, Missouri
- Was the above employee in employ of above employer at time of alleged accident? YES
- Did the employer receive proper notice? YES
- Did the accident arise out of and in the course of the employment? YES
- Was the claim for compensation filed within time required by Law? YES
- Was the employer insured by above insurer? YES
- Describe work employee was doing and how accident occurred:
On September 19, 2017, Employee was engaged in her employment with Butterball, LLC, when her feet became tangled in a rope on the floor, causing her to trip and fall, sustaining injuries to both knees, both legs, both hands, and her back.
Issued by DIVISION OF WORKERS' COMPENSATION
Employee: Nivian Mazariegos Hernandez
Injury Nos. 17-105883, 17-107000 & 19-056530
- Did the accident(s) cause death? NO
Part of body injured in the accident: Employee injured both knees, both legs, both hands, and her back.
- Nature and extent of any permanent disability: To be determined at a later date
- Compensation paid to-date for temporary total disability and temporary partial disability: None
- Value of necessary medical aid paid to date by employer/insurer? None
- Value necessary medical aid not furnished by employer/insurer? This issue is being deferred to be determined at a later date.
- Employee's average weekly wage: 679.58
- Employee's weekly compensation rate: 453.05 for TTD, TPD and PPD.
- Method wages computation: by agreement.
**COMPENSATION PAYABLE**
- Amount of compensation payable:
Unpaid medical expenses: Deferred
Unpaid temporary total disability benefits: N/A
Medical aid in the future: Yes, Employer/Insurer are ordered to provide the employee with additional medical care, as may be reasonably required to cure and relieve the employee of the effects of her injuries or disabilities, and which is reasonable, necessary, and causally related to the accident of September 19, 2017.
Costs and Fees: Yes, in the amount of $18,788.85. Employee is entitled to costs, including consideration of attorneys' fees, pursuant to Missouri Revised Statute Section 287.560.
Permanent partial disability: To be determined at a later date
Disfigurement pursuant to Missouri Revised Statute Section 287.560: To be determined at a later date
Issued by DIVISION OF WORKERS' COMPENSATION
Employee: Nivian Mazariegos Hernandez
Injury Nos. 17-105883, 17-107000 & 19-056530
- Second Injury Fund liability: N/A.
Weeks of permanent partial disability: N/A
Uninsured medical/death benefits: N/A
Permanent total disability benefits from Second Injury Fund: N/A
TOTAL: NONE.
Said payments to begin immediately and to be payable and be subject to modification and review as provided by law.
The compensation awarded to 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 claimant:
The Newman Law Firm, LLC
Issued by DIVISION OF WORKERS' COMPENSATION
Employee: Nivian Mazariegos Hernandez
Injury Nos. 17-105883, 17-107000 & 19-056530
FINDINGS OF FACT AND RULINGS OF LAW
| Employee: | Nivian Mazariegos Hernandez | Injury No.: 17-105883 |
| Injury No.: 17-107000 | ||
| Injury No.: 19-056530 |
| Employer: | Butterball, LLC |
| Additional Party: | Second Injury Fund |
| Insurer: | Ace American Insurance Company, c/o Sedgwick Claims, Management Services, Inc. |
Hearing Date: August 29, 2019, and September 19, 2019
On August 29, 2019, and September 19, 2019, the parties appeared before the undersigned administrative law judge for a hardship hearing. The employer/insurer appeared by counsel Paul Larimore on behalf of Butterball, LLC, and Ace American Insurance Company, c/o Sedgwick Claims Management Services, Inc. The Second Injury Fund did not appear. The claimant appeared in person and with her counsel, Jennifer L. Newman. Ms. Lisa Lewis served as the interpreter for the hearing.
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