Randy Skaggs v. Missouri Department of Transportation

Improvee: Randy Skaggs

Preliminarily, we address employer's allegation that the ALJ incorrectly found that the parties stipulated that, "On or about June 7, 2018, Randy Skaggs sustained an accident or occupational disease arising out of and in the course of his employment."1

The transcript documents the employer's attorney's agreement that the employee sustained an "incident" or "event" at work on June 7, 2018, and that employee reported burning in his right arm to the employer as required by law. ${ }^{2}$ We agree that employer fell short of stipulating that employee sustained a compensable accident as defined by $\S 287.020 .2$ RSMo. To the extent that the ALJ's description of the parties' stipulations suggests otherwise, we clarify the award to state that the parties stipulated that employee sustained a work incident or event on June 7, 2018, which he reported to the employer as required by law.

For purposes of responding to the parties' arguments on appeal relating to potential SIF liability, we consider the ALJ's analysis of $\S 287.220 .3(2)$.

The award initially states, "Employee had preexisting injuries/conditions but those do not reach the required threshold to trigger Second Injury Fund liability," and later reiterated "none of Employee's preexisting disabilities/conditions rise to the level of fifty weeks of permanent partial disability compensation as required by $\S 287.220 .3(2) .{ }^{3}$

In addressing "ISSUE 3 Whether the Second Injury Fund is liable for permanent total disability compensation", the award states:

To recover against the Fund, Employee must establish that pursuant to Section 287.220.3(2) that he had: (1) a medically documented preexisting disability equaling a minimum of fifty weeks of permanent partial disability compensation which was a direct result of a compensable injury funder the workers' compensation act; and (2) he thereafter sustained a compensable work-related injury that, when combined with the preexisting disability, resulted in a permanent total disability.

Section 287.220.3(2)(a)b. ${ }^{4}$

The award then concludes:

Employee's preexisting left shoulder, low back, bilateral knees, and diabetes do not qualify pursuant to 287.220 .3 (2) as they are not the direct result of a compensable injury . . .Employee's additional injuries and disabilities remove Employee from Fund liability under the statute because there was no evidence that these injuries fell within items (i), (ii), (iii), or (iv) of subparagraph a. of Section 287.220.3(2)(a). ${ }^{5}$

We find these statements confusing and inconsistent.

[^0]

[^0]: ${ }^{1} Award, p. 3.

{ }^{2} Transcript, pp. 3-4.

{ }^{3} Award, pp. 17-18, 19.

{ }^{4} Award, p. 19.

{ }^{5} \mathrm{Id}$.

The ALJ made no factual findings relating to the nature and extent of PPD related to employee's non-work-related chronic low back pain and radiculopathy or his left shoulder disability. Dr. Anne Rosenthal evaluated the employee's non-work-related chronic low back pain and radiculopathy as 20\% PPD rated at the 400-week level of the body as whole ( 80 weeks) and his left shoulder disability as 30 % PPD at the 232-week level of the upper extremity ( 69.6 weeks). These ratings each exceed the fifty-week threshold requirement of $\S 287.220 .3(2)$.

Assuming arguendo that employee's medically documented preexisting non-workrelated disability due to back pain exceeded fifty weeks of PPD, we agree that this condition would not qualify as a preexisting disability under $\S 287.220 .3(2)$ because there is no evidence that this condition met the additional requirement set out in § 287.220.3(2)(a), which states that, in addition to being medically documented and a minimum of fifty weeks of PPD, a preexisting disability must also be:

(i) A direct result of active military duty in any branch of the United States Armed Forces; or

(ii) A direct result of a compensable injury as defined in section 287.020; or

(iii) Not a compensable injury, but such preexisting disability directly and significantly aggravates or accelerates the subsequent workrelated injury and shall not include unrelated preexisting injuries or conditions that do not aggravate or accelerate the subsequent work-related injury; or

(iv) A preexisting permanent partial disability of an extremity, loss of eyesight in one eye, or loss of hearing in one ear, when there is a subsequent compensable work-related injury as set forth in subparagraph b of the opposite extremity, loss of eyesight in the other eye, or loss of hearing in the other ear;

Employee's preexisting non-work-related left shoulder disability, on the other hand, assuming adoption of Dr. Rosenthal's 69.6 week PPD evaluation, would qualify as a preexisting disability under $\S 287.220 .3(2)$ because employee's left shoulder constitutes an opposite extremity to his right shoulder under $\S 287.220 .3(2)(a)(i v) .{ }^{6}$

[^0]

[^0]: ${ }^{6}$ We have previously held that where an employee's PTD results from both qualifying and non-qualifying preexisting disabilities under $\S 287.220 .3(2)$, the SIF has no liability See James Swafford v. Treasurer of Missouri as Custodian of Second Injury Fund, Injury No. 17-085909 (LIRC, May 17, 2021). We construe Treasurer of the State As Custodian of the Second Injury Fund v. Parker, 622 S.W.3d 178 (Mo. banc, 2021) as requiring an employee to demonstrate PTD solely by a combination of disability related to the primary injury and preexisting disabilities that qualify under that statute. Id., at 182. The Missouri Court of Appeals Eastern District's contrary opinion in Christopher Klecka v. Treasurer for the State of Missouri-Custodian of the Second Injury Fund (ED108721, June 22, 2021) does not control this issue because the court's decision in that case, currently under review by the Supreme Court of Missouri, is not final and does not constitute binding precedent.

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Because we affirm the ALJ's determination that the employee's PTD resulted solely from disability attributable to his work injury on June 7, 2018, for which the employer is exclusively liable, we disavow the ALJ's findings relating to potential SIF liability, including his unclear description and application of § 287.220.3(2), as moot.

We affirm and adopt the award of the ALJ as supplemented herein.

We approve and affirm the ALJ's allowance of attorney's fee herein as being fair and reasonable.

The May 13, 2021, award and decision of Administrative Law Judge Lawrence Rebman is attached hereto and incorporated herein to the extent not inconsistent with this decision and award.

Given at Jefferson City, State of Missouri, this 19th day of November 2021.

LABOR AND INDUSTRIAL RELATIONS COMMISSION

Robert W. Cornejo, Chairman

Reid K. Forrester, Member

SEPARATE OPINION FILED

Shalonn K. Curls, Member

Attest:

Secretary

I have reviewed and considered all of the competent and substantial evidence in the record. Based on my review of the evidence, as well as my consideration of the relevant provisions of the Missouri Workers' Compensation Law, I concur in the majority's Final Award Allowing Compensation and supplemental opinion except for the dicta included in footnote six, which construes $\S 287.220 .3(2)$ as precluding consideration of non-qualifying in conjunction with qualifying preexisting disabilities in determining liability in post-2014 Second Injury Fund Claims.

As discussed in Christopher Klecka vs. Treasurer of Missouri as Custodian of the Second Injury Fund, (ED108721, June 22, 2021), harmonization of § 287.220.3 and § 287.020.6 of Missouri's Workers' Compensation Law, which defines "total disability" as interpreted by judicial precedent, requires that so long as an employee establishes one "qualifying" preexisting condition pursuant to $\S 287.220 .3(2)$ (a), additional nonqualifying physical conditions well as an employee's age, skills, education, training, and transferable work skills, must be examined in analyzing whether an employee is unable to compete in the open labor market and therefore permanently and totally disabled under § 287.220.3.

Shalonn K. Curls

Shalonn K. Curls, Member

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

FINAL AWARD

Employee: Randy Skaggs

Injury No: 18-042133

Dependents: N/A

Employer: Missouri Department of Transportation

Insurer: Self-Insured

Additional Party: Missouri State Treasurer, As Custodian for the Second Injury Fund

Hearing Date: February 11, 2021

Briefs Filed: March 19, 2021

Checked by: LGR/pe

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: June 7, 2018

1. State location where accident occurred or occupational disease was contracted: Grandview, Jackson County, Missouri

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 sustained injury by accident to his right shoulder and right bicep while weed eating and getting out of his truck.

1

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

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: Right shoulder, right bicep, right upper extremity.

1. Nature and extent of any permanent disability: See Conclusion.

1. Compensation paid to-date for temporary disability: $11,263.78.

1. Value necessary medical aid paid to date by employer/insurer? $72,713.76

1. Value necessary medical aid not furnished by employer/insurer? N/A

1. Employee's average weekly wages: 687.50

1. Weekly compensation rate: 458.34 for permanent total disability and $458.34 for permanent partial disability.

1. Method wages computation: By stipulation

COMPENSATION PAYABLE

1. Amount of compensation payable:

The Employer is liable for arrearages to the Employee in the amount of $458.34 per week beginning January 31, 2019 (date of MMI), through the date of this award, April 19, 2021, for a total of 53,034.52 (458.34 x 115 and 5/7 weeks). Beginning April 20, 2021, the Employer is liable to the Employee for a weekly benefit for permanent and total disability benefits at the rate of $458.34 so long as Employee remains so disabled.

1. Second Injury Fund liability: None.

The compensation awarded to the Employee shall be subject to a lien in the amount of 25 percent of all payments hereunder in favor of Joshua P. Perkins for the necessary legal services rendered to the Employee.

On February 11, 2021, the parties appeared for a final hearing. The Division had jurisdiction to hear this case pursuant to $\S 287.110$. The Employee, Randy Skaggs, appeared in person and with counsel, Joshua P. Perkins. The Employer appeared through counsel, Joseph Ebbert. The Second Injury Fund appeared through Assistant Attorney General, Maureen Shine.

The parties stipulated that:

1. On or about June 7, 2018, ("the injury date"), Randy Skaggs was an employee of Missouri Department of Transportation;
2. The employer/insurer was operating subject to Missouri's Workers' Compensation Law;
3. The employer's liability was fully self-insured;
4. Venue is proper in Grandview, Jackson County, Missouri;
5. A Claim for Compensation was filed within the time prescribed by law;
6. The employer received notice of said injury within the time prescribed by law;
7. On or about June 7, 2018, Randy Skaggs sustained an accident or occupational disease arising out of and in the course of his employment;
8. At the time of the alleged occupational disease or accident, Employee's average weekly wage was $\ 687.50 and his compensation rate for permanent partial/total disability benefits is $\ 458.34;
9. The employer paid $\ 11,263.78 in temporary total disability compensation;

1. Medical aid was provided in the amount of $\ 72,713.76.

The issues to be tried were as follows:

1) Was the June 7, 2018, work injury the prevailing factor in causing the injury and disability? 2) Nature and extent of permanent partial disability/permanent total disability; 3) Whether the Second Injury Fund is liable for permanent total disability compensation; and 4) Future medical.

The Employee, Randy Skaggs, testified in person and offered the following exhibits, all of which were admitted into evidence without objection:

Issued by DIVISION OF WORKERS' COMPENSATION Employee: Randy Skaggs

28 Terry L. Cordray 08-12-20 The Employer offered the following exhibits which were admitted into evidence without objection: A. Deposition of Thomas Samuelson $12 / 02 / 20 B. Deposition of Jason Purinton 12 / 02 / 20 C. Deposition of Randy Skaggs 09 / 26 / 19$ D. Settlement Stipulation Injury No. 13-096049 E. Settlement Stipulation Injury No. 17-048908 F. Medical Records of Orthopedic and Sports Medicine G. 2 reports of Dr. Anne Rosenthal

The Second Injury Fund offered the following exhibit which was admitted into evidence without objection: i. Employee's Deposition dated September 26, 2019

Based on the above exhibits and the testimony of the witness, this Court makes the following findings:

The Employee, Randy Skaggs, was present at the hearing and his testimony was credible. Employee is a 59-year-old, white male born on September 12, 1961. Employee graduated from Young High School in 1979 and has no formal education or training after high school.

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

After graduating high school in 1979, Employee's work history consisted of unskilled, medium to heavy physical demand labor. Employee performed work as a fry cook, ground maintenance, sawmill helper, gas station attendant, auto parts delivery driver, forklift operator. Employee worked minimum wage jobs from 1979 to 1996. Employee began his employment with the Missouri Department of Transportation in 1996 on the bridge crew doing bridge maintenance. His job tasks included jack hammering and shoveling to tear out concrete. He later transferred to the Belton location where he began working in road maintenance. Employee worked on highways and the right of way repairing potholes, picking up trash, mowing, cutting brush, weed eating, replacing stop signs, hauling rock and asphalt in a dump truck and occasionally supervising the inmate work release crews doing weed eating on a seasonal basis.

EMPLOYEE'S INJURY OF JUNE 7, 2018

On June 7, 2018, Employee sustained injury to his right upper extremity while he was weed eating. Employee stated that he was weed eating when he felt a sharp pain in his biceps area while swinging the weed eater away from his body in an extended fashion. He stated that he knew something was wrong because he could barely pull himself up into his MODOT work truck after this happened. He had immediate onset of symptoms including pain, popping, and grinding while getting back into his truck after the weed eating incident. He reported his injury right away. He complained of pain, popping, and a little grinding. Employee was sent to US Healthworks on June 7, 2018, directly after the incident. The US Healthworks physicians referred Employee to an orthopedist for further care.

On June 26, 2018, Employee was evaluated by orthopedic surgeon, Dr. Daniel Stechschulte. Dr. Stechschulte had treated Employee for his two (2) previous right shoulder injuries as well as a non-work related left shoulder injury. Dr. Stechschulte ordered an MRI arthrogram of the right shoulder. An MRI arthrogram of the right shoulder was performed on July 6, 2018, which revealed a large recurrent full thickness rotator cuff tear involving the supraspinatus and infraspinatus and post-operative changes. Employee followed up with Dr. Stechschulte on July 31, 2018 wherein Dr. Stechschulte recommended surgery.

On August 13, 2018, Employee underwent surgery with Dr. Stechschulte consisting of a right shoulder arthroscopy including extensive arthroscopic debridement of glenohumeral joint, rotator cuff and labrum, arthroscopic subcoracoid decompression with coracoplasty, arthroscopic removal of multiple foreign bodies and arthroscopic allograft superior capsular reconstruction.

Employee presented to his post-operative appointment with Dr. Stechschulte on August 21, 2018. Dr. Stechschulte ordered physical therapy and HEP. Employee was to wear an immobilizer at all times with no use of the right upper extremity. On October 2, 2018, Employee followed up with Dr. Stechschulte and was to continue physical therapy. Dr. Stechschulte placed temporary restrictions of no repetitive use of right arm, no repetitive push/pull, no push/pull over one pound, no lifting over one pound, no lifting overhead and no reaching above chest with right upper extremity. On October 23, 2018, Employee presented to his primary care physicians' office with complaints of chest discomfort with shortness of breath and edema. Employee was diagnosed with a DVT and was prescribed blood thinners (Xarelto). On December 20, 2018,

Employee had increased swelling pain in his lower leg and was again diagnosed with a DVT. Employee reported shortness of breath. Employee was to continue physical therapy for his right shoulder and was directed to the emergency for his leg swelling. Employee was to follow up in six weeks.

Employee was eventually released at maximum medical improvement by Dr. Stechschulte on January 31, 2019. Dr. Stechschulte placed permanent restrictions of no push/pull over 30 pounds, no lifting over 30 pounds, no lifting over head and no reaching above chest with the right upper extremity. Dr. Stechshulte opined that Employee would likely need future medical.

Employee currently has multiple complaints related to his June 7, 2018, right shoulder injury. Employee has pain in his right shoulder every day. Employee has decreased range of motion his right shoulder. Employee has difficulty reaching and cannot reach above his head with his right arm. Employee cannot do many of the recreational activities he used to do. Employee cannot lift anything overhead. Employee is very limited with activities around the house. Employee has difficulty with showering and washing his back. Employee has difficulty sleeping due to pain. Employee states that he is unable to work and is on Social Security Disability. Employee's pain averages $4 / 10 with a high of 8 / 10 and a low of 4 / 10$. Employee describes the duration of his pain to be constant.

Employee had two prior work-related right shoulder injuries while employed with MODOT. Dr. Stechschulte did surgery on Employee's right shoulder on February 12, 2014, and again on October 16, 2017. Employee's July 5, 2017, work injury was also the result of weed eating for MODOT. Employee did acknowledge that he continued to have pain, limited mobility, and other ongoing symptoms with his right shoulder at the time his most recent, June 07,2018 , work injury occurred; however, Employee stated that he had returned to full duty for MODOT in the same position without permanent work restrictions. Employee was able to complete all of his job tasks at the time the June 07,2018 , work injury occurred and had planned to retire with MODOT at age 65 . Employee testified that he would still be working for MODOT but for the June 07,2018 , work injury and the resulting permanent work restrictions placed on him by Dr. Steschschulte that ultimately cost him his 22 year career with MODOT.

Employee was evaluated by Dr. Anne Rosenthal on April 25, 2019, who opined that Employee needed permanent restrictions of push/pull 30 pounds max, lifting 30 pounds max, lifting 0 pounds max overhead, cannot reach above chest with right arm, no climbing, no reaching with right arm, no jack hammer use, no repetitive grasping, pushing or pulling. Dr. Rosenthal opined that Employee would more likely than not require future medical including a right reverse total shoulder arthroplasty and likely a revision of the reverse total shoulder in the future. Dr. Rosenthal assigned a rating of 55 % permanent partial disability rating at the 232 week level of the right shoulder, with 20.5 % attributed to the June 7,2018 , primary injury and 34.5 % attributed to Employee's two prior right shoulder work-related injuries. In addition, Dr. Rosenthal assigned a 10 % permanent partial disability rating at the 400 weeks level of the whole body for the pulmonary embolism and DVT.

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

Employee suffered a December 21, 2013, right shoulder injury while working for the Missouri Department of Transportation. Employee injured his right shoulder when he slipped and landed on his right arm. Employee was initially treated at US Healthworks and was referred to Dr. Stechschulte. Employee was evaluated by Dr. Stechschulte on January 21, 2014 and was diagnosed with a full thickness tear of the supraspinatus and subscapularis, a possible loose body and AC joint arthropathy.

Employee underwent surgery consisting of a right shoulder arthroscopy with bicep tenodesis, coracoplasty, subacromial decompression with acromioplasty, AC joint excision, rotator cuff repair with difficulty involving supraspinatus, infraspinatus, and subscapularis on February 12, 2014. Employee was released from medical treatment on July 10, 2014. Employee settled this claim with the employer for 20% of the right shoulder at the 232-week level on December 4, 2014, and the Stipulation for Compromise Settlement.

On July 5, 2017, Employee suffered a second right shoulder injury while working for the Missouri Department of Transportation. Employee injury his right upper extremity when he overextended his right arm while weed eating around a sign post.

Employee was initially treated at US Healthworks and an MRI was ordered. Employee was then referred to orthopedic surgeon, Dr. Michael Dempewolf, who ordered physical therapy. Employee was later transferred to Dr. Stechschulte for a second opinion on September 28, 2017. Dr. Stechschulte diagnosed a right full thickness supraspinatus tear and post-surgical changes to the biceps tendon and AC joint. Employee ultimately underwent a second surgery with Dr. Stechschulte consisting of a right shoulder arthroscopic debridement of glenohumeral joint, circumferential labrum, bicep stump, and rotator cuff, removal of multiple foreign bodies, coracoplasty, revision acromioplasty, revision rotator cuff repair on October 16, 2017. Employee was placed at MMI on April 18, 2018. Employee settled this claim with the employer for 14.5% of the right upper extremity at the 232-week level on August 14, 2018, and the Stipulation for Compromise Settlement.

Employee suffered a left shoulder injury when he fell through wooden stairs on a porch landing on his left shoulder on April 19, 2014. Employee was evaluated by Dr. Stechschulte on May 29, 2014, and was diagnosed with a left full thickness tear of the supraspinatus with 4.5 cm retraction, subscapularis tendinosis, AC joint arthropathy, and biceps tendinosis. On June 11, 2014, Employee underwent surgery consisting of a left shoulder arthroscopic debridement of circumferential labrum, glenohumeral joint, rotator cuff, and subcoracoid space, biceps tenotomy, subacromial decompression with acromioplasty, AC joint excision, and massive left rotator cuff

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

repair. Employee was released from treatment on December 17, 2014, and returned to work at the Missouri Department of Transportation on a full duty basis.

Employee sought treatment for chronic low back pain with his primary care physician, Dr. Anthony Gunn beginning in 2014. Employee has only received conservative treatment for his back complaints, no surgery. Employee was prescribed pain medication, anti-inflammatories, and muscle relaxers.

Prior to the June 7, 2018, primary injury, Employee also complained of bilateral knee pain as the result of arthritis. Employee has received treatment including injections and medication. Employee continues to suffer from ongoing knee pain but is not actively treating.

Prior to the June 7, 2018, primary injury, suffered from diabetes with diabetic peripheral neuropathy for which he sought treatment. Employee testified that he is no longer on medication for diabetes and it is controlled by diet and exercise.

Workers' compensation law was "intended to place upon industry the losses sustained by employees resulting from injuries arising out of and in the course of employment..." James v. CPI Corp., 897 S.W.2d 92, 94 (Mo.App.E.D.1995) (citation omitted).

The Second Injury Fund was created to "encourage the employment of individuals who are already disabled from a preexisting injury, regardless of the type or cause of that injury." Hall v. Missouri State Treasurer, 500 S.W.3d 282, 286 (Mo. App. S.D. 2016) (internal quotation omitted). The Fund "is responsible for the portion of disability attributable to the preexisting condition." Wickam v. Treasurer of the State of Missouri-Custodian of the Second Injury Fund, 499 S.W.3d 751, 756 (Mo. App. W.D. 2016). In 2013, the Missouri General Assembly modified the Second Injury Fund statute, Section 287.220. These changes went into effect on January 1, 2014.

Section 287.220-3(2) states "claims for permanent total disability against the second injury fund shall be compensable only when the following conditions are met:"

Total disability is defined in the statute as the inability to return to any employment and not merely an inability to return to the employment which the employee was engaged in at the time of the accident. See Section 287.020(6) R.S. Mo., 2005; Fletcher v. Second Injury Fund, 922 S.W.2d 402 (Mo. App., 1995); Kowalski v. M-G Metals and Sales, Inc., 631 S.W.2d 919 (Mo. App. 1982); Crums v. Sachs Electric, 768 S.W.2d 131 (Mo. App. 1989).

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

The phrase "inability to return to any employment" has been interpreted as the inability of the employee to perform the usual duties of the employment under consideration, in the manner that such duties are customarily performed by the average person engaged in such employment. *Kowlaski v. M-G Metals and Sales, Inc.*, 631 S.W.2d 919 at 922. The test for permanent total disability is whether, given the employee's situation and condition, he or she is competent to compete in the open labor market. *Reiner v. Treasurer of the State of Missouri*, 795 S.W.2d 479, 483 (Mo. App. 1990). An injured employee is not required, however, to be completely inactive or inert in order to be totally disabled. The key is whether any employer in the usual course of business would reasonably be expected to employ the injured worker in her present physical condition. *Boyles v. USA Rebar Placement, Inc.*, 25 S.W.3d 418 (Mo. App. W.D. 2000); *Cooper v. Medical Center of Independence*, 955 S.W.2d 570 (Mo. App. W.D. 1998); *Brokman v. Henry Transportation*, 924 S.W.2d 286 (Mo. App. 1996).

**ISSUE 1:** Was June 07, 2018 injury the prevailing factor in causing the injury and disability?

The Employer accepted this claim from the onset, paid 72,713.76 in medical expenses and 11,263.78 in TTD benefits, and one year and 11 months after Employee had been placed at MMI on January 31, 2019, the Employer elected to send Employee out for an independent medical evaluation with Dr. Samuelson who had never treated Employee. The Employer now contends that the June 07, 2018, work injury is not the prevailing factor in causing Employee's recurrent tear of the right rotator cuff and need for surgery performed by Dr. Stechschulte.

**a. Objective Medical Evidence Confirms a Subacute Tear**

The objective medical evidence in this case confirms that Employee did sustain an acute injury on June 07, 2018, while weed eating. In his July 31, 2018, office note, Dr. Stechschulte specifically states as follows:

"MRI arthrogram R shoulder 07/06/2018 is reviewed. There is a large recurrent full thickness tear of the supraspinatus and anterior infraspinatus which appears to be subacute. There is no fatty infiltration of atrophy of the muscle."

See Employee's Exhibit 11 (emphasis added).

The definition of "subacute" confirms that Employee retore his rotator cuff on June 7, 2018, while performing weed eating for MODOT. Subacute is defined as follows: "rather recent onset or somewhat rapid change. In contrast, acute indicates very sudden onset or rapid change, and chronic indicates indefinite duration or virtually no change." See MedicineNet.com.

The sequence of events provides further support that Employee sustained a subacute recurrent tear of his rotator cuff in the June 07, 2018, work injury. A review of the evidence and timeline further establishes that Employee sustained an acute injury to his right shoulder on June 07, 2018, while weed eating. He reported his injury immediately and was directed to US

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

Healthworks the same day, June 07, 2018, for treatment. Employee was referred to Dr. Stechschulte on June 26, 2018, who ordered an MRI arthrogram of the right shoulder. Employee underwent an MRI arthrogram on July 6, 2018, (just 29 days after the injury) which revealed a subacute tear which is consistent with Employee sustaining a new structural injury on June 07, 2018, while weed eating.

The Employer's argument that Employee's current right shoulder problem relates back to his July 05, 2017, work injury is not supported by the evidence. First, Employee had been released to full duty on February 22, 2018, by Dr. Stechschulte for his July 05, 2017, work injury. See Employee's Exhibit 25. Employee returned to his normal job duties for MODOT without restrictions. Employee was officially placed at MMI by Dr. Stechschulte on April 10, 2018, which was approximately two (2) months prior to the June 7, 2018, work injury. Second, the MRI arthrogram obtained on July 6, 2018, did not reveal any evidence of fatty infiltration or atrophy that would suggest the tear related back to Employee's July 05, 2017, work injury. There is no mention of a chronic tear or incomplete healing that would suggest the recurrent tear relates back to the July 05, 2017, work injury from one year before. Certainly, it is safe to assume that had Dr. Stechschulte saw indication that the tear was chronic or simply a continuation of the July 05, 2017, work injury, he would have been the best person to comment on this as he had performed Employee's two (2) previous right shoulder surgeries. There is no mention of incomplete healing in any of Dr. Stechschulte's medical records. Dr. Stechschulte was, therefore, familiar with Employee's previous rotator cuff tear and determined that the July 06, 2018, MRI revealed a subacute tear supporting a new injury occurring on June 07, 2018.

a. Employee sustained an acute injury on June 7, 2018.

Dr. Stechschulte's June 26, 2018, office notes state as follows: "[h]e reports an injury to his R shoulder on 6/7/18. He states he was weed eating when he felt a sharp pain in his biceps. He reported his injury right away away. He complains of pain, popping, and a little grinding."

See Employee's Exhibit 11 (emphasis added).

The evidence establishes that Employee experienced an acute event at work as recorded by Dr. Stechschulte in his initial office visit after the June 07, 2018, work injury. Employee experienced the immediate onset of symptoms including pain, popping, and grinding which were not present when Dr. Stechschulte released him at MMI on April 10, 2018, for the previous injury. This acute event followed by the immediate onset of new symptoms provides further support that the June 07, 2018, weed eating injury was the prevailing factor in causing the subacute recurrent tear.

The Employer offered the testimony of Dr. Samuelson who opined that Employee's injury was a continuation of the previous July 05, 2017, injury. Dr. Samuelson admittedly did not have a complete set of medical records from Dr. Stechschulte when he performed his independent medical evaluation. This is significant because Dr. Samuelson specifically stated in his report that "it does not appear that there was any significant accident, injury or stressful activity performed on June 07, 2018, that would have led to a recurrent tear of his rotator cuff . . ."

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Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

." See Employer's Exhibit A. However, Dr. Samuelson did not have Dr. Stechschulte's June 26, 2018, initial office notes (referenced above) wherein Employee clearly reported an acute event occurring on June 07, 2018, wherein he "felt a sharp pain in his biceps" while weed eating.

Dr. Samuelson specifically stated that "I do not have a complete list of office notes since the last injury from Dr. Stechschulte. The only note I have is from July 31, 2018. I do not have the initial visit for the evaluation of the new injury. I also have no other follow-up notes after the date of July 31, 2018. I do have the work status reports, but no office notes. I am not sure whether these notes would change my opinions, but I am happy to review them if they become available."

See Employer's Exhibit A (emphasis added).

Dr. Samuelson did not have the relevant treatment records to provide a credible opinion in this case, particularly on the critical issue of prevailing factor. He only had a single office visit, July 31, 2018. It would certainly be very relevant for Dr. Samuelson to have the initial office visit with Dr. Stechschutle which sets out the mechanism of injury that occurred on June 07, 2018. The Employer did not provide Dr. Samuelson with Employee's treatment records that were missing and ask him to author an addendum. Dr. Samuelson acknowledges that his opinion could change upon receipt of a complete set of Dr. Stechshutle's records.

b. Each of the medical experts assigned permanent disability to the June 07, 2018, work injury.

Dr. Stechsculte assigned a 4% permanent partial disability rating to Employee for the June 7, 2018, work injury. See Employee's Exhibit 15. Dr. Stechschulte would not have given Employee a 4% rating if the June 07, 2018, injury was a continuation of the July 05, 2017, work injury. In other words, he would not assign a 4% rating to this injury and not find prevailing factor. Dr. Rosenthal assigned a 20.5% permanent partial disability rating to Employee for the June 07, 2018, work injury. Interestingly, Dr. Samuelson, who failed to find prevailing factor, did agree that Dr. Stechschulte's rating of 4% was appropriate. Dr. Samuelson testified as follows:

A (Dr. Samuelson) Yeah. So he did give him a rating after his last surgery. I stand corrected.

Q (Mr. Perkins) And had -

A (Dr. Samuelson) 18 percent was a preexisting condition.

Q (Mr. Perkins) And four percent to the June 2018 event, correct?

A (Dr. Samuelson) That's what he applied towards that, yes.

Q (Mr. Perkins) Doctor, are you in agreement with that four percent?

A (Dr. Samuelson) Yes, I think that's appropriate.

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

Employee was evaluated by Dr. Anne Rosenthal on April 25, 2019. Dr. Rosenthal found that the June 07, 2018, work injury was the prevailing factor in causing Employee's right shoulder injury, need for medical treatment, and resultant disability. See Employee's Exhibit 6. Dr. Stechshulte rated Employee's permanent partial disability at 4% of the right shoulder for the June 07, 2018, work injury, in isolation. See Employee's Exhibit 15. Dr. Stechschulte diagnosed a subacute recurrent tear and made no mention of this being a continuation of the previous July 05, 2017, work injury. Dr. Samuelson agreed with Dr. Stechschulte's rating of 4%. The Employer accepted the claim throughout its entirety including paying a total of $83,977.54 in medical and TTD benefits. In fact, the Employer accepted Employee's prior July 05, 2017, work injury claim that involved the very same mechanism of injury (i.e. Employee injured his right shoulder weed eating) in that event as well.

The objective medical evidence supports a finding that Employee sustained a new, subacute tear while weed eating on June 07, 2018. This was confirmed by MRI arthrogram and Dr. Stechschulte. I do not find Dr. Samuelson's opinion credible. I find that Employee has sustained his burden of proof in establishing that the June 07, 2018, work injury was the prevailing factor in causing his subacute rotator cuff tear and need for medical treatment.

ISSUE 2: Nature and Extent of Permanent Partial/Total Disability

a. The ratings

Employee offered the July 31, 2019, rating report from Dr. Anne Rosenthal, M.D. who assigned an overall 55% permanent partial disability rating to Employee's right shoulder. Dr. Rosenthal apportioned 20.5% to the June 07, 2018, work injury, in isolation, and 34.5% to Employee's two prior work-related right shoulder injuries. Dr. Rosenthal also issued a rating of 10% to the body as a whole for Mr. Skagg's pulmonary embolism developed after his right shoulder surgery and resulting permanent residuals. The total number of weeks of disability assigned by Dr. Rosenthal for the June 07, 2018, injury is 87.56 and carries a value of 40,132.25 (87.56 x 458.34) from a permanent partial disability standpoint. See Employee's Exhibit 6. Dr. Stechschulte assigned an overall 22% permanent partial disability rating to Employee's right shoulder. Dr. Stechschulte apportioned 4% to the June 07, 2018, work injury, in isolation, and 18% to Employee's two prior work-related right shoulder injuries. See Employer's Exhibit F. Dr. Stechschulte's 4% rating carries a value of $4,253.39 from a permanent partial disability standpoint.

b. Employee's permanent work restrictions

The June 07, 2018, work injury resulted in permanent work restrictions being placed on Employee by Dr. Stechschulte. Specifically, Dr. Stechschulte placed permanent restrictions as follows: (1) 30 lbs. maximum push, pull, and lifting; (2) no reaching above chest level; and (3) no overhead lifting, no climbing, no reaching with the right arm, and no jack hammer use. See Employee's Exhibit 14. Employee did not have any permanent work restrictions prior to the June 07, 2018, work injury. Dr. Rosenthal agreed with the restrictions placed on Employee by Dr. Stechschulte and added the restrictions of: no repetitive grasping, pushing, or pulling with the

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

right arm. See Employee's Exhibit 6. The Employer also offered the October 25, 2020, report of Dr. Samuelson, M.D. who stated that he agreed with the permanent work restrictions placed on Employee by Dr. Stechschulte. See Employer's Exhibit A.

c. Permanent and Total Disability

Employee offered the January 23, 2020, vocational report and deposition testimony of Terry Cordray. See Employee's Exhibit 28. Mr. Cordray is a certified vocational rehabilitation counselor with 47 years of experience. Mr. Cordray evaluated Employee on January 23, 2020. Mr. Cordray reviewed the medical records relating to Employee's multiple preexisting injuries and conditions and as well as the medical records from his June 7, 2018, primary injury. He reviewed the permanent restrictions placed on Employee by Dr. Stechschulte and Dr. Anne Rosenthal. Mr. Cordray stated that Employee has a vocational profile of a 58 year old male who has below-average intelligence and is deficient in reading and writing. See Employee's Exhibit 28 pg. 26. Employee has a work history of performing very heavy physical work primarily operating equipment and doing labor work for the Missouri Department of Transportation. See Employee's Exhibit 28 pg. 26. Mr. Cordray acknowledged Employee's multiple preexisting injuries and conditions involving his left and right shoulders, legs, and back. However, Employee had been released to return to work full duty by Dr. Stechschulte and had no permanent work restrictions placed on him prior to the June 07, 2018, primary injury.

Mr. Cordray reviewed the permanent work restrictions placed on Employee by both Dr. Stechschulte and Dr. Rosenthal and offered the following opinion:

Q: (Mr. Perkins) To ask it another way, Mr. Cordray, in your vocational opinion, if the trier of fact were to look solely at the restrictions placed on him by Dr. Stechschulte, do you believe he is capable of gainful employment?

A: (Mr. Cordray) I do not. I—I do job counseling with people, and I'll tell you, the first thing that will happen is they'll look at his work history—he'll misspell the words on his application, for one thing. They'll ask him why he doesn't work for the state, and they'll look at his background in interviewing him and they'll realize that if the state couldn't allow him a job doing anything, that they're not going to hire him for a job. I've seen it with people that functioned higher than this gentleman, so no, no one is going to hire him for a job.

See Employee's Exhibit 28 pg. 30, 11. 14-25; pg. 31, 11. 1-5. (emphasis added)

d. Employee is permanently and totally disabled under either Dr. Stechschulte or Dr. Rosenthal's restrictions.

A vocational expert's job is to evaluate all permanent restrictions placed on an employee by each physician and render an opinion on employability. In this case, Mr. Cordray opined that Employee is permanently and totally disabled based solely on Dr. Stechschulte's permanent

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

restrictions assigned from the last accident, and is also permanently and totally disabled based on Dr. Rosenthal's permanent work restrictions which include a combination of Employee's limited intellect, preexisting left and right shoulder injuries, and low back.

Terry Cordray offered the following testimony on the issue of the medical restrictions assigned by both Dr. Stechschulte and Dr. Rosenthal:

Q. (By Mr. Perkins) Now, in essence, I mean, help us understand this, Mr. Cordray. I mean, you're giving two opinions; is that correct? I mean --

A. (Mr. Cordray) Right

Q. (Mr. Perkins) Okay.

A. (Mr. Cordray) Based on either doctor, I give an opinion. Starting on paragraph 2 of page 14, I noted within the restrictions of Dr. Stechschulte, when you consider his limited intellect and his unskilled work background, that no -- in my opinion, no employer in the usual course of business hiring individuals will be expected to hire a 58-year-old man who had below-average intelligence with a limited education, an unskilled work background, who is limited to 30 pounds light work, with no climbing, no lifting, no lifting overhead, cannot reach above his chest with his right arm. And with those restrictions, he would not be hired for any job. And then I hope I'm not contradicting myself. I go on in paragraph 7 and say if you consider the restrictions of Dr. Rosenthal with everything, he's also totally disabled. He has to alternate sitting and standing. He has to sit when necessary. That -- and she assigned her limitations to the right and left shoulders, the back, the knees, the diabetes, but, of course, when you add on more restrictions, of course he's going to be totally disabled. I already said he was disabled from the right shoulder.

Q. (Mr. Perkins) And in fairness, I mean, you were asked to comment on his employability with respect to the restrictions placed on him by each doctor.

A. (Mr. Cordray) Yes. My understanding, the foundations that I follow, the protocols that I follow, are that you give the trier of fact your opinion based on each physician and let the trier of fact decide which doctor he or she wants to provide the more weight to, and that's up to the trier of fact.

See Employee's Exhibit 28, pg.32, 11. 4-25; pg. 33, 11. 1-17.

Terry Cordray testified that Employee lacks the physical capacity to perform a limited number of sedentary unskilled jobs given that he has no computer skills and no transferable job skills. Mr. Cordray noted that Employee has never performed sedentary work and has no computer clerical skills. Mr. Cordray concluded that it is not realistic to expect that any employer in the state of Missouri, in the usual course of business seeking person to perform duties of employment in the usual and customary way would reasonably be expected to employ Employee in his physical condition. The evidence in this case supports Mr. Cordray's conclusion that Employee is permanently and totally disabled as a result of the June 07, 2018, injury in isolation.

16

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

The Employer offered the vocational opinion of Jason Purinton. Mr. Purinton testified that he has done "probably half a dozen of them [evaluations] for workers' comp in Missouri. See Employer's Exhibit B, pg. 33, 11. 24-25; pg. 34, 11. 1. He began doing workers' compensation evaluations in 2020. See Employer's Exhibit B Pg. 34, 11. 15-18. Mr. Purinton agreed that Employee could not return to his previous employment with MODOT based on the permanent restrictions placed on him by Dr. Stechschulte. See Exhibit B. Mr. Purinton further testified that the restrictions of Dr. Stechschulte eliminate all of Employee's previous work.

Mr. Purinton is, however, of the opinion that Employee is capable of performing the following jobs (1) shuttle driver; (2) food delivery driver; (3) parking lot attendant; (4) housekeeping; and (5) hospital cleaner. See Employer's Exhibit B. Mr. Purinton testified that Employee retains the ability to perform unskilled or semi-skilled jobs with the medical restrictions assigned.

I do not find Mr. Purinton's experience and testimony credible. Dr. Stechschulte or Dr. Rosenthal stated that the Employee is not to use of his right arm per his restrictions. Employee is prohibited from reaching with his right arm and is also restricted from any overhead lifting with his right arm. Housekeeping and hospital janitorial work will undoubtedly require some degree of reaching with his right arm and overhead lifting with the right arm. In fact, Mr. Purinton acknowledged that housekeeping would require some reaching with the right arm:

Q: (Mr. Perkins) Okay. But you would agree that of the -the requirements of a housekeeper do require reaching with the right arm?

A: (Mr. Purinton) There would be some reaching potentially.

See Employer's Exhibit B pg. 42., 11. 3-7.

On cross examination, Mr. Purinton could not provide the Court with any potential employers who would hire Employee with the restrictions of absolutely no lifting or reaching with the right arm.

Q: (Mr. Perkins) Can you give the Court any specific examples of potential employers that would hire him as a housekeeper with these restrictions?

A: (Mr. Purinton) Yeah. I mean, there are office housekeeping companies throughout Kansas City. Do I have a specific company name that I could give you? No. I could do a labor market survey search and try to find more employers. I don't have the employer names for you right now.

See Employer's Exhibit B pg. 45., 11. 17-25.

In sum, Employee certainly had preexisting disability associated with his right shoulder prior to the June 07, 2018, work injury. This is well documented by the medical records and prior stipulations for compromise. The Court also acknowledges that Employee had preexisting

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

injuries/conditions but those do not reach the required threshold to trigger Second Injury Fund liability. However, it is the June 07, 2018, that resulted in the permanent work restrictions that render Employee permanently and totally disabled. This is supported by the vocational opinion of Terry Cordray with 42 years of vocational experience. Permanent work restrictions are the foundation for determining employability. Employee has below-average intelligence with a work history consisting of unskilled, medium-heavy physical demand. When one considers his low level of functioning, lack of sedentary job skills, along with the permanent work restrictions that essentially restrict him to no use of his right arm, it is my opinion that Employee is permanently and totally disabled due to the June 07, 2018, work injury, in isolation. It is not realistic to expect that an employer in the usual course of business would hire a 59-year-old man with limited education, below average intelligence, an unskilled work background, who is limited to essentially no use of his right arm. Even light duty work requires the ability to lift and carrying up to 20 lbs. and also requires reaching above chest level which Employee is prohibited from doing.

ISSUE 3: Whether the Second Injury Fund is liable for permanent total disability compensation.

Analysis of Section 287.220.3(2) in light of Treasurer of the State of Missouri As Custodian of the Second Injury Fund v. Jonathan Parker, WD 83030, No. SC98704.

Section 287.220.3(2) provides, in relevant part:

(a) a. An employee has a medically documented preexisting disability equaling a minimum of fifty weeks of permanent partial disability compensation according to the medical standards that are used in determining such compensation which is:

(i) A direct result of active military duty in any branch of the United States Armed Forces; or

(ii) A direct result of compensable injury as defined in section 287.020;[6] or

(iii) Not a compensable injury, but such preexisting disability directly and significantly aggravates or accelerates the subsequent work-related injury and shall not include unrelated preexisting injuries or conditions that do not aggravate or accelerate the subsequent work-related injury; or

(iv) A preexisting permanent partial disability of an extremity, loss of eyesight in one eye, or loss of hearing in one ear, when there is a subsequent compensable work-related injury as set forth in subparagraph b of the opposite

18

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

extremity, loss of eyesight in the other eye, or loss of hearing in the other ear; and

b. Such employee thereafter sustains a subsequent compensable work-related injury that when combined with preexisting disability, as set forth in items (i), (ii), (iii), or (iv) of subparagraph a. of this paragraph, results in a permanent total disability[7] as defined under this chapter[.]

To recover against the Fund, Employee must establish that pursuant to Section 287.220.3(2) that he had: (1) a medically documented preexisting disability equaling a minimum of fifty weeks of permanent partial disability compensation which was a direct result of a compensable injury under the workers' compensation act; and (2) he thereafter sustained a compensable work-related injury that, when combined with the preexisting disability, resulted in a permanent total disability. Section 287.220.3(2)(a)b.

Employee suffers from multiple preexisting injuries/conditions involving his right and left upper extremities, bilateral knees, back and diabetes. However, none of Employee's preexisting disabilities/conditions rise to the level of fifty weeks of permanent partial disability compensation as required by Section 287.220.3(2). Employee settled his December 13, 2014, right shoulder claim for 20% of the right shoulder at the 232-week level on December 4, 2014 per the Stipulation for Compromise Settlement. Dr. Stechschulte rated this injury at 13% of the shoulder. Neither the settlement nor the rating meet the fifty week threshold. Employee settled his July 05, 2017, right shoulder claim for 14.5% of the right shoulder on August 14, 2018 per the Stipulation for Compromise Settlement. Dr. Rosenthall rated this injury at 45% with 20% preexisting and 25% attributed to the 2017 injury. While Dr. Rosenthall's rating would meet the threshold for the 2017 injury, the settlement does not meet the qualifying fifty week threshold. Furthermore, Dr. Rosenthall's rating of the 2014 injury is below the fifty week threshold. These are Employee's only preexisting injuries that are work related and both do not meet the fifty week threshold.

Employee's preexisting left shoulder, low back, bilateral knees, and diabetes do not qualify pursuant to 287.220.3(2) as they are not the direct result of a compensable injury under the workers' compensation act, activity duty military, etc. Employee's additional injuries and disabilities remove Employee from Fund liability under the statute because there was no evidence that these injuries fell within items (i), (ii), (iii), or (iv) of subparagraph a. of Section 287.220.3(2)(a).

Therefore, I do not find the Second Injury Fund liable for Mr. Skaggs's permanent and total disability.

ISSUE 4: Future Medical Treatment

Whether the Employer is liable for Employee's future medical treatment.

19

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

Injury No: 18-042133

"To receive an award of future medical benefits, a Employee need not show 'conclusive evidence' of a need for future medical treatment." *Stevens v. Citizens Memorial Healthcare Foundation*, 244 S.W.3d 234, 237 (Mo.App. S.D.2008) (quoting *ABB Power T & D Co. v. Kempker*, 236 S.W.3d 43, 52 (Mo.App. W.D.2007)). "Instead, a Employee need only show a 'reasonable probability' that because of his/her work-related injury, future medical treatment will be necessary. A Employee need not show evidence of the specific nature of the treatment required." *Id.*

Employee offered the February 01, 2019, rating report from his treating orthopedic surgeon, Dr. Stechschulte. In this report, Dr. Stechschulte specifically stated that Employee may require future medical treatment for his right shoulder. *See* Employee's Exhibit 15. In addition, Employee offered the July 31, 2019, report and opinion from Dr. Rosenthal who agreed with Dr. Stechschulte that Employee will more likely than not require future medical treatment due to the rotator cuff tear that was not amenable to repair. Dr. Rosenthal stated that future medical care would consist of a right reverse total shoulder arthroplasty. *See* Employee's Exhibit 6.

In addition, Dr. Samuelson testified in his deposition that Employee may require future medical treatment in the future consisting of a reverse shoulder arthroplasty. *See* Employer's Exhibit A.

Employee provided competent and credible medical evidence from Dr. Stechschulte, Dr. Rosenthal and Dr. Samuelson supporting his need for future medical. I, therefore, find that Employee met his burden and established that there is a reasonable probability that because of his June 7, 2018, work-related injury future medical care will be necessary. The Employer shall be liable to Employee for future treatment needs necessary to cure and relieve Employee of the effects of his right upper extremity injury that occurred on June 7, 2018.

**Conclusion**

I find that the Employee is permanently and totally disabled as a result of the June 07, 2018, injury in isolation. Employee's permanent and total disability rate is $458.34. Employee was placed at maximum medical improvement by Dr. Stechschulte on January 31, 2019. The Employer is liable for arrearages to the Employee in the amount of $458.34 per week beginning January 31, 2019, through the date of this award, April 19, 2021, for a total of 53,034.52 (458.34 x 115 and 5/7 weeks). Effective April 20, 2021, the Employer is liable to the Employee for a weekly benefit for permanent and total disability benefits at the rate of $458.34 so long as Employee remains so disabled.

An award of 25 percent of all payments made pursuant to this award is allowed Joshua P. Perkins, attorney for Randy Skaggs, for necessary legal services provided. Joshua P. Perkins is hereby assigned a lien of 25 percent of this award for necessary legal services provided Employee.

20

Issued by DIVISION OF WORKERS' COMPENSATION

Employee: Randy Skaggs

I certify that on 5-13-21 I deliver a copy of the foregoing award to the parties to the case. A complete record of the method of delivery and date of service upon each party is retained with the executed award in the Division's case file.

By __________________________


Made by: __________________________ *L. Rebman*

Lawrence Rebman

Administrative Law Judge

Division of Workers' Compensation