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American National Insurance v. Joan Knutter

No. 13-020414 (Mo. Lab. & Indust. Rel. Comm’n. July 10, 2018 )
Full Opinion: [American National Insurance v. Joan Knutter
]
Code(s): C040 Substitution of Parties; C002 Medical Causation; C001 TTD; C041 Death Benefits

 

Factual Background:

Employee slipped and fell on ice at work, which resulted in a right non-displaced fracture of the right distal fibula on March 25, 2013. Employee became wheelchair dependent due to her ankle injury. On May 9, 2013, she experienced shortness of breath while on the toilet and was taken to the hospital. Despite emergency medical treatment, claimant suffered a severe anoxic brain injury and passed away. The Claimant at hearing was Employee’s son, Michael. The Employee’s dependent, her husband Karl, died before the hearing but after he filed a motion for substitution of parties. Thereafter, Claimant attempted to be substituted as a party on behalf of his father. 

ALJ Decision:

The ALJ found that the claimant failed to sustain his burden of proof that Employee died as a result of her immobilization from her ankle injury on March 25, 2013, which resulted in a blood clot and pulmonary embolism. The ALJ granted Claimant’s motion and order to be substituted as the Claimant in this matter and was deemed the personal representative of the dependent and the only person entitled to the proceeds of the claim. 

Analysis/Holding:

The LIRC reversed the award and decision of the ALJ. They found under Section 287.020.3(1) that the prevailing cause of the Employee’s death was her March 25, 2013, ankle injury, subsequent immobilization resulting in venous stasis, and ultimately resulting in fatal saddle pulmonary embolism. Sections 287.149 and 287.170 provide for payment of TTD benefits while an employee is engaged in the rehabilitative process. Employee was underpaid TTD in amount of $116.48. Employer was liable for death benefits to the spouse in the amount of $43,160.00. Further, Employee’s husband filed a timely claim for dependent death benefits. Employee’s husband subsequently passed away on July 15, 2015, in which Employee’s only child filed a Motion for Substitution of Party and Suggestion of Death (Motion) with the Division and was entitled to the proceeds of the workers’ compensation claim pursuant to Section 287.580. 

The Takeaway:

Parties can be substituted for the dependent of Employee. Even if there is no medical opinion finding a cause of death, it is not purely speculative to link a work-related injury as a cause of death. 

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