FACTS: Claimant worked as a pizza delivery driver for the Employer. In January of 2002, claimant stumbled on a broken piece of sidewalk while delivering a pizza. Claimant alleged injury to his left 2nd toe and left knee at the time of the accident. He presented to the Emergency Room three days later. At the Emergency Room, claimant received treatment for his toe. There was no indication in the ER records of any injury to the left knee. However, claimant continued to follow up for treatment regarding his knee. Eventually, claimant underwent two surgeries to remove a synovial mass. Claimant’s left knee problems persisted over the years. Claimant alleged that his left knee condition relegated him to a wheelchair. In 2007, while transferring from his wheelchair, claimant fell injuring his left leg. This fall led claimant to first develop a DVT then resulted in claimant suffering a pulmonary embolism and ultimately his death.
At hearing, claimant’s widow was substituted for claimant. The ALJ found that claimant did sustain an accident in January of 2002 which caused claimant’s left toe fracture and left knee condition. The ALJ further found claimant’s surgeries related to the accident. The ALJ did not place much weight on claimant’s pre-existing medical conditions which included a kidney transplant and claimant’s history of gouty arthritis in his knees. The ALJ rather relied on claimant’s experts in finding his death related to the fall from the wheelchair which had been caused by his left knee condition which in turn had been caused by his work accident.
The ALJ awarded death benefits for life to the widow beginning from July 17, 2007, along with unpaid medical, burial expenses, and 115-1/7 weeks of TTD. Employer/Insurer appealed to the Commission.
FINDINGS: In its Final Award Denying Compensation, the Commission, in a 2-1 decision, reversed the ALJ’s finding that claimant’s work accident was a substantial factor in causing his left knee condition and subsequent death. The Commission instead found only claimant’s toe fracture related thus reversing the ALJ’s award of death benefits to the widow and further denying any TTD and PPD benefits. The Commission found claimant failed to meet his burden on proving any past medical expenses were due as related to his left 2nd toe fracture.