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Dennis Moss v. Treasurer of the State of Missouri – Custodian of the Second Injury Fund

WD81467 (Mo. App. W.D. 2018)

Code(s): C003 – SIF Liability; C026 – PTD 

Factual Background:

Claimant injured his right shoulder on 4/11/12 while working as a corrections officer. He was found to have sustained 30% PPD and assigned a 10-pound lifting restriction.  He had prior injuries to his right wrist, right elbow, and low back. Employee obtained an opinion by Dr. Hopkins who opined his pre-existing injuries along with the right shoulder injury created an overall greater disability and recommended various work restrictions. Dr. Hopkins did not specifically state he was PTD.  Claimant underwent a vocational assessment and was found to be unable to compete in the open labor market. Employer also provided a vocational report indicating he was totally vocationally disabled.  The Fund argues claimant is not entitled to benefits because no physician certified his status pursuant to §287.190.6(2) which states, PPD and PTD “shall be demonstrated and certified by a physician.” 

Commission Decision:

Commission affirmed the ALJ’s findings concluding 287.190.6(2)’s requirement to demonstrate and certify was satisfied.  It opined this section, “does not imply or mandate any requirement that a medical expert… specifically address or attempt to resolve the question whether the test for [PTD] under Chapter 287 has been satisfied.”  Analyzing the extent of disability requires weighing issues such as “job requirements and availability, transferrable skills, and retraining prospects”… which in most cases, “physicians do not possess the training, experiences, or access to information” to make those conclusions.

Analysis/Holding:

The court relies on the Patterson case (425 S.W. 3d. 759 (Mo. App. E.D. 2015)) and the established belief degree of disability is not solely a medical question. The court clearly articulated it interprets the mandate of §287.190.6(2) to require that a “physician show and attest as true the employee’s medical condition and resulting work-related restrictions post injury.” Then it is within the Commission’s purview to determine whether the medical condition and physical limitations confirmed by the physician makes employee employable. In sum, the Commission may consider the opinions of multiple exerts of differing specialties to arrive at its determination of claimant’s condition. 

The Takeaway:

When determining whether a claimant is PTD, the Commission does not require an opinion from a physician specifically stating the employee is unable to perform any work.  The Commission may rely on medical and non-medical experts to make the determination.    

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