No. 13-000909 (Mo. Lab. & Indust. Rel. Comm’n.
Jan. 17, 2019)
Code(s): C002 Medical Causation; C005 Credibility of Medical Experts; C006 Psychiatric Condition; C007 Accident; C017 Credibility of Witnesses; C031 Idiopathic Event
Factual
Background:
Employee was a teacher who fell in
entryway of school before clocking in on the date of injury. She landed on her
hands and knees. She went to the nurse for pain, dizziness, and shaking, then a
friend took her to the ER. The ER discharged her with ice and ibuprofen, and a
diagnosed contusion of the knee. She returned to the ER the next day saying she
had extreme pain, and they provided her with a leg splint and no apparent
diagnosis. Employer provided subsequent treatment: two PT sessions and a knee
brace. Employee returned to work, stopped shortly after due to pain, attempted
to return the next school year, then two days later stopped again. Further care
was denied. She sought unauthorized medical treatment, going to 15(+) care
providers. Ultimately her only diagnoses were somatic symptom disorder,
depression, and preexisting anxiety.
ALJ Decision:
The ALJ held that she failed to show
medical causation, as all of her medical expert testimony relied substantially
on her own subjective descriptions. He denied benefits.
Analysis/Holding:
The Commission affirmed, but on the
grounds that her injury did not arise from employment. They found under Miller v. Mo. Highway &
Transp. Comm'n, 287 S.W.3d 671 (Mo. 2009), that she did not fall due to,
nor were her injuries worsened by, a condition of her employment. They held
that her injury was one she would have been exposed to in normal non-employment
life. They went further and said she wasn’t even technically at work yet,
citing Henry v. Precision Apparatus,
Inc., 309 S.W.3d 341, 342 (Mo. App. 2010).
The Takeaway:
The commission’s use of a different
analysis than the ALJ to affirm the ALJ reflects the commission’s preference of
a particular logical order in workers’ compensation analyses: (1) whether the
injury arose out of and in the course of employment, then (2) whether the injury was the prevailing factor in causing
the disability.