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MEDICAL/FUTURE (INCLUDING COSTS)

In Cunningham v Research Medical Center, 108 S.W.3d 177 (Mo. App. W.D. 2003), employer appealed Commission award requiring employer to provide claimant with annual chest x-rays, due to work related exposure to tuberculosis. Employer argued that claimant's need for chest x-rays is remote and not based upon a reasonable probability that such future care will be necessary as required by ?287.140.1. The Court of Appeals rejected employer's argument and held that there was substantial, competent evidence in the record to support that the claimant had a substantially greater likelihood of future medical treatment for tuberculosis than general population because of her work exposure and such a finding was not against the weight of the evidence.

In Gott v Interstate Brands Corporation, Inj. No. 99-049417 (LIRC) 2002, claimant was kneeling down, filling an oiler, for 5 to 7 minutes, stood up, turned, felt a pop in his left knee, required assistance, denied prior problems. He had surgery, a torn medial meniscus, chondromalacia and degenerative changes from wear and tear. The employer?s orthopedist felt claimant was at MMI, no knee replacement surgery was necessary. Plaintiff's orthopedist stated that this was not simply about a "slim or remote possibility". "I can't say right now for sure that he needs his operation, but I think it is a definite possibility." He had good clinical, some clinical findings were not supported in the record. The employer's orthopedic knee surgeon, not suggesting total knee replacement or need for further treatment sustained, future treatment denied.

In Hayes v Einstein/Noah Bagel Corporation, (LIRC) 3/14/02, claimant awarded permanent partial disability, and medical care, including pain medication, sympathetic blocks of up to 3 every 6 to 12 months, and water therapy at the YMCA or as directed by the employer, for the employee's lifetime or as long as such treatment brings relief to the employee. (ALJ Fowler)

In Breckle v Hawk's Nest, Inc., 42 S.W.3d 789 (Mo.App. E.D. 2001), the Court reversed the Commission's allowance of only 4 hours of nursing care per day, and ordered nursing care for 24 hours per day, because the undisputed testimony was that the claimant was in need of "constant" medical care which she had required since the date of injury and would require for an indefinite time in the future. The Court did this on the basis that the Commission exceeded it's authority in trying to determine whether the employee had received "constant" medical care.

In Boyer v National Express Company, Inc., 49 S.W.3d 700 (Mo. App. E.D. 2001), the appellate court affirmed the portion of an LIRC award denying claimant's claim for future medical benefits. The Court found that the testimony of two physicians, Dr. Samson and Dr. Petkovich provided substantial and competent evidence to support the Commission's conclusions that the future treatment recommendations of Dr. Schoedinger were too remote in time with Dr. Schoedinger's diagnosis of a herniated disc not coming until 1998 or 1999 when prior diagnostic studies performed in 1995 demonstrated no conclusive findings of a herniated disc.

In Dunivan v Ford Motor Co., (LIRC), 2/5/01, future medical costs for analgesics was denied as speculative based solely on claimant's testimony where claimant did not describe frequency or quantity of medication used, and no expert addressed the issue. The commission found the 61-year old claimant PTD against SIF from bilateral CTS release and prior back complaints, and awarded 25% of the right wrist and 20% of the left wrist with decreased grip complaints. (ALJ Boresi)

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