MO: Court Remands Permanent Total Claim for Arthritis

MO: Court Remands Permanent Total Claim for Arthritis

The Missouri court of appeals remanded an alleged permanent total claim against the Second Injury Fund based on a claim that two different types of arthritis synergistically combined.  The Commission denied benefits and found that claimant’s work-related osteoarthritis did not combine with pre-existing rheumatoid arthritis to trigger fund liability because claimant never proved that he developed an occupational disease in the first place. The case is Angus v Second Injury Fund, WD 72141 (Mo. App. 10-12-10).

 

The employer settled the claim for 18% BAW that claimant’s heavy work duties for about 18 years in an ammunition factory aggravated his osteoarthritis in his knees. The Commission found that the 66-year old claimant’s total disability arose from prior rheumatoid arthritis alone. The court of appeals reversed and remanded.  The Commission failed to accept undisputed medical evidence from claimant’s expert Dr. Koprivica that claimant’s disability combined from prior rheumatoid arthritis and work-related osteoarthritis. As the issue was medically complex, the Commission usurped its role to make medical causation opinions and could not merely rely upon its own “logic and common sense.” Dr. Koprivica testified the progression of the rheumatoid arthritis could totally disable claimant alone, but did not render that opinion with a reasonable degree of medical certainty. The Second Injury Fund did not challenge with any medical evidence that the osteoarthritis was work-related or depose two other experts involved in the case. The court acknowledged that the Second Injury Fund “may” have other legal issues to defend the case but precluded in its remand any additional evidentiary hearings or to allow additional medical evidence.

 

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug’s Mo. Workers’ Comp Alerts