Missouri: Commission Douses ‘Pants on Fire’ Defense

Claimant “routinely exaggerated the nature and extent of his conditions and disabilities, and was less than fully truthful regarding his low back problems,” according to the administrative law judge, but the Commission reversed a denial of  benefits and provided claimant PTD benefits in the recent case of Saric v Centaur Building Services2012 MO WCLR Lexis 168 (Sept. 20, 2012).

The ALJ found claimant was not credible whether he could work and his experts were unreliable because they relied upon flawed histories and exaggerated symptoms.  The Commission found neither finding supported a denial of benefits.  “There is no rule that a claimant himself must provide credible testimony on the issue of permanent total disability.”  Even though claimant may not be credible, his experts support his PTD claim.  Claimant’s experts were not “felled by their reliance upon the history, presentation or complaints of employee” because they were “experienced enough and savvy enough to adequately account for the deficiencies” in claimant’s history or any exaggeration in his reported symptoms.

The 62-year old Bosnian claimant alleged he hurt his back and developed new radiculopathy (from a prior disc herniation) as a result of lifting a trashcan and developed worsening psychiatric conditions.  He offered expert opinions from an osteopath family physician, a psychiatrist and a vocational expert.  The Fund offered no expert evidence.  The ALJ noted that claimant failed 8 out 10 validity criteria on his FCE and had multiple positive Waddell signs.    Several doctors indicated claimant “might” be exaggerating his symptoms. 

Claimant settled the case with his employer and claimed he was PTD against the Second Injury Fund.  He had 3 prior work-related back cases and alleged prior heart, asthma and psychiatric conditions.   Claimant lives in an assisted living facility and states he can’t work because of back pain, leg pain and asthma.  He told his vocational expert he couldn’t work in part because of his heart and depression.

The Commission suggests the doctors may have not fully appreciated claimant’s diabetes to explain his “unexplained” leg symptoms.   His inconsistent histories didn’t mean he deliberately lied.  No doctor actually diagnosed symptom magnification. 

 The award could be explained as a one off due to the unusual circumstances of weak impeachment about inconsistent medical histories when a claimant doesn’t speak English.  On the other hand, the case radically suggests a new standard for proving cases and impeachment and goes to elaborate means to ignore the credibility findings of an experienced ALJ who is certainly savvy enough when someone is not ‘fully truthful.’

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

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