Missouri: Knee Injury Produces Dire “Natural” Consequences

After claimant returned to work to unrestricted duty following a knee surgery he reported multiple additional accidents from falling and each new claim added different body parts.    The employer argued the second injury fund was liable for a PTD claim due to a combination of multiple injuries.    The court of appeals rejected the employer's defense in this 10 year old case and affirmed an award of total disability against the employer alone and found that three subsequent "accidents" were the natural and probable consequence of the original injury.  Pace v City of St. Joseph, 2012 Mo. App. Lexis 716 (May 22, 2012).

What first started as an operated knee developed into a cascade of medical problems which ultimately included DVT, depression, CRPS, shoulder, back, and bilateral carpal tunnel syndrome.  The employer ultimately fired claimant for "poor work performance".  Claimant described limited ability to function without sitting in a recliner, he reported he needed to elevate his legs, and stated he had to shop using an electric cart.

The employer's expert, Dr. Koprivica, found claimant unable to work but attributed the disability to a combination of accidents and claimant's age.   Medical testimony sufficiently supported claimant's argument of causation by reasonable inference even though experts did not directly quote statutory language of "substantial factor."   The Commission determined credibility and accepted claimant's allegation of new back pain despite medical records indicating a previous herniated disc associated with a prior car accident.  Claimant's carpal tunnel flowed from using a cane and switching hands due to pain and weakness in his left arm, according to his expert.  Claimant used an orthopedist to testify his depression flowed from a 2002 accident.    Claimant admitted he was depressed because he didn't have a job and he didn't seek any treatment for depression for several years until after he was laid off.  The court rejected the City's argument that an orthopedist is not qualified to diagnose depression.

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

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