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Missouri: Prior Psych Condition Supports SIF Total from Break Room Accident

February 19, 2014 (2 min read)

The court of appeals affirmed an award  of total disability benefits against the second injury fund  benefits based in part on claimant's significant pre-existing psychiatric disabilities.  Blackshear v Adecco, ED 100251 (Mo. App. 2014), 2014 MO App Lexis 157 (2-18-2014) ( 2014 MO App Lexis 157 (2-18-2014) (Lexis Advance).

Claimant had been employed in 2005 only about 11 weeks as a customer service representative when she sat in a broken chair in a lunchroom and hurt her back.  Claimant had about a 20 year history of psychiatric problems which one expert identified as bi-polar disorder, PTSD, personality disorder, anxiety disorder and phobias which impaired her ability to maintain employment.  The employer provided more than 1/4 million in medical and TTD benefits until claimant reached MMI in 2010, nearly 5 years later.

The Fund  argued the last accident alone rendered claimant totally disabled, and that the Commission failed to first make a determination of disability from  the last accident alone and that its opinion of SIF liability was not based on substantial evidence.  The court rejected both propositions.

The Commission made a specific finding that the last accident rendered claimant 85% partially disabled and not totally disabled before assessing Fund liability. It specifically found the total disability flowed from a combination.  The Fund argued that Dr. Volarich supported an opinion that the last accident alone rendered claimant totally disabled when he imposed onerous restrictions such as a need to rest in recumbent positions.  A psychiatrist testified claimant after the accident developed or worsened 4 new psychiatric conditions.   Claimant asserted before the accident she was "fine."

The court rejected the proposition that substantial evidence did not support a total against the Fund based on vocational and psychiatric evidence.  The commission may rely upon experts that provide opinions only within their specialty and are not compelled to follow experts who purport to consider  the entirety of claimant's disability.  "The fact that these doctors [psychiatrists] did not provide an opinion as to Claimant's physical impairments does not render their conclusions as to Claimant's psychiatric conditions less relevant."   It is "simply not required" to only consider expert opinion which addresses the totality of various medical conditions.  The court further notes that Dr. Volarich deferred on the issue of psychiatric opinion.  "The Commission can and must be able to accept an expert's testimony in his area of expertise and then assess and weigh the collective evidence when making its determination "

The ALJ awarded an additional $94,000 in benefits against the employer with open medical for orthopedic and psychiatric conditions for the 41 year old claimant.  2013 MO WCLR Lexis 111 (July 3, 2013) ( 2013 MO WCLR Lexis 111 (July 3, 2013) (Lexis Advance).

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