MO: Fall Out Of Bed Defeats Causation

MO: Fall Out Of Bed Defeats Causation

A company president tripped over a telephone cord at work but failed to prove her radius fractures arose from work and not from falling out of bed the following morning. The court in Bond v Site Line Surveying, WD 72142 (Mo. App. 10-12-10), agreed that substantial evidence supported the Commission’s decision to deny benefits, reversing an award of benefits by the administrative law judge.

 

The court of appeals has a limited standard of review, and will not disturb a credibility finding that claimant failed to prove the fall was the prevailing factor if supported by substantial evidence. It is claimant’s burden of proof to establish causation and not the employer’s burden to establish an alternate cause. Claimant produced witnesses supporting an immediate onset of swelling, discoloration and pain complaints after falling at work and medical evidence to support causation. Dr. Pazell concluded that the 2007 work injury was the prevailing factor in her injuries and rated permanent partial disability. He recommended in 2009 additional MRI and EMG studies of the arm and shoulder.

 

The court of appeals summarized conflicting evidence in the case whether claimant’s injuries at work represented a “minor fall” or a traumatic fracture. The case demonstrates that medical evidence that is not contradicted by other medical opinions may fail without showing a fully informed basis for the opinion. The Commission was not obligated to accept the medical opinion when the expert’s opinion was not based on “medical judgment,” and did not fully consider all of the evidence or alternate causes. The Commission discredited facts relied upon by the expert including inconsistencies in the medical histories and pleadings and claimant’s a history of breaking bones previously from nocturnal seizures. Claimant’s initial emergency room record documented an injury at home and claimant made ‘‘less than a definite denial.” The pleading described claimant “moving furniture.” Claimant’s ex-boyfriend contradicted claimant’s denial that she injured her wrist at home. Claimant did not dispute that she fell out of bed, but states she denied she had a seizure or hurt her wrist and fell on her bottom while trying to avoid three sleeping dogs.

 

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