Brad Young of Harris, Dowell, Fisher & Young, LC
October 10, 2023 - The Missouri Labor and Industrial Relations Commission (LIRC) recently issued a decision awarding a claimant 10% of the body for a lumbar sprain but denying allegations of potential Permanent Total Disability, years of Temporary Total Disability benefits, psychiatric injury, along with past and future medical care. Here’s why:
FACTS
Claimant suffered a compensable work accident in 2018. However, during her deposition, claimant was “not candid” about her prior back problems. The employee’s deposition testimony denied diagnosis with any problem in her low back before January 19, 2018, prior imaging of her low back, or any prior instances of low back symptoms such as pain or aches or limitations of motion before January 18, 2018.
However, the medical evidence eventually demonstrated that claimant had significant lumbar spine problems dating back to 2009, along with a prior diagnosis of 6 herniated discs in her cervical and lumbar spine prior to the work accident.
Claimant requested years of unpaid TTD benefits, presumably PTD benefits, psychiatric overlay, along with past and future medical care.
AWARD
The ALJ noted the claimant’s failure in her memory after she became involved in litigation and only awarded 10% of the body for the compensable 2018 work accident, denying the request for all other benefits.
On appeal, the LIRC noted all of the references in the medical records where claimant sometimes admitted knowledge of prior back problems, while other times denying any history. In upholding the award from the ALJ, the Commission stated:
“The inconsistencies and contradictions set out, supra, establish that the employee’s accounts of her medical history over time were inconsistent and lacked credibility. We consider additional findings in the ALJ’s Award relevant to the issue of the employee’s credibility essential to the ultimate conclusion on this issue (that claimant is not entitled to other benefits, including PTD and medical care), which we affirm.”
PRACTICE POINTS
It goes without saying that one of the major focal points for the defense of every workers compensation claim is the claimant’s past medical history. This claim demonstrates why.
Even though the aggravation of a pre-existing injury is, most often, a compensable injury, the claimant’s credibility regarding those pre-existing problems is essential to the prosecution of the claimant’s claim for compensation. Demonstrating that the claimant lacks credibility can often, as seen here, dramatically reduce the amount of benefits owed to the claimant.
ISO reports, social media, medical canvassing, and a careful review of all known medical records is vitally important to the investigation of each and every claim. Once that information is available, the deposition of the claimant is essential to determine the credibility of the claim. Since the claimant’s credibility is the foundation for every award of benefits, demonstrating cracks in that foundation can often lead to a collapse of the entire claim.
Please let me know if you have any questions or if you wish to discuss how this award might apply to any of your current or potential claims. I’m happy to help at byoung@harrisdowell.com.
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