Work comp case legal update March 23, 2021
Thanks to J. Bradley Young of Harris Dowell Fisher and Young, LC, for this article. You may reach Mr. Young at firstname.lastname@example.org or at (636) 532-0300.
In Keavin Edwards v. Dairy Farmers of America decision from the Missouri Industrial Commission dated March 23, 2021, the Commission denied the compensability of a claim due to the fact that the claimant’s shoulder revealed only evidence of severe degenerative changes and no evidence of acute trauma.
Claimant alleged he injured his shoulder at work, and he also had a prior history of shoulder surgery almost 10 years prior to the alleged work accident. Claimant testified at trial that after he recovered from his prior injury, he had: “no problem with his left shoulder until his recent injury (at work).”
However, the defense found medical records between the date of the first injury and the date of the alleged work injury, demonstrating that claimant had ongoing issues with his shoulder. Furthermore, diagnostic imaging two weeks after the alleged accident revealed nothing but degenerative changes at the shoulder level.
The Commission denied the compensability of the claim for two reasons:
First, the Commission did not believe the claimant’s testimony:
“We expressly find not credible or persuasive claimant’s testimony that he had no pain or issues with his left shoulder during the time after his recovery from his (first surgery) until the January 30, 2017 injury.”
Second, the Commission found that there was no new injury:
“The January 30, 2017 incident did not create a new compensable injury, but aggravated a preexisting problem. In fact, the history, physical examination, MRI, operative report and review of medical records indicate the pathology is gradual deterioration caused by aging, hereditary, previous trauma and normal activities.”
Under the Tillotson standard, Employers are often stuck providing medical care for pre-existing degenerative conditions (like knee replacement surgeries or spine fusion surgeries) in cases where the work injury aggravates a pre-existing condition. Here, though, the ALJ and the Commission found that there was no actual injury from the alleged work accident, so Tillotson did not apply.
First, this case demonstrates the importance of investigating prior injuries that claimants may have experienced to the body part that is the focus of a workers compensation claim. Here, that investigation into the claimant’s medical history made the difference between a compensable and a non-compensable claim.
Unfortunately, this decision could be overturned by the Missouri Court of Appeals because the Tillotson doctrine continues to force Employers to pay for medical care to repair pre-existing degenerative conditions that are not medically-causally related to work accidents. That is why I have been working closely with business groups, including Associated Industries of Missouri, to introduce legislation in Missouri to overturn Tillotson. House Bill 1265, sponsored by Rep. Alex Riley, would overturn Tillotson and would ensure that employers are only responsible to pay for medical care pertaining to work-related injuries, NOT pre-existing and/or degenerative conditions.
We will keep you updated as this bill moves through the Legislature. If you have any questions or would like to discuss either the attached decision from the Missouri Industrial Commission or the attached HB 1265, please contact Mr. Fisher directly (his contact information is at the top of this story).
Here is a link to the case mentioned in this article.