Work comp update: Appeals court agrees disability cause predated work injury

By J. Bradley Young, Harris Young Kayser L.C.

In the case, Hasselbring v. Macon County Nursing Home District, 717 S.W.3d 218 (2025) from the Missouri Court of Appeals, Thomas Hasselbring, a nursing home employee, had a pre-existing condition—a thrombosed popliteal aneurysm in his left leg. On November 3, 2021, while assisting a resident, an electric wheelchair rolled over his left foot, causing acute pain and ultimately leading to the amputation of his leg.

An administrative law judge (ALJ) initially awarded Hasselbring workers' compensation benefits, finding the injury compensable and awarding lifetime medical care for the leg injury. However, the Labor and Industrial Relations Commission reversed that decision, concluding that the prevailing factor in Hasselbring’s disability was a pre-existing aneurysm, not the workplace accident.

RULING

The Missouri Court of Appeals affirmed the Commission’s decision denying workers’ compensation benefits. The key legal basis was the finding that the pre-existing thrombosed popliteal aneurysm, not the workplace accident, was the prevailing factor in causing Hasselbring’s disability (leg amputation), as required under Missouri workers’ compensation law.  All of this evidence was produced by the employer’s expert physician.

PRACTICE POINT

This case is a great example of a claimant-friendly ALJ who reached a bad decision, only to have that bad decision reversed by the Labor and Industrial Relations Commission on the strength of the employer’s expert that opined that the claimant’s pre-existing condition, NOT the work accident, was the cause of the claimant’s disability and need for medical care.

If the Commission adopts the opinions of the employer’s expert, and there is evidence to support the Commission’s decision, the Court of Appeals is unlikely to reverse that decision (as this case demonstrates).  That’s why is very important to:

• Choose a credible and qualified expert that the Labor and Industrial Relations Commission will know and trust;

• Be aggressive – don’t be afraid to take claims to trial;

• Understand that even if a claimant-friendly judge might give the claimant a favorable award, the Labor and Industrial Relations Commission isn’t afraid to overturn a bad decision from an ALJ.

If you have questions about this or another workers' compensation question or issue, please contact Brad Young, byoung@hyklegal.com, or by phone at (636) 532-0300.