James C. Bowman v. Central Missouri Aviation, Inc., and Treasurer of the State of Missouri as Custodian for the Second Injury Fund
2016 Mo. App. LEXIS 812
| Mo. Ct. App. | 2016Background
- Bowman, a line technician at Central Missouri Aviation (hired 2005), was physically assaulted by a pilot on July 16, 2007; he reported psychological symptoms afterward and did not return to work; employer terminated him for lack of attendance in December 2007.
- Bowman had preexisting psychiatric treatment (Green Meadows) dating to 2003 after an armed robbery/kidnapping; records show PTSD symptoms and later cannabis dependence.
- Bowman sought treatment after the 2007 workplace incident and filed a workers’ compensation claim alleging permanent partial disability from psychiatric injury; employer and Second Injury Fund defended.
- Claimant’s psychiatrist Dr. Daniel opined the 2007 incident was the sole prevailing causal factor; employer’s psychiatrist Dr. Stillings concluded Bowman’s psychiatric problems were primarily due to preexisting conditions (including the 2003 incident) and not caused by the 2007 event.
- The ALJ and then the Labor and Industrial Relations Commission found Dr. Daniel’s opinion unpersuasive (relying on Bowman’s inconsistent statements and Dr. Daniel’s inadequate record review), concluded Bowman failed to prove the 2007 incident was the prevailing factor, and denied compensation and Second Injury Fund liability.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether the Commission improperly discredited claimant’s medical expert (Dr. Daniel) | Dr. Daniel’s uncontradicted opinion established causation and should be credited | Commission properly found Dr. Daniel unpersuasive due to reliance on claimant’s inconsistent subjective reports and incomplete record review | Commission’s credibility finding and rejection of Dr. Daniel supported by substantial evidence; no error |
| Whether the 2007 work incident was the prevailing factor causing claimant’s psychiatric condition | 2007 assault was the prevailing cause (or at least exacerbated a latent condition to compensable disability) | Medical evidence shows preexisting PTSD from 2003 was the prevailing factor; claimant failed to prove 2007 was the primary cause | Claimant failed to meet burden to prove 2007 was prevailing factor; denial affirmed |
| Whether the Second Injury Fund (SIF) is liable | SIF liable if the 2007 accident escalated a preexisting condition into disability | SIF liability requires an actual, measurable preexisting disability that hindered employment at time of the later injury; claimant’s preexisting condition was not shown to be such a disability | No SIF liability: no evidence the preexisting condition constituted a disability/hindrance to employment at time of 2007 incident |
| Whether the Commission substituted its own medical opinion for experts | Claimant contends Commission impermissibly substituted judgment by disregarding expert causation | Commission relied on credibility determinations and impeachment of expert’s factual basis, not its own medical theory | Court finds Commission did not improperly substitute opinion; it permissibly discredited expert where factual basis was impeached |
Key Cases Cited
- Angus v. Second Injury Fund, 328 S.W.3d 294 (Mo. App. W.D.) (standards for reviewing Commission adoption of ALJ findings)
- ABB Power T & D Co. v. Kempker, 236 S.W.3d 43 (Mo. App. W.D.) (review of ALJ findings when Commission adopts them)
- Seifner v. Treasurer of State—Custodian of Second Injury Fund, 362 S.W.3d 59 (Mo. App. W.D.) (expert opinion may be disregarded when its factual basis is impeached)
- Smith v. Capital Region Med. Ctr., 458 S.W.3d 406 (Mo. App. W.D.) (standard for whole-record review of Commission awards)
- Wright v. Sports Associated, Inc., 887 S.W.2d 596 (Mo. banc) (limits on substituting administrative opinion for qualified medical expert)
- Portwood v. Treasurer of State—Custodian of Second Injury Fund, 219 S.W.3d 289 (Mo. App. W.D.) (elements to establish SIF liability)
- Gassen v. Lienbengood, 134 S.W.3d 75 (Mo. App. W.D.) (preexisting condition must be a disability to trigger SIF)
- Messex v. Sachs Elec. Co., 989 S.W.2d 206 (Mo. App. E.D.) (claimant must show preexisting permanent disability for SIF claims)
- E.W. v. Kansas City Mo. Sch. Dist., 89 S.W.3d 527 (Mo. App. W.D.) (preexisting disability must exist at time of work injury to trigger SIF)