Jefferson City Country Club v. Lydia Pace and Treasurer of the State of Missouri-Custodian of the Second Injury Fund
500 S.W.3d 305
| Mo. Ct. App. | 2016Background
- Lydia Pace, a waitress/bartender, was injured at work on Oct. 4, 2002 when table toppers fell, causing neck and right-shoulder injuries; Employer initially authorized and paid treatment and TTD through Nov. 17, 2005.
- Pace underwent multiple treatments including cervical surgeries (2004 and a two-level fusion after a 2010 Temporary Award) and shoulder surgery; she continued to report persistent neck/shoulder pain and developed depressive symptoms.
- Parties stipulated the injury was compensable, timely reported, rate and prior benefits, and that Pace reached MMI on Aug. 25, 2011; ALJ issued a July 2015 Final Award later adopted and modified by the Commission.
- The Commission (adopting the ALJ) awarded: compensable neck/right-shoulder injury; depression causally related to the work injury; PTD (neck/shoulder + depression); past TTD Nov. 17, 2005–Aug. 24, 2011; future medical care for physical injuries and depression; no Second Injury Fund liability.
- Employer appealed raising 11 points challenging causation of depression, sufficiency of evidence for future care, scope/duration of TTD and rehabilitative process, PTD findings, and Fund liability.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether Pace's depression is compensable (causation) | Pace: psychiatric experts (esp. Dr. Daniel) say work injury and chronic pain were the prevailing/substantial factor causing depression | Employer: depression is from litigation/adjustment disorder; employer's expert (Dr. Jarvis) more persuasive | Commission credited Dr. Daniel; court affirms: work was a substantial factor and depression is compensable |
| Entitlement to future medical care for neck/shoulder and depression | Pace: ongoing pain and expert testimony show reasonable probability of future pain management and psychiatric care | Employer: MMI reached; no additional treatment necessary under §287.140.1 | Court: substantial evidence supports reasonable probability of future care; MMI does not bar future relief |
| TTD period and rehabilitative process (Nov. 17, 2005–Jan. 2, 2011 / through Aug. 24, 2011) | Pace: continuously sought treatment, unable to work; stipulation of MMI date supports that earlier release was premature | Employer: ALJ's temporary award denied TTD after Nov. 17, 2005; final award lacked new significant evidence; subjective complaints insufficient | Commission identified additional significant evidence (post-temporary evaluations, testimony); court defers to Commission and affirms TTD award |
| Permanent total disability and Second Injury Fund liability | Pace: combined physical limitations + depression make her unemployable in open labor market; no preexisting disability | Employer: claimant not PTD; any PTD arises from combined conditions triggering Fund liability | Court: Commission reasonably credited medical and vocational testimony; finds PTD and no Fund liability because no preexisting disability existed |
Key Cases Cited
- Greer v. SYSCO Food Servs., 475 S.W.3d 655 (Mo. banc 2015) (MMI does not automatically end rehabilitative process; future medical/TTD may continue if treatment is part of rehabilitation)
- Leake v. City of Fulton, 316 S.W.3d 528 (Mo. App. W.D. 2010) ("prevailing factor" standard discussed relative to causation and its relation to "substantial factor")
- Angus v. Second Injury Fund, 328 S.W.3d 294 (Mo. App. W.D. 2010) (claimant bears burden to prove causal connection between injury and work-related condition)
- ABB Power T&D Co. v. Kempker, 236 S.W.3d 43 (Mo. App. W.D. 2007) (future medical care requires reasonable probability treatment is needed and that it arose from work injury)
- Treasurer of State–Custodian of Second Injury Fund v. Witte, 414 S.W.3d 455 (Mo. banc 2013) (purpose and allocation of liability to Second Injury Fund when preexisting disability exists)