LISA COOK, Claimant-Respondent v. MISSOURI HIGHWAY AND TRANSPORTATION COMMISSION, Employer-Appellant., 500 S.W.3d 917

Background

Lisa Cook, long-time data-entry senior secretary for Missouri Highway & Transportation Commission (employed 1997–2011), performed keyboarding ~85–90% of her workday.
She first sought medical care for wrist issues in 2005 (nerve study negative; no carpal tunnel diagnosis) and again in 2007 (treated for extensor tendinitis; symptoms resolved).
In Sept–Oct 2011 she developed worsening right-sided symptoms; an October 2011 nerve conduction study (Dr. Phillips) and exam by Dr. Crandall diagnosed moderately severe right carpal tunnel syndrome; Claimant filed right/left claims Jan 10, 2012.
In late 2012 Dr. Kubik and Dr. Schlafly diagnosed bilateral carpal tunnel syndrome; Dr. Schlafly performed bilateral release surgeries and rated 25% disability per hand.
ALJ and Labor & Industrial Relations Commission found Claimant’s work was the prevailing factor, claims timely under the occupational-disease statute, and awarded medical expenses, temporary total disability, permanent partial disability, and disfigurement. Employer appealed on statute-of-limitations, medical causation, and past-medical-expense grounds.

Issues

Issue	Cook's Argument	Employer's Argument	Held
1) Were Cook’s claims time-barred under § 287.063.3 (occupational disease accrual)?	Claims filed within two years of when carpal tunnel was reasonably discoverable (right: Oct 12, 2011; left: Oct 25, 2012).	Claims were discoverable earlier (2005 suspicion; 2007 tendinitis episode), so statute began running before 2012.	Affirmed: Commission reasonably found accrual dates when physicians diagnosed carpal tunnel; 2005/2007 records and expert testimony showed no carpal tunnel then.
2) Was the Commission’s causation finding (prevailing factor = employment) supported?	Dr. Schlafly’s opinion that repetitive keyboarding was the prevailing factor; Commission credited him.	Employer’s experts (esp. Dr. Crandall) attributed carpal tunnel to non-work risk factors.	Affirmed: credibility and conflicting medical testimony were Commission questions; substantial evidence supported finding for Cook.
3) Should Employer be credited for past medical payments (no liability)?	Past medical expenses are compensable; Claimant introduced bills and testimony tying them to work injury.	Employer contends its insurance paid all bills and Claimant’s liability was extinguished, so no award.	Affirmed: Cook met initial burden; Employer failed to prove extinguishment or that payments were employer-funded for § 287.270 credit.
4) Did the Commission apply the correct standard (objective vs. subjective) for accrual?	Use the settled “reasonably discoverable and apparent to the employee” standard (objective but based on what is discoverable to claimant).	Commission applied a subjective standard by focusing on what claimant knew.	Affirmed: statutory language and precedent support the cited standard; Commission did not err.

Key Cases Cited

Hampton v. Big Boy Steel Erection, 121 S.W.3d 220 (Mo. banc) (review standard: award contrary to overwhelming weight of evidence is rare)
Lawrence v. Anheuser Busch Companies, Inc., 310 S.W.3d 248 (Mo. App.) (statute accrual factual inquiry; remand where Commission made no factual finding)
Wiele v. Nat’l Super Markets, Inc., 948 S.W.2d 142 (Mo. App.) (occupational disease accrual principles; employee awareness alone not enough)
Miller v. U.S. Airways Group, Inc., 316 S.W.3d 462 (Mo. App.) (duplicative carpal-tunnel claims and consolidation/dismissal principles)
Farmer-Cummings v. Pers. Pool of Platte County, 110 S.W.3d 818 (Mo. banc) (burden on employer to prove claimant not liable for charged medical amounts)
Proffer v. Fed. Mogul Corp., 341 S.W.3d 184 (Mo. App.) (employer must prove entitlement to credit for write-offs/adjustments)
Martin v. Mid-America Farm Lines, Inc., 769 S.W.2d 105 (Mo. banc) (elements for awarding past medical expenses)