Maness v. City of De Soto
421 S.W.3d 532
| Mo. Ct. App. | 2014Background
- Claimant (working supervisor) reported neck injury from moving 60–65 lb decorative stones at work on or about June 11–12, 2007; Employer initially provided limited care then denied further treatment.
- Claimant later obtained treatment from Dr. Philip Poepsel and Dr. Kevin Rutz; Dr. Rutz performed a three-level cervical fusion on August 22, 2007.
- ALJ awarded compensation; Employer and Insurer appealed to the Labor and Industrial Relations Commission; the Commission issued a final award ordering Employer and the Second Injury Fund to pay various benefits (temporary total, permanent partial, past and future medical); Employer appealed to appellate court.
- Key medical dispute: whether the June 2007 event was an "accident" and the prevailing factor causing disc herniations and need for surgery versus preexisting degenerative cervical disease.
- The Commission credited Claimant’s testimony (except limited date inconsistency) and the opinions of Drs. Kennedy and Volarich over Dr. deGrange, finding the work event the prevailing factor and awarding benefits including $101,769.64 in past medicals and future care.
Issues
| Issue | Claimant's Argument | Employer's Argument | Held |
|---|---|---|---|
| Existence/date of accident (June 11 vs. 12) | Claimant testified he injured his neck while moving stones on or about June 11 (reported to employer June 14) | Employer pointed to time records and some medical notes suggesting different dates and inconsistencies, arguing testimony unreliable | Commission’s credibility finding upheld: accident occurred on or about June 11–12; sufficient competent evidence supported finding |
| Compensability / prevailing factor for neck condition | Work event was the prevailing factor causing disc herniations (esp. C6–7) and aggravation of degenerative disease; surgery required | Employer stressed preexisting degenerative disease and alternative doctors’ opinions that the accident at most caused a strain | Court deferred to Commission credibility determinations; substantial evidence (comparative MRIs and experts Kennedy/Volarich) supports prevailing-factor finding; injury compensable |
| Temporary total disability for post‑surgery healing period | Surgery (Aug 22, 2007) and related recovery were reasonable, necessary, and caused by compensable injury; off work Aug–Nov 2007 | Employer asserted surgery and healing were due to preexisting degeneration, not compensable accident | Award of approx. three months temporary total disability upheld based on credited medical testimony that surgery and healing were work-related |
| Permanent partial disability, future medicals, and past medical expenses | Claimant entitled to 40% PPD, reasonable probability of future treatment, and reimbursement of billed past medicals introduced with records | Employer argued lack of permanent impairment from accident, that medical bills were reduced/paid by insurer so credit or reduction should apply | Commission’s PPD determination (within its fact-finding discretion) and future-care award upheld; past medicals awarded to Claimant—Employer failed to prove reductions extinguished liability and statutory collateral-source rules bar credits for insurer payments |
Key Cases Cited
- Miller v. Mo. Highway & Transp. Comm’n, 287 S.W.3d 671 (Mo. banc 2009) (standard for appellate review of commission awards)
- Hornbeck v. Spectra Painting, Inc., 370 S.W.3d 624 (Mo. banc 2012) (deference to commission fact findings when evidence supports opposing conclusions)
- Hager v. Syberg’s Westport, 304 S.W.3d 771 (Mo. App. E.D. 2010) (deference on credibility and weight of evidence)
- Leake v. City of Fulton, 316 S.W.3d 528 (Mo. App. W.D. 2010) (prevailing-factor determination is factual)
- T.H. v. Sonic Drive In of High Ridge, 388 S.W.3d 585 (Mo. App. E.D. 2012) (weight to be given medical expert opinions rests with commission)
- Farmer-Cummings v. Pers. Pool of Platte County, 110 S.W.3d 818 (Mo. banc 2003) (collateral-source rule and employer’s burden to prove extinguished liability for billed amounts)
- Martin v. Mid-America Farm Lines, Inc., 769 S.W.2d 105 (Mo. banc 1989) (proof necessary to recover past medical expenses)