Tillotson v. St. Joseph Medical Center
2011 Mo. App. LEXIS 812
| Mo. Ct. App. | 2011Background
- Tillotson, a registered nurse, sustained a January 7, 2006 work-related injury when a patient bed rolled, causing her to strike her right knee.
- MRI showed a torn lateral meniscus with pre-existing degenerative arthritis affecting the medial meniscus.
- Orthopedic surgeons advised that arthroscopy would not adequately relieve her pain due to arthritis; a total knee replacement was recommended.
- Employer refused to authorize the knee replacement, relying on a physician's assertion that pre-existing arthritis was the prevailing factor.
- Tillotson underwent a total knee replacement at her own cost of $4,646.21 and experienced temporary total disability during recovery.
- Division denied compensation for medical costs, temporary disability, future medical care, and permanent partial disability; the Commission affirmed and adopted those findings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether prevailing-factor analysis applies to medical treatment under 287.140.1 | Tillotson—prevailing-factor not required for medical care under 287.140.1 | Employer—prevailing-factor required to justify medical treatment | Prevailing-factor not required; treatment must be reasonably required to cure/relieve injury; remanded for compensation under 287.140.1 |
Key Cases Cited
- Sell v. Ozarks Medical Ctr., 333 S.W.3d 498 (Mo. App. S.D. 2011) (standard of review and statutory construction guidance in WC appeal)
- Hawthorne v. Lester E. Cox Med. Ctrs., 165 S.W.3d 587 (Mo. App. S.D. 2005) (review of Commission findings; credibility and weight principles)
- Stevens v. Citizens Memorial Healthcare Foundation, 244 S.W.3d 234 (Mo. App. S.D. 2008) (medical causation and future medical care flowing from compensable injury)
- Bowers v. Hiland Dairy Co., 188 S.W.3d 79 (Mo. App. S.D. 2006) (medical treatment reasonably required; flow from injury; impact of pre-existing conditions)
- Gordon v. City of Ellisville, 268 S.W.3d 454 (Mo. App. E.D. 2008) (discussion of 287.140.1 construction and prevailing-factor debate)
- Martin v. Town and Country Supermarkets, 220 S.W.3d 836 (Mo. App. S.D. 2007) (treatment costs when employer fails to provide required care)