Lorentz v. Missouri State Treasurer

Citations: 72 S.W.3d 315; 2002 Mo. App. LEXIS 864; 2002 WL 709739Docket: No. 24308

Court: Missouri Court of Appeals; April 25, 2002; Missouri; State Appellate Court

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Alfred Leon Lorentz, Jr. sustained injuries on March 21, 1996, while working as an underground mining prospector for Doe Run Company when an 800-pound piece of equipment fell on him. He suffered rib and low back injuries and subsequently filed a claim against Doe Run and the Missouri Second Injury Fund. Doe Run settled for 25 percent permanent partial disability. An Administrative Law Judge (ALJ) initially found Lorentz permanently and totally disabled due to his injury but ruled that the Fund was not liable for any pre-existing disabilities. 

The Labor and Industrial Relations Commission, however, agreed with the total disability finding but determined it was due to both the primary injury and pre-existing disabilities, thus reversing the ALJ's decision regarding the Fund's non-liability. The Commission awarded Lorentz lifetime weekly benefits payable by the Fund. 

On appeal, the Fund contended that the Commission erred in finding it liable for permanent total benefits, asserting that the evidence indicated Lorentz's total disability stemmed solely from the 1996 injury. The review process involves determining if the record supports the Commission’s award and whether the award is against the overwhelming weight of the evidence. The court defers to the Commission on witness credibility and evidence weight, resolving conflicts in evidence in favor of the Commission's findings. For the Fund's liability, a pre-existing disability must combine with a subsequent injury either to create a greater overall disability or to result in permanent total disability. The court’s review focuses on the latter condition in Lorentz's case, considering the Commission's findings of permanent total disability.

Section 287.220.1 addresses permanent total disability, stating that if a combination of previous disabilities and a last injury results in total and permanent disability, the employer at the time of the last injury is liable only for the last injury's disability. However, if the compensation from this employer is less than the amount specified for permanent total disability, the employee can receive the difference from the Second Injury Fund, created for such situations and rehabilitation benefits. Pre-existing injuries hindering employment competitiveness can activate Second Injury Fund liability. Total disability is characterized as the inability to return to any kind of employment, not limited to the job held during the accident. The determination of permanent total disability focuses on the worker's ability to compete in the labor market, assessing whether any employer would reasonably hire the claimant given their current physical condition.

The claimant has a high school education with no formal training aside from on-the-job experience, having worked in various physically demanding jobs, including logging and construction. Following a March 21, 1996 accident, he was diagnosed with rib fractures and a pre-existing spondylolisthesis at L5-S1. Despite some improvement noted by Dr. Wagner, who reported a 30% loss of lumbar motion, he acknowledged that the claimant's spinal issues predated the 1996 injury, which only exacerbated the existing condition.

Claimant reported low back and lower extremity symptoms, which prompted his referral to Dr. Wagner after unsuccessful physical therapy. Dr. Wagner recommended surgery, leading to an evaluation by Dr. Boland, who concurred that lumbar fusion was necessary. Claimant underwent surgery on August 14, 1997, performed by Dr. Wagner and Dr. Boland, which included a laminectomy, nerve root decompression, and bone grafting. Despite surgery, by March 1998, Claimant continued to experience significant pain, with Dr. Boland noting in April that his symptoms were nearly as severe as before the operation. By July 1998, Dr. Wagner determined Claimant had reached maximum medical improvement and assessed a 25 percent permanent partial disability. 

The Fund's vocational expert, Dr. James England, indicated Claimant had no prior vocational impairment but acknowledged that if Claimant's pain was as severe as claimed, he would be unemployable. Conversely, Claimant's vocational expert, Mr. James Israel, testified that Claimant's inability to work stemmed from both his primary and pre-existing injuries. Claimant is 40 years old, weighs 250 pounds, and has no vocational training beyond high school. He was terminated from Doe Run due to physical inability to perform job duties as restricted by his physicians. 

Claimant detailed a history of injuries, including a 1981 ankle injury and a 1992 knee injury requiring two surgeries, leading to ongoing issues with weakness and pain. He described difficulties with bending, lifting, and squatting, admitting that such tasks caused him pain during his last job. Additionally, he underwent two surgeries for ganglion cysts related to carpal tunnel syndrome but continues to experience wrist weakness and tingling. Claimant reported chronic pain, weakness in his back, left knee, and right ankle, and limitations in sitting and climbing stairs.

Dr. C. Chastain's deposition on March 24, 1999, revealed significant physical findings regarding the Claimant, who presented with a stiff, limping gait, obesity, and discomfort. The Claimant was equipped with a TENS unit and displayed restlessness, difficulty undressing, and an inability to bend over. Examination indicated a five-inch scar over the lumbar spine with no movement in that area; any spinal flexion occurred in the thoracic spine and hips instead. Dr. Chastain noted diminished pinprick sensation in the left leg and crepitant sounds in the left knee, which had full motion but caused audible discomfort. 

Dr. Chastain reviewed the Claimant's medical history, including a 1996 back injury and a 1992 knee injury that required two surgeries. He indicated that the knee injury continued to cause significant pain. Additional past surgeries addressed issues in the left wrist and ankle, with the Claimant reporting ongoing ankle instability. 

During cross-examination, Dr. Chastain identified a congenital vertebral slippage, contributing to the Claimant's susceptibility to injury and pain from both the slippage and the 1996 injury. He expressed doubt about the Claimant's ability to hold a sedentary job and concluded that the combination of the knee and back injuries rendered the Claimant essentially unemployable and 100% disabled. 

The Commission reviewed the evidence, including Dr. Chastain's testimony, and concluded that the combination of the Claimant's knee and back disabilities resulted in permanent and total disability. The findings were supported by credible evidence, and the Commission's determinations regarding the credibility and weight of the evidence were upheld. The Final Award of the Commission affirming the Claimant's total disability was confirmed as consistent with the evidence presented.

Judges Shrum and Montgomery concurred in assessing the claimant's case under RSMo 1994 statutes. For claims involving permanent partial disability (PPD) resulting from both pre-existing and primary injuries, statutory thresholds require a primary injury to meet specific criteria: a minimum of fifty weeks for body as a whole injuries or a fifteen percent impairment for major extremities. Dr. Wagner described the claimant's condition as involving an internal fixation device and spinal fusion. Dr. Chastain provided a written report asserting that the claimant is permanently and totally disabled, noting that pre-existing conditions, such as a pars interarticularis defect, spondylolisthesis, and internal derangement of the left knee, hindered the claimant's ability to work and made him more susceptible to low back injuries. Dr. Chastain testified that the claimant faces significant limitations in daily activities, including an inability to walk or sit for extended periods, severe pain during short walks and car rides, difficulty entering and exiting vehicles and chairs, and an inability to bend, lift, or stoop. He emphasized that pain severely restricts the claimant's capacity for tasks requiring mental concentration.