Coverage Denied Because Medical Experts Used Extra Injury
The case, Ingles v. Corrigan Brothers, involved a 66-year-old union pipefitter who ruptured his rotator cuff at work in 2014. He claimed that the injury amounted to a permanent total disability (PTD) when combined with two earlier workplace injuries:
- A workplace injury to his left shoulder that required two surgeries in 2011
- A lingering back injury that first occurred in 1978
Expert testimony for the worker used both of these injuries to support their conclusion that he was PTD. The administrative law judge, however, took exception to the use of the lower back injury to support a PTD claim against the SIF. According to the judge, a boating accident that happened a year after the rotator cuff injury contributed to the severity of the back injury. Therefore, the medical experts who used the back injury in their testimony could be disregarded. This left the worker with very little evidence to support his claim for compensation against the Fund.
LIRC Affirms Decision Based on Misreading of Court Case
When the worker appealed, the LIRC affirmed the decision: Because “there was no credible expert testimony that only considered” the primary injury and the 2011 shoulder injury, the worker’s claim should be denied.
The LIRC, however, took Parker to mean that SIF liability required the combined disabilities from the primary injury and a “qualifying preexisting disability” under Missouri Statute 287.220.3(2)(a). The back injury, in the eyes of the LIRC, was not “qualifying.”
However, as the LIRC dissent correctly points out, that is very much not what Parker stood for.
In fact, the Missouri Supreme Court in Parker discussed the exact dilemma presented in Ingles: If hurt workers present multiple prior injuries to support a claim against the SIF, and then one of them is deemed “not qualifying,” does that doom the claim? According to the court in Parker, the answer is no: “The existence of non-qualifying disabilities does not count against (or for) the claimant” in deciding whether the worker is PTD.
Workers’ Compensation Lawyers at the Smith Law Office Serve St. Joseph
Workers’ compensation claims against the Second Injury Fund continue to get thrown out as judges use the Fund’s 2013 amendments as a reason to limit its liability as much as possible. The results, needless to say, have been hurt workers being denied the compensation that they need and deserve.
If you or a loved one has been hurt at work in St. Joseph, Kansas City, Springfield, or the rest of western Missouri, call the personal injury lawyers at the Smith Law Office at (816) 875-9373 or contact them online.