MO Workers Comp Commission awards death benefits for ankle injury
Today, the MO Industrial Commission continued its streak of bad decisions. I have attached a copy of the decision from the Commission in Knutter v. American National Insurance. Click here to read the decision.
Claimant suffered an ankle injury and was in a wheelchair for 6 weeks following the ankle injury. While on the toilet at home, the obese 69 year old employee died of a pulmonary embolism (a blood clot in the lung). The ALJ denied benefits on the following grounds:
“While it is possible that a blood clot or a deep vein thrombosis could have
formed as a result of [the claimant’s] wheelchair ridden status, there is no
evidence in any of the medical records before or contemporaneous with
Mrs. Knutter’s death to suggest that this was the case. There are no
medical records after the death from the saddle pulmonary embolus
because Mrs. Kn utter was cremated. While both parties to this case cite
resources indicating the likelihood of pulmonary embolism due to a wide
variety of causes, without any information regarding the location of the
blood clot or deep vein thrombosis, it is purely speculative to link the
saddle pulmonary embolism which resulted in Mrs. Knutter’s death to her
accident and injury to the right ankle about six weeks prior, much less to
find that the accident and injury is the prevailing cause.”
The Industrial Commission reversed, found the claim to be compensable (based on nothing but speculative evidence), and awarded death benefits to the surviving spouse for a death that occurred while the claimant was at home on the toilet.
Under Missouri law, the claimant has the burden of proving that the employment or work accident was the prevailing factor in causing both the resulting medical condition and disability. §287.020.3(1). That wasn’t done here.
Furthermore, section 287.190 states: “In determining compensability and disability, where inconsistent or conflicting medical opinions exist, objective medical findings shall prevail over subjective medical findings. Objective medical findings are those findings demonstrable on physical examination or by appropriate tests or diagnostic procedures.”
Even though there was no objective evidence that the death was caused by the work injury, the Industrial Commission still awarded benefits.
The current chair of the Industrial Commision, John Larson, knows that by basing a decision on the credibility of the witnesses, the Court of Appeals cannot reverse that decision. Here, the Commission cited the medical expert hired by the claimant’s attorney as being more credible, even though that expert had no objective evidence upon which to base a medical causation opinion.
If you have any questions or wish to discuss how this decision might apply to a current claim, please feel free to call or email.