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What Do You Think: Did Hostler’s Preexisting Injuries Support Award of PTD Benefits?

20 Apr, 2023 Frank Ferreri

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Jefferson City, MO (WorkersCompensation.com) -- A preexisting condition may have no impact on a worker's claim for benefits or could be the basis for a determination that the worker has experienced a permanent disability.

A hostler for a truck company had multiple preexisting conditions that included ankylosing spondylitis, various cardiac conditions, and right shoulder pain that was associated with his repetitive single-hand cranking of jacks.

The worker experienced an injury on the job when he slipped while getting out of a truck and was left hanging by his right arm. He felt a "pop" in his right shoulder and was subsequently diagnosed with a "moderately large" rotator cuff tear and a labrum tear.

After settling his workers' compensation claim with the company, the hostler filed a claim for permanent total disability benefits against the Second Injury Fund, alleging that his preexisting conditions, combined with his primary injury, rendered him permanently and totally disabled.

In spite of a doctor's opinion that the there was "significant synergistic effect" between the hostler's preexisting disabilities and primary injury, an administrative law judge concluded that the hostler failed to demonstrate that he suffered from a "qualifying" preexisting disability.

The full Commission agreed with the ALJ that the hostler did not show that his preexisting disabilities "directly and significantly aggravated or accelerated" his primary injury.

The hostler appealed to the Missouri Supreme Court.

Under Missouri law, to receive PTD benefits from the Fund, an employee must:

  1. Have a qualifying preexisting disability.
  2. Sustain a subsequent compensable work-related injury that, when combined with the preexisting disability, results in a permanent total disability.

Did the hostler have a qualifying preexisting disability?

A. Yes. The hostler's preexisting injuries made the primary injury worse.

B. No. The evidence did not show that the hostler's primary injury was exacerbated by the preexisting conditions.

If you went with B, you went with the court Swafford v. Treasurer of Missouri, 659 SW 3d 580 (Mo. 2023). which upheld the lower rulings and determined that the hostler did not "clearly articulate the extent to which any of those [preexisting] disabilities exacerbated" his primary injury.

The court also noted that although the doctor stated that there was a "significant synergistic effect" between the hostler's preexisting disabilities and primary injury, that language referred to the relevant statute as it existed prior to amendments that went into effect in 2013.

Post-2013, "significant synergistic effect" was a lower standard to meet than the "directly and significantly aggravates or accelerates" language.

To get there, the court turned to Webster's to define the following:

TermsDefinitions
AggravateTo burden and to add weight to
AccelerateTo hasten the ordinary progress or the development of and increase the rate or amount of
DirectCharacterized by or giving evidence of a close especially logical, causal, or consequential relationship
SignificantDeserving to be considered

So, put it all together, and the court reasoned that the impact of preexisting conditions disabilities on the primary injury must be more than incidental. Instead, they must clearly exacerbate the primary injury in a meaningful way.

Because the hostler could not make this showing regarding his injuries, the court found that he was not entitled to PTD benefits from the Fund.

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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law.

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