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RONALD MALAM, ) ) Claimant-Appellant, ) ) v. ) No. SD33620 ) STATE OF MISSOURI, DEPARTMENT ) Filed: June 24, 2015 OF CORRECTIONS, ) ) Employer-Respondent. )

APPEAL FROM THE LABOR AND INDUSTRIAL RELATIONS COMM ISSION

AFFIRMED PER CURIAM. On August 12, 2011, Ronald Malam ("Cla imant"), a correctional officer employed by the Missouri Department of Corr ections ("Employer"), was involved in an incident where he was "required to 'take down ' an uncooperative inmate." Although Claimant felt nothing unusual at the time, other th an "an adrenaline rush," the incident started a chain of events that ultimately resulted in a significant amount of hospitalization and medical treatment for a "hypertensive crisis" s uffered by Claimant. The Labor and Industrial Relations Commission ("the Commission") ultimately found the largest portion of that medical treatment to be non-compensable und er section 287.020 of the workers' compensation law. 1

1 All statutory references to section 287.020 are to RSMo Cum.Supp. 2010. All other statutory referenc es are to RSMo Cum.Supp. 2005.2 Claimant raises two points on appeal. The first cl aims that the Commission erred in finding that Claimant failed to meet his burden of proving that his "accident was the prevailing factor under [section 287.020.3(1)] in c ausing [Claimant's] hypertensive crisis" because his medical expert's report "unambiguously" opined that it was. It further asserts that the Commission "only considered the medical op inions" and ignored evidence and its own findings regarding other circumstances surround ing the accident. Claimant's second point asserts the Commission erre d in finding that Claimant failed to prove that his work accident was the prev ailing factor in causing his hypertensive crisis because "the Commission failed to first determine whether a compensable injury of any kind occurred, in that a compensable physical and emoti onal injury did result from the sudden and extreme stres ses of the accident that in turn caused the need to treat the hypertensive crisis." Finding no merit in either claim, we affirm the dec ision of the Commission. Governing Law and Applicable Principles of Review We review the findings of the Commission, not those of the Administrative Law Judge ("ALJ"). Clark v. FAG Bearings Corp. , 134 S.W.3d 730, 734 (Mo. App. S.D. 2004). To determine whether Claimant suffered a co mpensable injury, the Commission was required to utilize the statutory scheme set fo rth in section 287.020. Armstrong v. Tetra Park, Inc. , 391 S.W.3d 466, 472 (Mo. App. S.D. 2012). In per tinent part, that statute provides: 2. The word "accident" as used in this chapter shal l mean an unexpected traumatic event or unusual strain identifiable by time and place of occurrence and producing at the time objective symptoms of an injury caused by a specific event during a single work shift. An injury is not compensable because work was a triggering or pr ecipitating factor

.3 3. (1) In this chapter the term "injury" is hereby defined to be an injury which has arisen out of and in the course of em ployment. An injury by accident is compensable only if the accident wa s the prevailing factor in causing both the resulting medical condition an d disability . "The prevailing factor" is defined to be the primary factor, in relation to any other factor, causing both the resulting medica l condition and disability

. (2) An injury shall be deemed to arise out of a nd in the course of the employment only if: (a) It is reasonably apparent, upon consideration of al l the circumstances, that the accident is the prevailing factor in causing the injury ; and (b) It does not come from a hazard or risk unrelated to the employment to which workers would have been equally exposed ou tside of and unrelated to the employment in normal nonemployment life. Section 287.020.2–3 (emphasis added). 2 The determination of whether an accident is the "pr evailing factor" causing a claimant's condition is an inherently factual one. Maness v. City of De Soto , 421 S.W.3d 532, 539 (Mo. App. E.D. 2014). Under our standard of review, we "must examine the

whole record to determine if it contains sufficient competent and substantial evidence to support the award, i.e., whether the award is contr ary to the overwhelming weight of the

evidence." Hampton v. Big Boy Steel Erection , 121 S.W.3d 220, 222-23 (Mo. banc 2003). We do not review issues involving the credibility o f witnesses and the weight to be given to their testimony; instead, we defer to t he Commission's determination of all

such issues. Caldwell v. Delta Exp., Inc. , 278 S.W.3d 251, 253 (Mo. App. S.D. 2009). The Commission, as the trier of fact, is free to be lieve all, part, or none of the evidence

2 Neither party disputes that the requirements of se ction 287.020.3(2)(b) were satisfied in this case.4

presented. Mihalevich Concrete Constr. v. Davidson , 233 S.W.3d 747, 755 (Mo. App. W.D. 2007).

The Evidence After Claimant's "take down" of the inmate, he and another officer were escorting the inmate to another location within the prison. While doing so, Claimant began to notice that he was short of breath, and he "felt li ke his lungs were filling up." Claimant went to get a drink of water, and he began to spit up blood. A nurse noticed what was happening and called an ambulance. Claimant was transported by ambulance to Texas Coun ty Memorial Hospital, where he lost consciousness. Chest x-rays revealed the presence of a pulmonary edema. The impression of the treating physician, Dr. Thoma s Stubbs, was that Claimant had "severe pulmonary contusions" and "possibly had asp irated." Claimant was eventually intubated and transported t o Lester E. Cox Medical Center ("Cox") in Springfield, where he remained un conscious for approximately a week. During this period, Claimant was evaluated by sever al doctors. Dr. Timothy Woods, a pulmonary specialist, noted an abrasion to Employee 's left knee, but "no other external trauma [was] noted." Dr. Woods found, "It does not appear that the patient’s disease process is related to trauma. It is likely that tr auma precipitated the medical processes he has going on." Dr. Douglas Ham’s impression was "s ignificant congestive heart failure, pulmonary edema." Dr. Ham further stated, "It is u nclear whether this was all related to a possible cardiac contusion tipping him into the con gestive heart failure or whether he could have also had a pulmonary contusion which wor sened his respiratory and cardiac status or could have been secondary to the stress o f the altercation." According to Dr.5

Mark Anderson, a cardiologist, Claimant was sufferi ng from a "hypertensive crisis" with acute renal and respiratory failure and that he had hypotension and shock associated with the hypertensive crisis. 3 Claimant ultimately recovered with no permanent dis ability, and he has since returned to work. He sought workers' compensation reimbursement from Employer in the amount of $138,010.15 for medical expenses bill ed by Cox. 4 An ALJ denied his claim. Claimant appealed that decision to the Comm ission, which unanimously affirmed

the denial of benefits but modified the award. The Commission found that, although Claimant had suffered a work-related accident, he h ad failed to prove that the accident was the prevailing factor causing his injuries. See section 287.020. The Commission's Findings The Commission, unlike the ALJ, concluded that Clai mant had suffered an "accident" pursuant to section 287.020.2. More spe cifically, it stated: We conclude that the incident on August 12, 2011, w as (1) unexpected, (2) traumatic, (3) identifiable by time and place o f occurrence, and (4) produced at the time objective symptoms of an injur y caused by a specific event during a single work shift-namely, employee's difficulty breathing and his spitting up blood. We conclude, therefore, that employee suffered an accident.

3 Claimant quotes the Mayo Clinic's website for the definition of hypertensive crisis in his brief. Ac cording to that website: A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure — a top number (systo lic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diast olic pressure) of 120 mm Hg or higher — damages blood vessels. They become inflam ed and may leak fluid or blood. As a result, the heart may not be able to pump bloo d effectively.

M AYO C LINIC , http://www.mayoclinic.org/diseases-conditions/hig h-blood-pressure/expertanswers/hypertensive-crisis/faq-20058491 (last visi ted June 19, 2015). Upon admission to Cox, Claimant's blood pressure peaked at 252/140. 4 At the time of Claimant's reimbursement request, E mployer/insurer had already paid $6,085.46 in medic al aid for Claimant, and Claimant had also received $2 ,284.95 in temporary disability benefits.6 With regard to whether Claimant's accident was the prevailing factor causing Claimant's resulting medical condition, the Commiss ion considered the written reports of two medical experts. One of these experts, Dr. Ann e-Marie Puricelli, had conducted an independent medical examination of Claimant at Empl oyer's request. In her conclusions, where she noted Claimant's preexisting hypertension and cardiomyopathy, Dr. Puricelli opined: It is my opinion that [Claimant] went into acute hy pertensive crisis and developed hemoptysis due to the elevated pulmonary capillary pressure that occurred due to his left ventricular failure s econdary to the hypertensive crisis. He did not admittedly sustain any trauma. There was minimal exertion that occurred surrounding the subd uing of the inmate. He had not been adequately treated for his hyperten sion or his cardiomyopathy and he was drinking, admittedly, exc essive amounts of fluid per day which, in my opinion, exacerbated bot h his hypertension and his underlying cardiomyopathy. It is my opinion th at none of [Claimant]'s current diagnoses are related to any work event tha t occurred on August 12, 2011. The Commission disagreed with Dr. Puricelli's concl usion, however, explaining:

This is because Dr. Puricelli did not have the corr ect facts; she believed, for instance, that [Claimant] did not fall to the g round during the take down of the inmate. She also based her opinion, in part, on her determination that [Claimant]'s preexisting hyperte nsion was inadequately treated before August 12, 2011, but we find no clea r indication in the record that this was the case, and Dr. Puricelli do es not explain how or why she believed [Claimant]'s hypertension to have been inadequately treated. [Claimant]'s unimpeached and credible tes timony suggests (and we so find) that he was taking medications for hype rtension and was regularly seeing a physician for checkups regarding his high blood pressure before August 12, 2011. The Commission then noted that the only evidence o ffered by Claimant on this issue was the written report of Dr. Brent Koprivica , who had conducted an independent

medical examination on behalf of Claimant. In his report, Dr. Koprivica detailed7

Claimant's medical history and offered medical obse rvations and opinions. As to causation, Dr. Koprivica opined: 1. [Claimant]'s described work-related incident wi th the takedown of the offender on August 12, 2011, is felt to repres ent the direct, proximate and prevailing factor precipitating his hypertensive crisis. I would like to point out that but for the wo rk injury, it would be impossible to predict that [Claimant] would ha ve developed the hypertensive crisis that has necessitated the care and treatment that followed that event. 2. Clearly, [Claimant] had an underlying hypertens ive cardiomyopathy identified as far back as 2005. Nevertheless, the prevailing factor precipitating

the specific event were the unexpected emotional a nd physical stresses associated with restraining the offender. (Emphasis added). Noting the word "precipitating," as used in section 287.020.2, the Commission concluded, "While we believe an accident may be both a precipitating and the prevailing factor causing a compensable injury, this does not appear to be Dr. Koprivica's opinion in this case. Rather, Dr. Kopr ivica says the accident was the prevailing factor that precipitated [Claimant's] hypertensive crisis." The Commission continued: "Even if we were to credit this opinion from Dr. Koprivica, absent further explanation as to what Dr. Koprivica meant by choos ing those specific words, we simply are unable to conclude that [Claimant] has proven t he requisite degree of causation to satisfy the requirements of the statute." We find no error in this conclusion. Analysis Claimant's arguments to the contrary fail for sever al reasons. For one, Claimant ignores the fact that he had the burden of proving causation. "Medical causation, which is not within common knowledge or experience, must be established by scientific or medical evidence showing the relationship between t he complained of condition and the8

asserted cause." Gordon v. City of Ellisville , 268 S.W.3d 454, 461 (Mo. App. E. D. 2008) (emphasis added). In such situations, an injury may be of such a nature that expert opini on is essential to show that it was caused by the accident to which it is a scribed. Where the condition presented is a sophisticated injury that requires surgical intervention or other highly scientific technique f or diagnosis, and particularly where there is a serious question of p re-existing disability and its extent, the proof of causation is not within th e realm of lay understanding nor—in the absence of expert opinion— is the finding of causation within the competency of the administrati ve tribunal. Silman v. William Montgomery & Assoc. , 891 S.W.2d 173, 175-76 (Mo. App. E.D. 1995) (citations omitted), overruled on other grounds by Hampton , 121 S.W.3d 220. "Whether a particular matter is beyond lay understa nding has been treated as a question

of law." Bock v. City of Columbia , 274 S.W.3d 555, 562 (Mo.App. W.D. 2008). Here, Claimant argues that the Commission "only con sidered the medical opinions" and, as a result, "overlooked" or "ignore d" other evidence. The problem with this argument is that a "hypertensive crisis" is a sophisticated injury that could be caused by various factors. 5 Further, Dr. Koprivica -- Claimant's own expert - - noted in his

5 The Mayo Clinic’s website (cited by Claimant) prov ides: A hypertensive crisis is a severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure — a top number (systo lic pressure) of 180 millimeters of mercury (mm Hg) or higher or a bottom number (diast olic pressure) of 120 mm Hg or higher — damages blood vessels. They become inflam ed and may leak fluid or blood. As a result, the heart may not be able to pump bloo d effectively. Causes of a hypertensive emergency include:

• Forgetting to take your blood pressure medication

• Stroke

• Heart attack

• Heart failure

• Kidney failure

• Rupture of your body's main artery (aorta)

• Interaction between medications

• Convulsions during pregnancy (eclampsia)9

review of Claimant's medical records that Claimant "has a very complex history." As such, the evidence Claimant alleges the Commission ignored or overlooked — adequate treatment of preexisting conditions, no prior histo ry of hypertensive crisis, and the circumstances surrounding the accident — is evidenc e that would be insufficient to establish that Claimant's hypertensive crisis was d irectly caused by his work-related

accident instead of some other factor. 6 In this regard, Dr. Koprivica's opinion, which purp orts to address causation, was necessary to meet Claimant's burden of proof on thi s issue. However, as the Commission correctly observed, Dr. Koprivica's opinion was lim ited to a conclusory statement in his report that Claimant's accident was the "prevailing factor precipitating" his injury. The Commission's inability to determine whether Dr. Kop rivica was asserting that Claimant's work accident was "the prevailing factor" in causin g his resulting treatment and disability (the statutory requirement for compensation) or tha t his work accident was merely the main "precipitating factor" of his injury went to t he weight that the Commission afforded the opinion. Although Dr. Koprivica's phraseology might have permitted an alternative interpretation, as Claimant strenuously suggests, t his is not the standard by which we review the evidence in a workers' compensation appe al. Rather, the weight afforded a medical expert's opinion is exclusively within the discretion of the Commission. Sartor v. Medicap Pharmacy , 181 S.W.3d 627, 630 (Mo. App. W.D. 2006). Moreover, the Commission's written decision demonst rates that it found that Dr. Koprivica's conclusions, like those of Dr. Puricell i, stemmed from an incorrect

M AYO C LINIC , http://www.mayoclinic.org/diseases-conditions/hig h-blood-pressure/expertanswers/hypertensive-crisis/faq-20058491 (last visi ted June 19, 2015). 6 For a list of cases in which medical conditions ha ve been found to exceed lay understanding, see Bock , 274 S.W.3d at 562.10

understanding of the facts. Specifically, the Comm ission noted, and the record reflects, that although Dr. Koprivica's report suggested that Claimant had experienced "extreme exertion" in taking down the inmate, Claimant had c onsistently testified that the event required only "minimal exertion" on his part. 7 When expert testimony is thus impeached, the Commission is free to disregard it, even in the absence of other credible testimony.

See Seifner v. Treasurer of State-Custodian of Second I njury Fund , 362 S.W.3d 59, 67 (Mo. App. W.D. 2012) (finding that where claimant's unopposed expert testimony regarding medical causation had been impeached, the Commission was free to find in the other party's favor). For these reasons, Claimant' s first point is denied. Claimant's second point takes the position that he was not required to prove that his hypertensive crisis was a compensable injury, a rguing that the Commission should have determined "whether a compensable injury of any kind occurred, in that a compensable physical and emotional injury did resul t from the sudden and extreme

stresses of the accident that in turn caused the ne ed to treat the hypertensive crisis." Relying on Tillotson v. St. Joseph Med. Ctr. , 347 S.W.3d 511 (Mo. App. W.D. 2011),

7 The transcript from the hearing reflects that Clai mant testified as follows: [Employer's attorney:] . . . Now you told me in you r deposition that actually the exertion that you did taking him down you thought w as minimal. Is that still your testimony today? [Claimant:] Yes. [Employer's attorney:] Okay. And do you recall see ing Dr. Koprivica, who your attorney sent you to see? [Claimant:] Yes. [Employer's attorney:] Okay. Now he says in his re port, with respect to this incident, that you wrestled. I know he uses that term. I wa nt to get it so I don't -- okay. Here's the quote from Dr. Koprivi ca's report. I want to make sure I read it correctly. It's on pag e 7 of Dr. Koprivica's first report. He says in this event, i n wrestling the individual and taking him to the ground, there was extreme exertion. You don't agree with that. You told me it was minimal exertion, right? [Claimant:] Yes.11

Claimant asserts that he was only required to show that the treatment for his hypertensive crisis "flowed from" the circumstances surrounding his accident. Tillotson does not support such an argument. Unlike the instant case, there was no dispute in Tillotson that the claimant had suffered a compensable injury. See Tillotson , 347 S.W.3d at 517. The dispute there was whether the "prevailing factor" requirement in sect ion 287.020 applied to the determination of what type and extent of medical tr eatment a claimant with a compensable injury was entitled to receive. Id. at 517-18. The Western District of this Court found that the requirement did not apply to s uch a question; instead, once a compensable injury is established, the question bec omes whether, pursuant to section 287.140, the treatment that followed was reasonably required to cure and relieve the effects of the injury. Id. at 518. The flaw in Claimant's argument is that he incorrec tly conflates his hypertensive crisis with its ensuing treatment and claims that b oth flowed from some earlier injury attributable to his work accident. A hypertensive crisis is not a medical treatment. It is a medical condition. And the "prevailing factor" req uirement does apply when a medical condition or disability, i.e., an injury, is at iss ue. Compare section 287.020.3(1) with section 287.140.1; Tillotson , 347 S.W.3d at 518. As noted in Tillotson , there is a "material distinction between determining whether a compensable injury has occurred and determining the medical treatment required to b e provided to treat a compensable injury." 347 S.W.3d at 517. Tillotson involved the latter situation; this appeal involve s the former. See Armstrong , 391 S.W.3d at 472-73; Jordan v. USF Holland Motor Freight, Inc. , 383 S.W.3d 93, 95 n.4 (Mo. App. S.D. 2012).12 To be entitled to compensation for the treatment th at flowed from his hypertensive crisis, Claimant was required to first establish that his accident was the prevailing factor in causing his hypertensive crisi s. As detailed in our analysis of Point I, the Commission did not err in finding that Claimant failed to do. Claimant's second point is also denied, and the decision of the Commission is affirmed.

DON E. BURRELL, J. - OPINION AUTHOR MARY W. SHEFFIELD, P.J. - CONCURS NANCY STEFFEN RAHMEYER, J. - DISSENTS1

RONALD MALAM, ) ) Claimant-Appellant, ) ) v. ) No. SD33620 ) STATE OF MISSOURI, DEPARTMENT ) Filed: June 24, 2015 OF CORRECTIONS, ) ) Employer-Respondent. )

APPEAL FROM THE LABOR AND INDUSTRIAL RELATIONS COMM ISSION

DISSENT I must respectfully dissent. My problem with the m ajority opinion is that, although a crisis may be caused when a latent medic al condition becomes symptomatic following an accident, it is undisputed that Claima nt had absolutely no symptoms of any hypertensive crisis until he “took down” the prison er. Then, while on the job, he started to experience shortness of breath and began spittin g up blood. There was no time delay where he somehow recuperated; rather, he was transp orted by ambulance to Texas County Memorial Hospital, where he lost consciousne ss. Chest x-rays revealed the presence of a pulmonary edema. Claimant was eventu ally intubated and transported to Lester E. Cox Medical Center (“Cox”) in Springfield , Missouri, where he remained unconscious for approximately a week. During this period Claimant was evaluated by several doctors. None of the doctors at the hospit al provided evidence as to the2

prevailing cause; however, Dr. Mark Anderson, a car diologist, determined Claimant was suffering from a “[h]ypertensive crisis,” acute ren al failure, respiratory failure, and “[h]ypotension and shock following a hypertensive c risis.” Claimant had never been diagnosed with a “hypertens ive crisis” before the August 11, 2012 incident, nor has he suffered one s ince. The take-down set in motion the chain of events that culminated in $138,010.15 for medical expenses billed by Cox; in other words, but for the take-down, Claimant would not have had that particular “hypertensive crisis.” Did Claimant have a predisp osition to having this type of injury as opposed to some other, certainly, but the fact is t hat his injury was an “accident” (which the Commission found) that caused the subsequent in jury. As noted by the majority opinion, the Commission found that, although Claima nt had suffered a work-related accident, he had failed to prove that the accident was the “prevailing factor” causing his injuries. I believe that is a misapplication of th e law in parsing out Dr. Koprivica’s

words.

As the Commission found: We conclude that the incident on August 12, 2011, w as (1) unexpected, (2) traumatic, (3) identifiable by time and place o f occurrence, and (4) produced at the time objective symptoms of an injur y caused by a specific event during a single work shift--namely, employee’ s difficulty breathing and his spitting up blood. We conclude, therefore, that employee suffered an accident. According to all doctors, Claimant had preexisting hypertension and cardiomyopathy. Even Employer’s expert, Dr. Purice lli, opined: It is my opinion that [Claimant] went into acute hy pertensive crisis and developed hemoptysis due to the elevated pulmonary capillary pressure that occurred due to his left ventricular failure s econdary to the hypertensive crisis.3

At issue are the words of Dr. Koprivica: “Clearly , [Claimant] had an underlying hypertensive cardiomyopathy identified as far back as 2005. Nevertheless, the prevailing factor[s] precipitating the specific event were the unexpected emotional and physical stresses associated with restraining the offender.” The Commission challenged the meaning of “the prevailing factor precipitating” th e hypertensive event. Noting the word “precipitating,” as used in section 287.020.2,

1 the Commission concluded, “[w]hile we believe an a ccident may be both a precipitating

and the prevailing factor causing a compensable injury , this does not appear to be Dr. Koprivica’s opinion in this case.” Where both a pr eexisting cardiovascular condition and a work-related activity contribute to cause an empl oyee’s injury, the question becomes which of the contributing factors was “the primary factor, in relation to [the] other factor, causing . . . the resulting” injury. Section 287.0 20.3(1); Leake v. City of Fulton , 316 S.W.3d 528, 532 (Mo. App. W.D. 2010). In making th is determination it is important to note that “[t]he words a medical expert uses when t estifying are . . . important, not so much in and of themselves, but as a reflection of w hat impression such witness wishes to impart.” Mayfield v. Brown Shoe Co. , 941 S.W.2d 31, 36 (Mo. App. S.D. 1997). At no point in Dr. Koprivica’s opinion does he sta te that Claimant’s accident was merely a “precipitating factor” in relation to another “p revailing factor.” Rather, in evaluating the contributing factors at issue, Dr. K oprivica emphasized the role of Claimant’s accident while minimizing the role of hi s preexisting conditions: “Clearly, [Claimant] had an underlying hypertensive cardiomyo pathy identified as far back as

2005. Nevertheless, the prevailing factor[s] precipitatin g the specific event were the unexpected emotional and physical stresses associat ed with restraining the offender .”

1 All references to statutes are to RSMo Cum.Supp. 2 008, unless otherwise specified.4

(emphasis added). Given this context, Dr. Koprivic a’s use of “precipitating,” rather than “causing,” per the precise language of section 287. 020.3(1), should not be singled out in a manner which defeats his overall impression. I con clude that the Commission misapplied the law in finding that the words used did not comp ly with the statute. 2 The Commission considered two expert opinions on th e issue of medical causation and explicitly decided to not credit one of those opinions—that of Dr. Puricelli. The Commission concluded that Dr. Koprivica’s opini on did not conform to the requirements of section 287.020. It defies reason and is a misapplication of the law to

conclude that Claimant had an “accident” as defined by the statute and found by the Commission which caused Claimant to have difficulty breathing and spitting up blood, but that the immediate hypertensive crisis was not part and parcel of that accident.

Moreover “once it is determined that there has been a compensable accident, a claimant need only prove that the need for treatmen t and medication flow from the work injury.” Tillotson v. St. Joseph Medical Center , 347 S.W.3d 511, 519 (Mo. App. W.D. 2011). An employer shall provide, among other thin gs, “hospital treatment, . . . as may reasonably be required after the injury or disabili ty, to cure and relieve from the effects of the injury.” Section 287.140.1, RSMo Cum.Supp. 200 5. I would reverse the decision of

the Commission. Nancy Steffen Rahmeyer, J. - Dissenting Opinion Aut hor

2 Where the record is silent as to whether the Commi ssion disbelieved an expert medical witness, the Commission may not arbitrarily disregard the uncont radicted, unimpeached, and undisputed testimony of that witness. Bond v. Site Line Surveying , 322 S.W.3d 165, 171 (Mo. App. W.D. 2010).