Court Opinion

ID: 9646920
Source: CourtListenerOpinion
Date Created: 2023-08-23 13:16:13.429065+00
Date Added: 2024-06-11T18:11:43.648693
License: Public Domain

MAUS, Judge,
dissenting.
I dissent. It is fundamental that the liability of an employer to pay, and the right of an employee to recover, workers’ compensation is statutory. Such a cause of action is created by and is governed by Chapter 287, The Workers’ Compensation Law, RSMo 1986. The provisions of that code are to be construed as a whole. Marie v. Standard Steel Works, 319 S.W.2d 871 (Mo. banc 1959).
The basic concept of that code is that an employee has a right to compensation for disability resulting from an accident. “Accident” is defined as:
“The word ‘accident’ as used in this chapter shall, unless a different meaning is clearly indicated by the context, be construed to mean an unexpected or unforeseen event happening suddenly and violently, with or without human fault, and producing at the time objective symptoms of an injury.” § 287.020.2.
Historically, it was held that an “injury itself could not constitute the ‘event’ or ‘accident’.” Wolfgeher v. Wagner Cartage Service, Inc., 646 S.W.2d 781, 784 (Mo. banc 1983), citing State ex rel. Hussman-Ligonier Co. v. Hughes, 348 Mo. 319, 326, 153 S.W.2d 40, 42 (1941).
*645“ ‘True, proof of fault or negligence has been dispensed with, but proof of “accident” is necessary. Nor does the injury itself constitute the “event” or “accident” as held by the court of appeals. To so hold would make the Act provide for insurance against disease and injury rather than against accident. Id. 153 S.W.2d at 42 [Hussman].” Wolfgeher, 646 S.W.2d at 784.
The definition of accident was judicially modified in Wolfgeher. In that case, the employee suffered an injury to his back while moving a refrigerator although he did not perform that work in an abnormal manner or suffer a slip or a fall. Recovery was allowed because the injury itself was unexpected and arose from the employment. In so holding, the court made the following observations:
“The Missouri rule is in contrast with the overwhelming majority of states which hold that a strain is compensable even though the work being performed at the time of the injury was routine and the strain was not unusual or abnormal. IB Larson, Workmen’s Compensation Law, § 38.20 (1980) and cases cited therein. Where the performance of the usual and customary duties of an employee leads to physical breakdown or a change in pathology, the injury is compensable. (Citations omitted)....
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This concept of ‘accident’ also prevents compensation for gradual and progressive injuries which result from repeated or constant exposure to on-the-job hazards, even though the injuries are clearly work related. (Citations omitted).” Wolfgeher, 646 S.W.2d at 784, 785.
The impact of Wolfgeher has been succinctly stated by the Supreme Court in the following terms.
“The end result of Wolfgeher was to abandon a narrow construction of the term ‘accident’ and attain congruency with the majority of states which have eliminated the abnormal or unusual strain requirement for not only job related injuries but for accidents of the type suffered by Mr. Wynn — a work related heart attack during the course of his employment without regard to unusual or abnormal strain. (Footnote omitted).” Wynn v. Navajo Freight Lines, Inc., 654 S.W.2d 87, 89 (Mo. banc 1983).
However, the language in Wolfgeher has been construed to permit recovery not only for disability from a physical injury suddenly produced but for a progressive disability arising over a period of time in the absence of any sudden physical change. In dictum it has been said:
“Wolfgeher does not eliminate the statutory requirement of accident but dispenses with the employee’s need to prove abnormal or unusual strain to show an accident. In essence, Wolfgeher permits the concept of ‘accident’ to encompass gradual and progressive injuries resulting from repeated exposure to on-the-job hazards. Wolfgeher, supra, at 785.” Westerhold v. Unitog-Holden Mfg. Co., 707 S.W.2d 456, 458 (Mo.App.1986).
It is on this basis that cardiac dysrhythmia has been found to have resulted from an accident. Low v. ACF Industries, 772 S.W.2d 904 (Mo.App.1989). The same is true of “carpenter’s elbow”. Sansone v. Joseph Sansone Const. Co., 764 S.W.2d 751 (Mo.App.1989).
Nonetheless, the modification of the definition of the term “accident” accomplished by Wolfgeher, has not been reconciled with the balance of the code, the terms of which contemplate an accident to be “an unexpected or unforeseen event happening suddenly and violently.”
An example is the following statutory definition: “The terms ‘injury’ and ‘personal injuries’ shall mean violence to the physical structure of the body.... These terms shall in no case except as specifically provided in this chapter be construed to include occupational disease in any form....” § 287.020.3.
The basic liability of an employer is created by the following language.
“Every employer ... shall be liable, irrespective of negligence, to furnish compensation ... for personal injury or death of the employee by accident arising out of and in the course of his em-*646ployment_” § 287.120.1. (Emphasis added.)
It is difficult to rationalize that an injury can be found to be caused by accident arising out of and in the course of employment merely because it is a work-related injury.
In this case, the “accident” of April to September 1987 was neither evidenced by a sudden injury nor by an event. There was no “triggering cause”. The disability was manifested by gradually increasing symptoms and complaints. The facts of the case raise a question of compensability even under Wolfgeher, as there was neither a sudden injury nor an event. For example, a carpal tunnel syndrome occurring gradually has been declared to be an occupational disease. Collins v. Neevel Luggage Manufacturing Company, 481 S.W.2d 548 (Mo.App.1972); Jackson v. Risby Pallet and Lumber Co., 736 S.W.2d 575 (Mo.App.1987). This case could also raise a question of the application of the “Second Injury Fund” statute. § 287.220.
However, it is not necessary to resolve those issues to decide this case. I believe Rector’s claim of disability from the “accident” of April through September is barred by the settlement of his claim arising from the accident in July 1986 in which he suffered a herniated intervertebral disc.
That settlement, in part, recites:
“[T]hat on or about the 23rd day of July, 1986, Harvey Rector, while in the employ of City of Springfield, sustained an accident arising out of and in the course of employment in Springfield, Greene County, Missouri; that said accident resulted in an injury to body as a whole, approximately 15 percent permanent partial disability; ...
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“that there is now a dispute between the employer and employee as to nature and extent of disability; that because of said dispute it is agreed by said parties to enter into a compromise to sum settlement under Section 287.390 RSMo., 1969, for the payment of a lump sum of ...”
The reference in that recitation to “body as a whole, approximately 15 percent permanent partial disability” is not a determination that Rector sustained disability of 15% from the July 1986 accident. The Schedule of Losses for various parts of the body does not include the back. The use of the words “approximately 15 percent permanent partial disability” is a reference to the fact Rector suffered a back injury. The compromise settlement approved by the commission does not fix the extent of Rector’s disability from the July 1986 accident at 15%. It was not unexpected that he would return to work and wear a gun belt. Moreover, it was contemplated that Rector would suffer from continuing disability, including pain and discomfort in physical activities. Whether that disability was 5% or 35%, his disability arising from that accident has been compromised and settled by the lump sum settlement.
The scope of review by this court has been defined by statute. That statute, in part, provides:
“I. ... The court, on appeal, shall review only questions of law and may modify, reverse, remand for rehearing, or set aside the award upon any of the following grounds and no other:
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(4) That there was not sufficient competent evidence in the record to warrant the making of the award.” § 287.495.-1(4).
That authorization is to be applied in the light of the following mandate.
“In a workers’ compensation case, the claimant carries the burden of proving all essential elements of the claim. (Citation omitted).” Fischer v. Archdiocese of St. Louis, 793 S.W.2d 195, 198 (Mo.App.1990).
The only evidence in this case to establish there was an injury or an accident from April to September 1987 is evidence of increased complaints concerning back pain. The claimant admitted suffering increased back pain in February 1987, even before the lump sum settlement was approved on April 8, 1987. The claimant’s right to recover rests solely upon the testimony of William P. Folck, M.D. His testimony includes the following:
“[CROSS-EXAMINATION BY MR. GEISLER]:
*647Q. Doctor, based upon the July 23rd, 1986 accident, it’s my understanding that it’s your opinion that Harvey Rector sustained a permanent partial disability of 20 percent to the body as a whole?
A. Yes.
Q. And that injury resulted in surgery which was performed by Dr. Whitlock on September 13, 1986, correct?
A. Yes.
Q. What type of surgery was that?
A. It was removal of a herniated inter-vertebral disk [sic], according to Mr. Rector.
Q. Is that a fairly serious back injury?
A. I consider it serious, yes.
Q. With a fairly serious back injury, would you expect a person such as Harvey Rector to even after surgery have back pain?
A. I would expect him to, yes.”
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Q. He basically said that after he returned to work, he found that he had back pain which he attributed to the wearing of the uniform and sitting in and driving a patrol car? I’m sorry, let me rephrase it. In other words, when you saw him on March 3rd, 1988, he basically told you that the pain and the discomfort he attributed to the wearing of an ammunition belt and gun and sitting in a patrol car for long periods of time?
A. That is correct.
Q. That did not surprise you, did it, Doctor?
A. I felt that he would have that problem. No, I was not surprised; surprised only to the extent.
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Q. When you saw Mr. Rector on March 3rd, 1988, did he complain about any portion of his body different from what he complained to you about when you saw him on February 3rd, 1987?
A. No.
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Q. As I believe, Doctor, you’ve indicated, the fact that he returned and complained of these complaints did not surprise you because you were aware of his serious back injury, correct?
A. I was not surprised that he was having troubles; I was surprised only to the extent.”
The nature of the claim under consideration can best be visualized by contemplating the allegations of the claim Rector would have filed if he had not entered into the compromise settlement. If the settlement process is to have meaning, the amendment of the definition of “accident” to include gradual and progressive injuries, must be construed to exclude symptoms arising from an initial injury even though those symptoms are more severe than anticipated.
The “extent” of the disability arising from the accident of July 1986, whether expected or unexpected, was determined by the settlement of April 8,1987 and compensated by the lump sum settlement. This settlement was conclusive and bars the present claim resulting from unexpected complaints. Rector has not carried his burden of proving that his increased complaints were caused by a second accident, even as that term is defined by Wolfgeher. For this reason, I would reverse the award of compensation.