Case Law Updates Simon Law Group, P.C.

Attorney Profiles

Case Law Updates

Simon Law Group, P.C.

701 Market Street, Suite 340, St. Louis, MO 63101

314-621-2828

Case Law Updates

Missouri Workers' Compensation

Simon Law Group, P.C. has established this page to inform clients and colleagues of recent, pertinent case law. This site is updated quarterly. Complete quarterly case law updates are available in Adobe Acrobat format (*.pdf) by clicking on the link next to each update. (Acrobat Reader required).

April 2024 - June 2024

Injury is Not Compensable Because Work Was a Triggering or Precipitating Factor

Employer Did Not Waive Its Right to Select Medical Providers for Claimant's Future Treatment

Claimant Sustained Compensable Mental Injury Due to Actual Work Events That Would Have Caused Unusual and Extraordinary Stress to a Reasonable Highway Worker

Evidence of Extraordinary and Unusual Stress Must Meet Required Objective Standard

Medical Evidence in PTD Cases Must Be Credible and Persuasive

Evidence Must Be Convincing that Claimant's Combination of Qualifying Preexisting Disability and Primary Injury Rendered Claimant PTD

Occupational Diseases Are Compensable Pre-Existing "Injuries" As Defined by Statue to Trigger SIF Liability for PTD

Claimant Must Show Preexisting Disability Reaches Necessary Threshold for SIF Liability for PTD

Untimely Notice of Appeal Dismissed

January 2024 - March 2024

Expert Must Consider Only Qualifying Pre-Existing PPD

Employer Liable for PTD From Primary Injury Alone Despite Conservative Treatment

"Right to Control" Establishes Employment

Must Consider "Usual Wages From Similar Services" For Volunteer Workers

October-December 2023

Ex-Spouse Does Not Qualify as Dependent for Death Benefits Under Statute

Claimant Must Present Persuasive and Credible Expert Testimony of Qualifying Preexisting Disability to Be Awarded PTD from Fund

Employer's Untimely Answer Results in Admission of Factual Allegations but Not Legal Conclusions Regarding Issues of Prevailing Factor in Occupational Diseases

Claimant Must Submit Evidence Constituting a Prima Facie Case Showing Incident was Compensable

Parties Can Stipulate to Settlement and Modify the ALJ's Award After Medical Fee Dispute Hearing

Complex Issues Involving Medical Causation from Occupational Exposure Must be Based on Persuasive and Credible Expert Medical Testimony, Not Common Knowledge

July-September2023

Defense of Lack of Written Notice Fails when Employer Received Actual Notice

Claimant Found PTD for Back Injury, in Insolation, Despite Subsequent Neck injury

PTD Awarded on Vocational Expert's Opinion Based only on Qualifying Pre-Existing Disabilities

Second Injury Fund Required by Statute to Pay Medical Bills of Uninsured Employer but Claimant is not Entitled to Windfall from Medical Payment

Settlement of a Primary Injury is Relevant Evidence in a Hearing Regarding Fund Liability for PTD

An Award for PTD Cannot be Based on Medical Opinions which Include any Non- Qualifying Pre-Existing Disabilities

Commission has Authority to Determine Fair and Reasonable Attorney's Fees

April 2023 - June 2023

Claimant Must Meet Burden to Show Job Duties, and Not Repetitive Activities at Home, are the Prevailing Factor in Causing Occupational Disease

Benefits Denied When Claimant Did Not Sustain an Accident or Fall but Instead Incurred Heat Exhaustion Which is a Risk He Would be Equally Exposed to Outside of Work

Section 287.780 Does Not Prohibit an Employer from Discriminating Against a Former Employee for Exercising Their Workers' Compensation Rights

Claimant Properly Awarded Benefits for PTSD When Evidence Demonstrated Employer/Insurer Must Have Authorized the Treatment for Medical Provider to Have Standing in Medical Fee Dispute

For SIF PTD Liability, Claimant Must Meet 50 Week Threshold for Each Separate Body Part for Pre-existing Disability to Qualify

January 2023 - March 2023

Claimant Must Establish a Medically Documented Pre-existing Condition Significantly Aggravated the Primary Injury

Claimant's Medical Evidence Must Show Pre-existing Disability Significantly and Directly Aggravated the Primary Injury

Claimant Must Present Evidence Required to Meet All Statutory Requirements to Show PTD

Claimant Found PTD, After ALJ Determined MMI for All Conditions

Objective Symptoms at Time of Accident Include Indications of Injury Perceptible to Others

Claimant Not Entitled to Additional TTD Benefits After MMI Because Refusal to Look for Work is Not Inability to Work

Awarding of Attorney's Fees is in the Discretion of ALJ

Under Strict Construction, There are No Exceptions for the Late Filing of an Application for Review

October 2022 - December 2022

Tripping Over Pallet is Not a Hazard Which Employee is Equally Exposed Outside of Work

Work Accident Was Not the Prevailing Factor, Because Based on Credible Expert Testimony and Prior Medical Records, Claimant had Symptoms Prior to Date of Injury

Claimant Met Objective Standard of Extraordinary and Unusual Stress Involving Police Shooting Incident

Claimant Has Burden of Proof to Show That a Contract of Employment Was Entered Into in the State of Missouri to Establish Jurisdiction

Work Injury Alone Sufficient for PTD Where Restrictions Are Result of Accident Despite Significant Pre-Existing Conditions Prior Disabilities Must Individually Meet Fifty Week Threshold for Second Injury Fund Liability for PTD

To Establish a Claim Against the SIF, The Claimant Must Meet the Burden of Persuasion That a New or Second Injury Occurred

Settlement of Civil Suit Against Uninsured Employer Barred Recovery From Second Injury Fund for Medical Expenses Under Workers' Compensation Statute

Claimant is Not a Statutory Employee Unless Performing Activities Within the Usual Business of Alleged Employer

July-September 2022

New Claim for Wrist Denied Following Settlement of Earlier Claim for Repetitive Injury to Same Upper Extremity

Claimant Must Present Sufficient Evidence to Establish that a Work-Related Exposure is The Prevailing Factor Causing Occupational Disease

Claimant's Bilateral Carpal Tunnel Syndrome Resulted from Longstanding Occupational Exposure from First Employer Despite Limited Exposure with Concurrent Second Employer

Evidence Must Persuasively Establish that Work Related Injuries Combine with Pre-existing Conditions to Render Claimant PTD.

No Fund Liability for PTD When Claimant Failed to Establish a New, Second Work Injury Combined with First Work Injury Alone Rendering Claimant PTD

Fund Can Receive Reimbursement from Uninsured Employer Absent at Hearing When Appeal is Not Timely Filed

Employer Cannot Claim Sovereign Immunity as School District Under Work Comp Law

Must Consider Number of Hours Needed to Qualify as Full Time Employee for Specific Employer to Calculate AWW

April - June 2022

Knee Injury Sustained While Turning Not Compensable as Equally Exposed to Risk in Normal Non-Employment Life

Injury Compensable as Claimant Not Exposed to Twisting in Tight Space and Working at Fast Pace Outside of Work in Non-employment Life

Sitting in Parked Vehicle on Public Street is Non-compensable as a Risk Source of Injury for Which the Public is Equally Exposed

Claimant Must Show a Causal Link Between Work Activities and New Alleged Injury After Prior Settlement For Fusion Surgery

Claimant Must Prove Work is More Likely Than Not the Prevailing Factor of Carpal Tunnel and Not One of Several Factors Such as Age and Prediabetes

The Employer and Insurer on the Day of Last Exposure Prior to the Date of Injury are Liable for the Toxic Exposure; Also, Date of Injury is Date of Diagnosis

A Preexisting Non-Compensable Injury Does Not Qualify as a Preexisting Condition Under the Statute for Fund Liability if it is Unrelated and Does Not Aggravate or Accelerate the Primary Injury

Only Qualifying Pre-existing Conditions Can be Considered When Determining Fund Liability; Also Life Factors Can be Considered in Determining PTD

Under Strict Construction, No Temporary Benefits Are Payable After Termination for Positive Drug Test After Primary Injury; Also, Work Accident Must Cause Mental Injury to be Compensable

Court Undecided if Prior Employee Has Standing Under the Statute for Retaliation Claim for Refusal to Rehire

Commission's Authority to Assess Costs Against a Party is Discretionary

Medical Provider Not Entitled to Prejudgment Interest Under Statute

January 2022 - March 2022

By Inhaling Fumes The Claimant Sustained an Accident But Failed to Prove Prevailing Factor For PPD

Claim Denied for Disability From Blood Clots Based on History of Unrelated Health Problems

Claimant Failed to Show Employer Refused or Failed to Provide Treatment

ALJ Failed to Consider Expert Testimony that Prior Conditions Aggravated Primary

Injury for SIF Liability Claimant Allowed to Submit New Evidence to Meet New PTD Standards Against SIF

Uninsured Employers Appeal Denied for Failure to File Bond

Civil Actions Against Co-Employees Must Show Negligence for an Unforeseen Risk Beyond the Non-Delegable Duty of Employer to Provide Safe Workplace

Personal Liability of Co-Employee Must Be Unforeseen Risk of Intended to Cause Harm

October 2021 - December 2021

Need for Total Knee Replacement Necessitated by Work Injury

Claim Denied as Claimant’s Injuries Sustained in Motor Vehicle Accident After Choking on Breakfast Sandwich Not Sustained in Course and Scope of Employment

Testimony of a Vocational Expert Relying on Hearsay Found Admissible

Expert Need Not Have Specialized Knowledge of Workers’ Compensation Law to Qualify as Expert Witness

Fund Liable for Benefits as Priors Met Criteria for Fund Liability

Commission’s Decision Reversed After Substituting Own Opinion in Lieu of Qualified Medical Expert’s Opinion

Fund Not Responsible for PTD Benefits as No Evidence That All Claimant’s Pre-existing Disabilities Met Threshold for Fund Liability

Co-employee Immune from Liability for Claimant’s Injury Absent Intention to Cause or Increase Risk of Injury to Claimant

ALJ Has Authority Reopen a Record After a Hearing Before Final Award

July 2021 - September 2021

Claimant Denied PPD For Compensable Injury as Claimant Not Credible, Testifying Inconsistently with Testimony of Treating Physicians

Experts Who Reviewed Surveillance Found More Persuasive than Experts Who Relied on Subjective Evidence

Pre-existing Work Injury Involving Three Different Body Parts Which Settled for 43% or 172 Weeks Qualifies for Fund Liability as Each Body Part Would Meet 50 Week Threshold

Fund Liable for Benefits as Primary Injury Combined With Three Qualifying Pre-existing Conditions to Render Claimant PTD

When Looking at Qualifying Pre-existing Disabilities, Filing a Claim and Receiving PPD is Just One Factor to Look at When Determining Fund Liability

Consideration of Multiple Qualifying Pre-existing Disabilities Allowed in Determining PTD Fund Not Liable for Benefits Because Prior Settlement of 15% of Body Referable to Back and Bilateral Knees Did Not Qualify as Pre-existing Disability

Fund Responsible for Benefits As Both Pre-existing Conditions, Including Polio, Found to be Qualifying Pre-existing Conditions

Commission Decision Reversed After Erroneously Asserting Own Opinion on Matter of Casuation

Claimant Failed in Burden of Persuasion as Commission Had Province to Believe or Disbelieve Witness

Employer/Insurer Responsible for PTD for 2015 Low Back Injury Despite Subsequent Neck Injury in 2016 Because Despite Continuing to Work Claimant was Highly Accommodated After 2015 Injury

Employer/Insurer Responsible for PTD Due to Conservatively Treated Low Back Injury, Despite Claimant’s History of a C3-C7 Cervical Fusion

Claimant PTD Due to Hearing Loss and Pre-existing Disability so Fund Responsible for Benefits

Claimant Able to Move Forward with Appeal as Application for Review Complied with Statute Despite Cover Sheet Not Being Detailed

April-June2021

Claim Denied Because Changing Directions When Walking Not Related to Employment

Claim Denied as Twisting and Turning Was Not a Condition of Claimant’s Employment or Necessary for Performance of Job Duties

Application of §287.140.4 (post January 1, 2014) Proper When Date of Service and First Notice of Dispute Occurred After Section Became Effective in 2014 Claim Denied Because Claimant Found Not Credible and No Evidence of Injury in Medical Records

Claim Denied as Claimant Testified Additional Job Duties Caused Symptoms But No Doctor Connected His Condition to Those Additional Job Duties Claimant’s Shoulder Arthroplasty Found Not Work Related

Commission Erred in Finding that Claimant Must Prove PTD Resulting From a Combination of the Primary Injury and a Single Qualifying Pre-existing Condition

Both Claimant’s Physical Condition as well as Non-medical Considerations Such as Age, Education and Transferable Work Skills Can Be Considered When Analyzing Whether Claimant is PTD

All of Claimant’s Preexisting Disabilities Being Considered for Fund Liability Have to Meet Criteria in Statute; Also Qualifying Preexisting Conditions Do Not Have to be at MMI Prior to Primary Injury

Claimant Could Not Pursue Civil Suit Due to Workers’ Compensation Exclusivity

Claimant’s Injury Resulting in Death Compensable so Claimant Could Not Pursue Civil Liability Due to Exclusive Remedy

Civil Claim Barred as Contractor Found to Be Statutory Employer

Employee’s Use of Hairdryers Prevailing Factor in Mesothelioma But Claimant Not Entitled to Enhanced Benefits as Employer Not in Business to Have Elected Them

Expert Credible Despite Providing Alternative Opinions For Party Responsible for PTD

Claimant PTD as Result of 3 Elbow Surgeries and Employer Liable for Medical Treatment Despite Claimant Initially Treated On Own

Mere Mention in Award that Claimant Was Married Insufficient to Establish Dependency at the Time of the Injury

January 2021 - March 2021

Claim Denied as Claimant Not in Course and Scope Because No Hazard Connected to Employment Caused Falls

Post Injury Misconduct Proven Therefore TTD Benefits Not Owed

Application for Payment of Additional Reimbursement of Medical Fees Dismissed Because Not Filed Within One Year of Notice of Dispute

Claimant Not Entitled to Past Medical Expenses Because No Demand Made or Notice Given to Employer

Claimant Not Entitled to PTD From Fund Because No Documented Pre-existing Disability Qualified Per Statute

Fund Not Responsible for PTD Because Claimant PTD Prior to Last Injury

Claimant PTD From Last Injury Alone Therefore Not Entitled to Fund Benefits

Claimant Failed to Meet Burden Entitling Him to Fund Benefits

Missouri Claim Denied as Claimant's Kansas Settlement Entitled to Full Faith and Credit

October - December 2020

Claimant’s Accident Compensable as Risk Source was Driving/Conditions of Road, Not Choking on Breakfast Sandwich, but Employer Entitled to Reduction in Benefits for Safety Violation

Claimant’s Condition Not Compensable as Workplace Stress Not Extraordinary and Unusual

Claimant’s Shoulder Condition Denied as Employer’s Expert More Credible than Claimant’s Expert

Claimant’s Unauthorized Surgery Not Compensable due to Pre-existing Condition, Gap in Treatment and Subsequent Exacerbation of Symptoms Surgery and Pulmonary Emboli Claim Filed Against Fund Denied Because Not Timely Filed

Claimant’s Claims Against the Fund Denied Based on The Statute of Limitations

Court Upheld Commission’s Dismissal of Claimant’s Fund Claim for Failure to Prosecute

Employer Responsible for PTD Benefits Due to Left Knee Surgery and Pulmonary Emboli

Employer Responsible for PTD Benefits Despite Claimant’s Pre-existing Conditions Including Bilateral Shoulder, Back and Carpal Tunnel Surgeries Employer Responsible for PTD Benefits Due to Left Knee Surgery and Pulmonary Emboli

Fund Not Responsible for PTD Benefits as No Evidence That All Claimant’s Pre-existing Disabilities Met Threshold for Fund Liability Employer Responsible for PTD Benefits Due to Left Knee Surgery and Pulmonary Emboli

Civil Claim Barred Against Distributer as It was Found to Be Claimant’s Statutory Employer

July 2020 - September 2020

Fall not Compensable Because Stairs Were Risk Source Claimant Equally Exposed to in Nonemployment Life

CNA’s Bilateral Carpal Tunnel Syndrome Compensable Despite Other Risk Factors Claimant Awarded Future Medical Treatment in Accordance with Expert Testimony

Dependents Denied Benefits as No Evidence in Award Showing Dependency of Wife or Children On Date of Injury

The Claimant Failed to Prove his Pre-Existing Disabilities Combined with His Work Injury Rendering Him PTD

Fund Found Responsible for PTD Benefits Due to No Medical Expert Testifying that Claimant PTD Due to Last Injury Alone

Fund Liable for PTD Benefits as All Pre-existing Disabilities Can be Considered as Claimant Had One Pre-existing Disability Which Met Fund Liability under §287.220.3

Claimant Failed to Prove His One Qualifying Prior Disability and Work Injury Combined to Make Him PTD and Therefore Benefits From Fund Denied

Claim Against Fund Denied as PTD Arose Solely From Work Injury Employer Responsible for PTD Benefits After Right Shoulder Injury Despite Claimant’s Pre-existing Conditions

Due to Chronic Pain and Physical Impairment Claimant Found PTD as Result of Work Injury

Claimant’s Work as Hairdresser Prevailing Factor to Causing Mesothelioma

April 2020 - June 2020

Court Found Civil Procedure Rule Regarding Time Limit For Substitution of Parties Did Not Preclude Final Award

Commission Found Claimant’s Application for Review Deficient as Claimant Did Not Explain why ALJ Ruling was in Error

Employer’s Application for Review Dismissed because Untimely Filed Claimant Entitled to Review of all Motions While Application Pending Before Commission

Payments Made on Kansas Claim Tolled Statute of Limitations to File Claim in Missouri

Application for Review Submitted by Fund Defective on Face and Therefore ALJ’s Ruling Stands

Claimant Failed to Meet Burden of Proof to Show his Pre-Existing Condition Combined with the Work Injury Rendered him PTD Court Reversed

Commission’s Decision That Claimant Not PTD Due to Not Meeting Burden of Proof

Claim Not Compensable as Claimant Provoked Assault

Fund Liable for Benefits as Court Found Pre-Existing Injury Does Not Need to Be Symptomatic to Render Claimant PTD

Fund Liable for Benefits After First MMI Release as Claimant’s Condition Did Not Improve with Subsequent Treatment

Claimant’s Death Due to Hyperthermia Found Work Related

Last Employer to Expose Claimant to Asbestos Responsible for Benefits Claimant’s Work as Hairdresser Not Prevailing Factor in Causing Mesothelioma

January 2020 - March 2020

COVID – 19 & Missouri Workers’ Compensation

Claimant’s Fall Not Compensable Because Claimant Just Walking Claim Denied as Claimant’s Condition Due to Degenerative Conditions and Not Unexpected Traumatic Work Accident

Tinnitus Found Not Work Related

Claimant Entitled to Future Medical Treatment as the Need for Future Medical Care Flowed Directly from the Work-Related Injuries

Part-time Claimant Entitled to Rate Based on Forty Hour Work Week, Not 30 Hour Rule

Commission Affirmed ALJ’s Award of Permanency That Did Not Take Reduction At Elbow for Compensation Placed on Wrist

Claimant Found to Have Minimal Pre-existing Disability in Hand Despite Prior Settlement of 15% of Hand

Fund Not Liable for Compensation as Claimant did not Prove Work Injury Aggravated or Accelerated Pre-Existing Conditions

SIF Not Liable for PTD benefits Because Claimant Filed Claim After January 1, 2014 and Claimant Did Not Prove Pre-existing Conditions Fell into 1 of 4 Categories

Court Confirms It Will Defer to ALJ’s Credibility Determinations Commission Does Not Have Statutory Authority to Increase Amount of PDD

Commission Does Not Have Statutory Authority to Increase Amount of PPD Claimant Received After ALJ Approved Settlement Stipulation Despite Claim that Claimant’s Condition Worsened

Claimant Entitled to TTD Despite Employer’s Allegations That Claimant Not Entitled to TTD Due to Post-Injury Misconduct Because His Absence Was Due to Injury

Claimant Not Entitled to Enhanced Benefits as Employer Could Not Elect to Accept Liability for Enhanced Benefits

October 2019 - December 2019

Claimant’s Injury after Fall in Employer’s Hallway Compensable

Injury Sustained in Motor Vehicle Accident While Claimant Eating Breakfast Sandwich Not in the Course and Scope of Employment

Claim Denied as Claimant’s Condition was Due to Degenerative Condition, Not His Job Duties

Fund Not Responsible for Benefits Because Claimant PTD Before Primary Injury

Claimant PTD Due to Primary Knee Injury and Pre-existing Condition

Claimant Not PTD as Claimant Did Not Meet Her Burden of Proof Based on Her Self-Reported Limitations and Her Expert Evaluation

Court Overturned Commission’s Decision that Claimant Not PTD Because Award Not Supported by Sufficient Competent Evidence

Fund Liable for PPD Benefits Even Though Occupational Disease Claim Filed in 2016 Because “Injury” was Prior to January 1, 2014

Claimant Awarded Compensation for Wife’s Nursing Care After Employer Denied Necessary Nursing Care Services

Court Increased Commission’s Award of 5% PPD to 20% Due to Objective Testing and Findings

July 2019 - September 2019

Claim Not Compensable Because Accident Caused Aggravation of Pre-Existing Condition but not a New Injury

Claimant Not Injured in Course and Scope of Employment After Falling in Parking Lot Because Equally Exposed to Hazard or Risk of Tripping on Parking Island Outside of Work in Normal Non-Employment Life

Court Reversed Commission Decision and Found Claimant Injured in Course and Scope of Employment Because the Risk or Hazard of Injury Was Slipping on Dirt/Ice on that Hallway Floor, and Claimant Was Injured in a Hallway Owned and Controlled by Employer

Court Affirms Commission’s Decision that Claimant Not Employee of Ginger C, and Ginger C Not a Statutory Employer

Employer Liable for Shoulder Replacement Despite Pre-Existing Condition Because Surgery Reasonably Required to Cure and Relieve Claimant of Effects of Work Injury

Injuries Sustained When Tripped by Authorized Treatment Provider Were Compensable

April 2019 - June 2019

Work Accident Prevailing Factor in Causing Ankle Injury and Resulting Disability, Including Death Due to Pulmonary Embolism

Claimant’s Work as Firefighter Prevailing Factor in Development of Non-Hodgkin’s Lymphoma and Claimant’s Death

Court Reversed Circuit Court Decision Granting Summary Judgment Finding a Genuine Issue of Material Fact as to Whether Defendant Engaged in Affirmative Negligent Act That Purposefully and Dangerously Caused or Increased Risk of Injury to Employee

Compensable Injury Because No Evidence Claimant was Equally Exposed to Hazard or Risk of Injury of Pulling 2-Wheeled Cart Through Congested Doorway Outside of Work in Non-Employment Life

Claimant Not Injured in Course and Scope of Employment Because Equally Exposed to Risk Source of Descending Stairs Outside of Work in His Normal Non-Employment Life

Windsor Not Liable for Benefits as Statutory Employer, Because ALJ Found No Joint and Several Liability with Primary Employer, A Staffing Agency

Court of Appeals Reversed Commission Decision and Found That Employer That Went Out of Business Before 2014 Could Still Be Liable for Enhanced Benefits by Fully Insuring Its Liability for Occupational Disease at Time of Last Exposure

Employer/Insurer Liable for PTD After Rotator Cuff Tear Due to Permanent Lifting Restrictions, Age, Education, and Other Life Factors

Claim Barred by Statute of Limitations Because Medical Payments Made in Kansas Did Not Toll Statute of Limitations in Missouri Under Strict Construction

Claimant Not Owed Past TTD After Terminated for Post-Injury Misconduct When He Failed To Work For Several Months After Being Released From Care Without Restrictions and Failed to Follow Employer Policies

When Primary Work Injury Occurs After January 1, 2014, Claimant Not Entitled to PPD Benefits From SIF

The use of any information on this website does not create an attorney-client relationship.
© Copyright Simon Law Group, P.C. 2012-2016 Design by Neterm.Net