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Bowman v. Central Missouri Aviation, Inc.

Court of Appeals of Missouri, Western District, Second Division

August 23, 2016

JAMES C. BOWMAN, Appellant,

         Appeal from the Labor and Industrial Relations Commission

          Before: Karen King Mitchell, Presiding Judge, and Cynthia L. Martin and Gary D. Witt, Judges.

          Karen King Mitchell, Presiding Judge.

         James Bowman appeals from a decision of the Labor and Industrial Relations Commission denying his claim for workers' compensation benefits. Bowman raises three claims on appeal: (1) the Commission erred in discrediting Bowman's medical expert; (2) the Commission erred in finding Bowman's preexisting psychological injury to be the prevailing factor in his disability; and (3) the Commission erred in finding that the Second Injury Fund had no liability to Bowman. Finding no error, we affirm.


         On June 20, 2005, Central Missouri Aviation (CMA) hired Bowman as a line technician. His duties were directing traffic on the tarmac, cleaning and servicing planes, fueling planes, putting planes up in the hangar or pulling planes out of the hangar, catering, and attending to any other customer needs.

         On July 16, 2007, a pilot who had just arrived approached Bowman and advised Bowman, "You need to get in there and do the lav." Bowman responded, "There's already somebody in there, you don't need to reiterate." The pilot then pressed his left forearm against Bowman's chest, placed his right hand around Bowman's throat, and pushed Bowman against the nose of the plane. The incident lasted approximately five seconds. Bowman suffered no physical injuries as a result of the incident, but he felt scared, confused, and helpless because everyone in management at CMA had already left for the day, so there was no one to whom he could immediately report the incident. That night, Bowman had difficulty sleeping and trouble concentrating because he felt violated. Bowman contacted the human resources representative the following day to report the incident, and he requested medical help to deal with the situation. CMA refused to pay for any medical treatment beyond the health insurance it was already providing for Bowman. Bowman did not work again after that day. On December 14, 2007, CMA terminated Bowman's employment for lack of attendance.

         Bowman sought out psychological treatment on his own at Green Meadows Adult Psychiatry Clinic (Green Meadows). Bowman had previously sought treatment at Green Meadows on May 4, 2007, shortly before the incident with the pilot, because his girlfriend and roommate had become concerned with his behavior. Bowman had begun screening people as they came into his home, and he was experiencing problems with intense anxiety, agitation, feelings of insecurity, nervousness, and paranoia. During the May 4, 2007 evaluation, Bowman revealed that, in January 2003, an armed intruder entered his home, struck him with a gun, forced him to drive somewhere, then stole his money, kicked him out of the car, and drove away. Bowman felt helpless and frantic during the incident, believing that he would be killed. Afterward, he suffered from acute sleep problems (resulting from fear) and felt insecure, hopeless, afraid, and unsettled. He became isolated and distrustful of people, but, as time passed, he found it easier to leave his home and to work. Bowman also revealed, during the evaluation, that he had been in a rehabilitation program twice for marijuana usage. The evaluation resulted in a diagnosis of generalized anxiety disorder.

         Following the 2007 incident with the pilot, Bowman received therapy from Linda Hodges. Ms. Hodges discussed the symptoms of post-traumatic stress disorder (PTSD) with Bowman, and he agreed that the diagnosis of PTSD "fits [him] to a 'T'" because he experienced many of those symptoms following the 2003 kidnapping. Ms. Hodges suggested to Bowman that his response to the 2007 work incident likely would not have been so severe had he not experienced the 2003 kidnapping.

         On January 24, 2008, Bowman filed a claim for workers' compensation, claiming psychological injuries from the July 16, 2007 incident with the pilot. Bowman alleged that he was permanently partially disabled. To support his claims, Bowman underwent an evaluation by psychiatrist Dr. A. E. Daniel. Dr. Daniel concluded that Bowman is permanently and partially disabled and that the 2007 work incident was "the sole prevailing factor in the causation of his disability." CMA retained Dr. Wayne Stillings to conduct a separate evaluation. Dr. Stillings concluded that Bowman was "probably disabled from employment, " but determined that the disability was "due to pre-existing psychiatric problems." Specifically, Dr. Stillings opined that Bowman's need for psychiatric treatment "is prevailingly causally related to his pre-existing, inherent psychiatric disorders and possibly the life-threatening incident in 2003, neither of which was aggravated by the 07/2007 work incident."

         The Administrative Law Judge (ALJ) found "Dr. Stillings'[s] opinions regarding the cause of [Bowman]'s PTSD . . . much more persuasive than those of Dr. Daniel." The ALJ noted:

While I would disagree with Dr. Stillings'[s] apparent opinion that the July 16, 2007 incident did not "exacerbate" (at least temporarily) [Bowman]'s pre-existing PTSD, the remainder of Dr. Stillings'[s] opinions appear much more in line with the facts of the case than do Dr. Daniel's opinions.

         The bases for the ALJ's rejection of Dr. Daniel's conclusions are as follows:

I find it very difficult to believe that Dr. Daniel did any type of thorough review of [Bowman]'s treatment records, particularly the records from Green Meadows Adult Psychiatry Clinic. Dr. Daniel obviously did not know that [Bowman] was having panic attacks 2-3 times a month prior to July 16, 2007. It is almost impossible to believe that Dr. Daniel reviewed the August 1, 2007 [report] . . . where [Bowman] and his therapist agree that [Bowman] suffered from classic PTSD symptoms from and after the 2003 robbery/kidnapping incident. As Dr. Daniel also states "(d)etailed inquiry did not indicate that [Bowman] has any substance abuse-related legal or occupational problems[, ]" it is extremely difficult to see how he could miss the references to [Bowman]'s daily marijuana use in the July and August 2007 records, and how he could not see that [Bowman] was being treated for "cannabis dependence" and how Dr. Daniel could miss the many references to [Bowman]'s legal problems involving marijuana possession, drug court[, ] and probation.

         The ALJ concluded that Bowman's "PTSD was caused by the 2003 robbery/kidnapping incident, and not by the July 16, 2007 incident[, ]" which "was nothing more than a triggering or precipitating factor in an exacerbation of the already-existing symptoms of the already-existing PTSD." The ALJ expressly found the 2007 work incident "was NOT the prevailing factor in the cause of [Bowman]'s PTSD. The 2003 robbery/kidnapping incident WAS the prevailing factor in the cause of [Bowman]'s PTSD." Upon determining that the 2007 work incident was not the prevailing factor in causing Bowman's PTSD, the ALJ found "there is no 'compensable injury'" and denied all of Bowman's claims.

         Bowman applied to the Commission for review of the ALJ's decision. The Commission upheld the ALJ's determination but issued a supplemental decision, incorporating the ALJ's decision "to the extent not inconsistent with [the] supplemental decision." In the supplemental decision, the Commission noted the starkly contrasting opinions of Dr. Daniel and Dr. Stillings, but stated: "[O]ur analysis does not turn on the simple either/or question whether the 2003 or 2007 event caused [Bowman] to suffer the medical diagnosis of PTSD . . . because it is possible for [Bowman] to have suffered psychiatric injury from both events." The Commission noted that Bowman "had the burden of proving that the work accident was the prevailing factor causing a resulting medical condition and disability." It then pointed out that "the term 'medical condition' is in no way synonymous with 'medical diagnosis.'" The Commission noted:

There is evidence in this record which, if believed, would support findings that [Bowman] suffered from PTSD in the past, that (although he may have been left in a more fragile state) this condition because quiescent for an extended period of time leading up to the date of injury, and that the sudden, violent assault at the workplace caused a permanent worsening of the latent condition, a permanent increase in disability, and a need for medical care that otherwise would never have been required.

         The Commission then concluded that its "inquiry must begin with the sole question whether Dr. Daniel persuasively established that the July 2007 accident was the prevailing factor causing [Bowman] to suffer a resulting psychiatric condition and disability, regardless of whether [Bowman] was also suffering (or had previously suffered) from preexisting psychiatric conditions and/or disabilities."

         The Commission first noted that the only objective psychological test Dr. Daniel administered (the MMPI-II) yielded invalid results; thus, Dr. Daniel's analysis was based "on [Bowman]'s subjective complaints and symptoms." "As a result, " the Commission determined, "the persuasive force of Dr. Daniel's opinion turns to a substantial degree upon the extent to which [the Commission] c[ould] rely upon [Bowman]'s subjective description of his history, complaints, and symptoms." The Commission then identified numerous "material inconsistencies" in Bowman's testimony and statements to evaluating and treating physicians involving things such as his marijuana usage, his feelings about the 2003 kidnapping, and his interactions with the pilot after the work incident. Based upon these inconsistencies, the Commission found that Bowman "[wa]s an unreliable witness, " and "[w]here [the Commission was] unable to rely on [Bowman's] self-reported subjective complaints and symptoms, it follows that [it] c[ould] not rely on the causation opinions from Dr. Daniel that were substantially derived therefrom." Accordingly, the Commission deemed "Dr. Daniel's testimony insufficiently persuasive to satisfy [Bowman's] burden of proof, " and, therefore, "the accident of July 16, 2007, was not the prevailing factor causing claimant to suffer any psychiatric condition or disability." The Commission expressly declined "to weigh the relative credibility of [CMA's] contrary expert medical opinion evidence from Dr. Stillings" in light of its determination that "the opinions from Dr. Daniel [were] insufficient to satisfy [Bowman's] initial burden of proof with respect to the issue of medical causation." Bowman appeals.

         Standard ...

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