Court of Appeals of Missouri, Southern District, Second Division
FROM THE LABOR AND INDUSTRIAL RELATIONS COMMISSION
JEFFREY W. BATES, J.
D's (Employer) appeals from two unanimous final awards
from the Labor and Industrial Relations Commission
(Commission) awarding James Morris (Morris) workers'
compensation benefits arising out of injuries he sustained
from two work-related accidents. Employer challenges only one
aspect of each award. According to Employer, the award of
future medical treatment for pain management is not supported
by substantial and competent evidence in the record. Because
we find no merit in this contention as to each award, we
and Procedural Background
January 2007, Morris was injured in two work-related
accidents just a week and a half apart: (1) a car accident on
January 3rd; and (2) a slip-and-fall accident on
January 14th. As of the dates of these accidents,
Morris had worked for Employer for 21 years. Although most of
Morris' career was spent in supervisory positions, his
job required extensive standing, walking, driving and some
lifting. Morris performed these job duties despite
preexisting injuries involving his right knee, back and neck.
Morris also experienced chest pain and high blood pressure
due to heart disease. Following the two work accidents in
January 2007, Morris quit his job with Employer in May 2007.
Thereafter, Morris filed a claim for workers'
compensation benefits with respect to each accident.
hearing, an administrative law judge (ALJ) determined that
Morris was permanently and totally disabled from injuries
caused by the last 2007 accident on January 14th,
combined with the permanent disability preexisting that
date. With respect to Employer only, the ALJ
found that Morris sustained "permanent disability from
each of the two separate work accidents." With respect
to each accident, Employer was ordered to pay benefits for:
(1) permanent partial disability; (2) past medical treatment;
and (3) future medical treatment for pain management. Because
Employer only challenges the award of future medical
treatment on each claim, the following facts are relevant to
January 2008, Morris was evaluated for the first time by his
medical expert, Dr. David Volarich. Dr. Volarich opined that
Morris was permanently and totally disabled as a result of
both of his January 2007 work-related injuries to his neck
and back, when considered in combination with each other and
his preexisting medical conditions. According to Dr.
Volarich, Morris had reached maximum medical improvement as
of the January 2008 evaluation date. Dr. Volarich also opined
that Morris "will require ongoing care for his pain
syndrome using modalities including but not limited to
narcotics and non-narcotic medications (NSAID's), muscle
relaxants, physical therapy, and similar treatments as
directed by the current standard of medical practice for
symptomatic relief of his complaints."
January 2009, Morris was seen by his treating physician, Dr.
Wade Ceola, due to complaints of: (1) low back pain; (2)
radiating pain in his lower extremities; and (3) cervical
pain with radiation into both arms. Dr. Ceola diagnosed a
failed response to physical therapy and injections, and he
recommended surgery. In July 2009, Morris underwent surgery
involving a fusion at C5-6 and C6-7, followed by physical
therapy. Morris continued to have complaints of ongoing low
May 2010, Morris saw Dr. Ceola again. Morris had been in two
rear-end car collisions on May 1st and
24th of that month. Dr. Ceola diagnosed Morris
with a whiplash and concussion. He recommended physical
therapy for Morris' cervical and lumbar spine. Over the
next year, Morris continued to experience ongoing neck and
back pain. Dr. Ceola subsequently diagnosed Morris with,
inter alia, a new large herniation at L4-5. Dr.
Ceola again recommended surgery. In May 2011, Morris
underwent a second surgery, which included "left L4-5
hemilaminectomy with discectomy." In July 2011, due to
ongoing complaints, Dr. Ceola performed a third surgery
involving a fusion at L4-5.
December 2012, Dr. Volarich evaluated Morris after his
additional surgeries. In the doctor's opinion, there was
a causal connection between Morris' January 2007 work
accidents and his total and permanent disability. Dr.
Volarich also opined that Morris required ongoing care for
his pain syndromes and listed additional treatment
modalities. As the doctor explained in his report:
Mr. Morris would benefit from ongoing treatment at a pain
clinic for his chronic cervical and lumbar pain including his
left lower extremity neuropathic pain. Epidural steroid
injections, foraminal nerve root blocks, trigger point
injections, TENS units, radiofrequency ablation procedures,
and consideration for a spinal cord stimulator are all
indicated. He also requires chronic pain management and
treatment of his neuropathic pain with oral medications.
August 2013 deposition, Dr. Volarich was asked whether these
treatments were directly related to his work injuries and
gave the following answer:
Not completely. They would be related to the fact that he had
injuries to the neck and back from work, but he also had
subsequent deterioration, a couple of car wrecks and such,
and had surgeries during that time, so it's - it's a
mixture of subsequent problems as well as the work injuries
and I think also as well as the preexisting difficulties in
his low back.
February 2015, Morris was evaluated by Employer's expert,
Dr. Ted Lennard. According to Dr. Lennard, Morris suffered a
cervical strain and lumbar strain related to the 2007 work
injuries on January 3rd and 14th,
respectively, but those injuries resolved without further
problems. With respect to future ...