Court of Appeals of Missouri, Western District, First Division
from the Labor and Industrial Relations Commission
Before: Cynthia L. Martin, Presiding Judge, Victor C. Howard,
Judge and Thomas H. Newton, Judge.
Cynthia L. Martin, Judge.
Luke's Hospital of Kansas City ("St.
Luke's") appeals the decision of the Labor and
Industrial Relations Commission ("Commission")
awarding workers' compensation benefits to its employee,
Lois McDowell ("McDowell"), for a wrist injury she
suffered after falling at work. St. Luke's argues that
the Commission erroneously concluded that: (1) the risk that
caused McDowell's injury was causally connected to
McDowell's work; (2)McDowell's injury was not
directly or indirectly the result of an idiopathic cause; and
(3) McDowell was entitled to an award of permanent partial
disability. Finding no error, we affirm.
and Procedural Background
has worked at St. Luke's since 1971. At the time of her
injury, McDowell was a Laboratory Scientist 1. Her normal
workings hours were from 3:00 p.m. to 11:30 p.m. Typically,
McDowell arrived about 15 minutes before 3:00 p.m. and would
park on the fourth level of a high-volume parking garage used
exclusively by St. Luke's employees. She would descend an
elevator and continue through the north-facing parking garage
exit into the hospital. As she arrived for work, she
frequently encountered other employees who also worked in St.
Luke's as they departed for the day. Over time, as
McDowell aged, she began experiencing difficulties with these
arrival practices as she could not walk long distances while
carrying work and personal items.
1996, an orthopedic specialist began treating McDowell for
pain in her hips, knees, and ankles. The pain affected
McDowell's gait, causing her to limp. In 2013, the
orthopedic treatment culminated in McDowell undergoing a
right hip replacement. After her recovery and return to work,
McDowell used a support cane. While using the cane, McDowell
experienced increased difficulty carrying items from her
vehicle in the St. Luke's parking garage to her work
station within the hospital. A supervisor provided McDowell
with a two-wheeled rolling cart to more easily transport her
McDowell stopped using her support cane, she continued to use
the cart upon arrival to and departure from work each workday
to transport her purse, lunch, medications, work schedule,
and occasionally other employment-related paperwork. McDowell
would appropriately store the cart during work hours and upon
arriving home from work McDowell would leave the cart in her
car. McDowell only used the cart to transport belongings to
and from work.
13, 2016, McDowell arrived at work and parked on the fourth
floor of the parking garage. She descended the elevator while
pulling the rolling cart. She exited the elevator, and
continued to exit the parking garage through the north door.
At the north door, she encountered two other employees. One
employee opened the door for her, while the second employee
stood next to the other, somewhat blocking McDowell's
path through the door. McDowell proceeded through the door,
and attempted to maneuver to the right of the second
employee. In doing so, the wheel of the rolling cart, which
McDowell pulled, caught on the door frame. This jerked
McDowell, causing her to fall to the ground, fracturing her
left wrist. Shortly thereafter, McDowell underwent surgery to
repair the fracture and was ordered off work until August 29,
2016. McDowell filed a claim for workers' compensation
benefits on August 31, 2016.
a hearing before an Administrative Law Judge
("ALJ"), McDowell testified that she encountered
other St. Luke's employees at the elevators and parking
garage's north exit 75 percent of the time she used the
exit. McDowell testified that her orthopedic surgeon had
noted in medical records that she was a fall risk due to her
hip replacement. But, McDowell also testified that, except
for the fall on July 13, 2016, she had never before fallen
because of pain or weakness associated with her
the hearing, two medical reports were presented that
evaluated McDowell's left wrist injury and recovery. Both
reports concluded that she had a permanent partial disability
because of the wrist injury. McDowell testified that she
continues to suffer from pain, decreased grip strength, and
decreased range of motion in her left wrist, but has been
able to resume her pre-injury job duties with minor
awarded McDowell workers' compensation benefits in a
written decision on March 2, 2018 ("ALJ Award").
The ALJ Award found that the "risk source (pulling a
cart of work related supplies through a congested entryway)
[was] related to the workplace and not a risk source Ms.
McDowell would be likely to encounter in her non-work
life." The ALJ Award further concluded that
McDowell's injury arose in the course and scope of
employment. The ALJ Award also found that the McDowell's
fall was not the result of an idiopathic cause. The ALJ Award
included an award of permanent partial disability of 25
percent at the 200 week level of the left upper extremity.
St. Luke's appealed the ALJ Award to the Commission. The
Commission affirmed and incorporated the ALJ Award.
Luke's timely appeals.
the extent that the Commission affirms and adopts the
ALJ's findings and conclusions, [this Court] review[s]
the ALJ's findings and conclusions." Jefferson
City Country Club v. Pace, 500 S.W.3d 305, 311
(Mo. App. W.D. 2016). Section 287.495.1 provides that our
review is limited to:
[O]nly questions of law and [the Court] may modify, reverse,
remand for rehearing, or set aside the award upon any of the
following grounds and no other:
(1) That the commission acted without or in excess of its
(2) That the award was procured by fraud;
(3) That the facts found by the commission do not support ...