The Language Used by Medical Experts in their Reports and the Injured Worker’s Testimony Can Sink His Case or Win His Case

The case of Malam v. Missouri Department of Corrections was decided by the Western District Missouri Court of Appeals on June 24, 2015. It shows that the language used by an injured worker’s expert in finding a particular event or accident on the job caused the injury is all important in the legal system’s determination whether a particular injury was “compensable,” meaning sufficiently work-related to entitle the injured employee to workers compensation benefits.

It is not enough for a worker to just prove he suffered a traumatic accident or strain to become entitled to workers compensation benefits. Missouri law clearly requires the worker to prove that the accident or event that preceded his injury actually was the main (primary) cause in causing the injury. The Missouri Workers’ Compensation Law in effect since the major changes legislature put into effect in 2005 make it clear that an accidental strain that merely triggers or precipitates the worker’s injury is NOT enough to entitle him to benefits.

The Malam case makes that crystal clear. In that case a majority of judges in the appellate court affirmed a Labor and Industrial Relations decision holding the injured worker’s hypertensive (high blood pressure) heart muscle problem (cardiomyopathy) to be at most a precipitating or triggering factor and not the primary causal factor. The employee lost the case in front of the Industrial Commission on appeal, and again on further appeal to the Missouri Court of Appeals.

The injured worker was a corrections officer working at a Missouri prison. An inmate he was escorting from one part of the prison to another started acting up and the officer had to restrain and take the inmate down. When the officer did this he felt a shortness of breath and his lungs filling up and began to spit up blood. His lungs suffered bruises and he became unconscious. A lung specialist found he had suffered no external trauma and gave the opinion that Officer Malam’s lung swelling trauma “precipitated” the lung problems but that his heart and lung conditions were preexisting and not mainly caused by the officer’s exertions in his takedown of the prisoner.

The officer’s attorney sent him to their own expert. That expert concluded that the takedown both “precipitated” and was the primary cause of the heart contusion. The Industrial Commission and the Missouri Western District Court of Appeals both decided that at most the exertion of the officer’s takedown of the inmate triggered but was not the main cause of the officer’s already existing heart and lung condition.

The Appeals Court majority pointed to the officer’s admission at the hearing before the workers’ compensation judge that he had testified at a previous deposition that his exertion at the time he took down the inmate was only minimal. This admission by the office himself together with the officer’s own expert’s saying that his exertion in restraining the unruly inmate “precipitated” the heart and lung bruising convinced the court that the corrections officer had not proven his entitlement to workers’ compensation benefits. That includes medical treatment and any money benefits.

The officer suffered no permanent disability he could get compensated for so he sought only payment of his medical bills for treating his hear and lung bruising. The state’s coverage of these extensive medical costs required to deal with his heart and lung bruising incident were denied. This case just goes to show how an injured worker’s own testimony (in this case that his exertion trauma was minimal) and his expert’s testimony (that the exertion had “precipitated”/triggered the heart and lung injury) can sink his workers’ compensation claim. This fit right in with a treating heart specialist’s earlier statement that the officer’s takedown of the inmate “precipitated” but was not the main cause of his heart and lung problems. Both the corrections officer and his medical expert should have been a lot more aware of what they said.

St. Louis Workers Compensation Center can defend and demand your rights to workmens compensation benefits. They can fight to legally enforce these rights. They can prevent the company from cancelling or underpaying your benefits. Please call us for advice and assistance on any work-related injury suffered on the job in St. Louis County, the City of St. Louis, St. Charles County, Jefferson County, Lincoln County, Warren County, Franklin County, or any other counties in eastern Missouri within 100 miles of the greater St. Louis metropolitan area. Our consultations are completely free of charge. Tom Hyatt will talk to you about your case right away. He will fight as hard he can to enforce all of your rights to Missouri workers compensation benefits. Our attorney’s fee would be a modest percentage of the Missouri workers’ comp disability benefits we get for you. Please call now for a free consultation. (See Contact Us).

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