McDowell v. St. Luke's Hosp. of Kan. City

• Decision Date: 16 April 2019
• Docket Number: WD 82076
• Citation: McDowell v. St. Luke's Hosp. of Kan. City, 572 S.W.3d 127 (Mo. App. 2019)
• Parties: Lois MCDOWELL, Respondent, v. ST. LUKE'S HOSPITAL OF KANSAS CITY, Appellant.
• Court: Missouri Court of Appeals

572 S.W.3d 127

Lois MCDOWELL, Respondent,

v.ST. LUKE'S HOSPITAL OF KANSAS CITY, Appellant.

WD 82076

Missouri Court of Appeals, Western District.

OPINION FILED: April 16, 2019

Brett J. Coppage, Kansas City, MO, for respondent.

Matthew J. Stretz, Kansas City, MO, for appellant.

Before Division One: Cynthia L. Martin, Presiding Judge, Victor C. Howard, Judge and Thomas H. Newton, Judge

Cynthia L. Martin, Judge

St. 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.

Factual and Procedural Background¹

McDowell 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.

In 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 belongings.

After 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.

On July 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.

During 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 hips.²

During 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 accommodations.

The ALJ 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.

St. Luke's timely appeals.

Standard of Review

"To 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 287.495.1³ 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 powers;

(2) That the award was procured by fraud;

(3) That the facts found by the commission do not support the award;

(4) That there was not sufficient competent evidence in the record to warrant the making of the award.

"We review the whole record to determine whether there is sufficient and substantial evidence to support the award or if the award is contrary to the overwhelming weight of evidence." Gleason v. Treasurer of State of Missouri-Custodian of Second Injury Fund , 455 S.W.3d 494, 497 (Mo. App. W.D. 2015). "This court defers to the Commission's factual findings and recognizes that it is the Commission's function to determine credibility of witnesses." Pace , 500 S.W.3d at 312. "When the relevant facts are not in dispute, the issue of whether an accident arose out of and in the course of employment is a question of law requiring de novo review." Miller v. Missouri Highway and Transp. Com'n , 287 S.W.3d 671, 672 (Mo. banc 2009).

Analysis

St. Luke's Brief asserts three points on appeal. First, St. Luke's argues that the Commission erred because there was not sufficient competent evidence to support a finding that McDowell's injury had a causal connection to her work. Second, St. Luke's argues that the Commission erred in finding McDowell's injury was not a result of idiopathic causes. Third, St. Luke's argues the Commission erred in awarding permanent partial disability to McDowell. At oral argument, St. Luke's abandoned its second point on appeal. We therefore address only points one and three on appeal.

Point One

St. Luke's asserts that the Commission erred by finding a causal connection between McDowell's injury and her work. It argues there was no causal nexus between McDowell's use of a rolling cart and her work because the cart was not necessary for McDowell to complete her work. Without a sufficient causal nexus between the cart and her work responsibilities, St. Luke's posits, the Commission could not have found that McDowell's injury arose from the course and scope of her employment.

Under the Missouri Workers' Compensation Law ("Act"), an employer "shall be liable, irrespective of negligence, to furnish compensation under the provisions of the [the Act] for personal injury ... of the employee by accident ... arising out of and in the course of the employee's employment." Section 287.120.1. Whether an injury arises out of the course and scope of employment is governed by Section 287.020.3, which provides:

(2) An injury shall be deemed to arise out of and in the course of employment only if:

(a) It is reasonably apparent, upon consideration of all the circumstances, that the accident is the prevailing factor in causing the injury; and

(b) It does not come from a hazard or risk unrelated to the employment to which workers would have been equally exposed outside of and unrelated to the employment in normal nonemployment life.

St. Luke's does not contest that McDowell's fall was the prevailing factor in causing her wrist injury. Instead, St. Luke's limits its argument in its first point on appeal to the application of 287.020.3(2)(b).

"For an injury to be deemed to arise out of and in the course of the employment under section 287.020.3(2)(b), the claimant employee must show a causal connection between the injury at issue and the employee's work activity." Johme v. St. John's Mercy Healthcare , 366 S.W.3d 504, 510 (Mo. banc 2012). Our courts have applied a two-part test to determine whether there is a causal connection between an injury and an employee's work activity. See Gleason , 455 S.W.3d at 499 (discussing Miller , 287 S.W.3d at 674 ; and Johme , 366 S.W.3d at 511 ); see also Wright v. Treasurer of Missouri as Custodian of Second Injury Fund , 484 S.W.3d 56, 62 (Mo App. E.D. 2015). The two-part test "first requires identification of the risk source of a claimant's injury, that is, identification of the activity that caused the injury , and then requires a comparison of that risk source or activity to normal...