Stevens v. Citizens Memorial Healthcare

• Decision Date: 30 January 2008
• Docket Number: No. 28457.,28457.
• Citation: 244 S.W.3d 234
• Parties: Linda STEVENS, Claimant-Respondent, v. CITIZENS MEMORIAL HEALTHCARE FOUNDATION, Employer-Appellant, and Health Care Facilities of Missouri, Insurer-Appellant.
• Court: Missouri Court of Appeals

244 S.W.3d 234

Linda STEVENS, Claimant-Respondent, v. CITIZENS MEMORIAL HEALTHCARE FOUNDATION, Employer-Appellant, and Health Care Facilities of Missouri, Insurer-Appellant.

No. 28457.

Missouri Court of Appeals, Southern District, Division Two.

January 30, 2008.

Kevin M. Johnson, Wallace, Saunders, Austin, Brown & Enochs, Chartered, of Overland Park, KS, for appellant.

Jay P. Cummings, Gannaway & Cummings, of Springfield, MO, for respondent.

THEODORE B. SCOTT, Senior Judge.

This appeal arises from a Labor and Industrial Relations Commission ("the Commission") award affirming Citizens Memorial Healthcare Foundation's and Healthcare Facilities of Missouri's (collectively "Citizens") liability for a compensable injury and the payment of additional benefits to Linda Stevens ("Stevens"). Stevens worked for Citizens Memorial Healthcare Foundation as a certified nurse's aid and a registered medication technician. Citizens Memorial Healthcare Foundation is apparently self-insured by Healthcare Facilities of Missouri. On appeal, Citizens asserts that the Commission's order was not based on competent and substantial evidence.

While working in February of 1999, Stevens heard a loud snap in the back of her left knee right before her knee gave way. Stevens was taken to the emergency room for treatment and care on, her knee. Stevens was treated by Dr. Marion Wolf ("Dr. Wolf"), an orthopedic surgeon, who eventually conducted an arthroscopic surgery on Steven's left knee and then a total knee joint replacement. Prior to the injury, Stevens testified that she did not have any pain or discomfort in her left knee.

Stevens had arthroscivic surgery done on her knee in April of 1999, and then a full knee replacement in October of 1999. Citizens denied coverage for the first surgery and, because of that denial, Stevens did not ask Citizens to pay for part of the second surgery. Stevens testified that she did not work and believed she was unable to work from the date of injury until the time of her knee replacement surgery. During that time her movement was restricted by the use of a cane or a walker, her feet and legs were swollen, and she did not want to place any weight on the knee.

Dr. Wolf diagnosed Stevens as having chondromalacia and torn cartilage in her left knee. According to Dr. Wolf, chondromalacia is a roughness of the rubbery pad that lines a knee joint and may be a sign of early osteoarthritis. In his deposition testimony, Dr. Wolf stated that Stevens' underlying condition was not caused by the injury, but was aggravated by it. He indicated that Stevens was unable to return to gainful employment from the time of the injury until the time of the knee replacement, and that Stevens would need three months to recover after the surgery where she would not be able to work, and then an additional three months in which she could work part time. Dr. Stevens stated that the life expectancy of the knee prosthetic was around twenty years, and that if Stevens lived beyond that point there was a good chance that she would need further surgery.

In May of 2000, Stevens filed a claim with the Division of Workers' Compensation ("the Division") for workers' compensation stemming from Stevens' knee injury. A hearing was held before a Division administrative law judge ("ALJ") and Stevens was awarded sixty and five-sevenths weeks of temporary total disability at a rate of $196.23 per week for a total of $11,913.96; twenty-four weeks of permanent partial disability at a rate of $196.23 for a total of $4709.52; and $31,290.77 in unpaid medical expenses. The ALJ also ordered Citizens to provide Stevens with future medical care as is necessary to cure or relieve her from the effects of the injury. The Commission adopted and affirmed the ALJ's award.¹

Where the Commission adopts and affirms the findings of an ALJ, we review the decision adopted by the Commission as adopted by the ALJ. Carnal v. Pride Cleaners, 138 S.W.3d 155, 158 (Mo.App. W.D.2004). Our review is governed by Section 287.495,² which states that a reviewing court may reverse, remand, or set aside the award upon only upon certain grounds, one of which is "[t]hat there was not sufficient competent evidence in the record to warrant the making of the reward." Hampton v. Big Boy Steel Erection, 121 S.W.3d 220, 222 (Mo. banc 2003).

For their first point on appeal, Citizens asserts that there was not sufficient competent evidence to support the award of future medical treatment to Stevens. The Missouri Workers' Compensation Act allows for an award of future medical treatment. Section 287.140 provides, in part, that

[i]n addition to all other compensation, the employee shall receive and the employer shall provide such medical, surgical, chiropractic, and hospital treatment, including nursing, custodial, ambulance and medicines, as may reasonably be required after the injury or disability, to cure and relieve from the effects of the injury.

To receive an award of future medical benefits, a claimant need not show "conclusive evidence" of a need for future medical treatment. ABB Power T & D Co. v. Kempker, 236 S.W.3d 43, 52 (Mo. App. W.D.2007). Instead, a claimant need only show a "reasonable probability" that, because of her work-related injury, future medical treatment will be necessary. Id. A claimant need not show evidence of the specific nature of the treatment required. Aldridge v. Southern Missouri Gas Co., 131 S.W.3d 876, 883 (Mo.App. S.D.2004).

Dr. Wolf stated that the life expectancy of the knee proximity was around twenty years. He then opined that there was a possibility that Stevens would need further surgery on the knee, stating that it was "probably a 50-50 chance." When pressed further, Dr. Wolf indicated that it was likely that Stevens will have to face another surgery in the future, if she lives long enough. We find that Stevens, through Dr. Wolf's deposition testimony, presented sufficient and competent evidence upon which the Commission could base their award of future medical treatment.

Citizens also...