No. 13-020414 (Mo. Lab. & Indust. Rel. Comm’n. July 10, 2018 )
Full Opinion: [American National Insurance v. Joan Knutter]
Code(s): C040 Substitution of Parties; C002 Medical Causation; C001 TTD; C041 Death Benefits
Factual
Background:
Employee
slipped and fell on ice at work, which resulted in a right non-displaced
fracture of the right distal fibula on March 25, 2013. Employee became
wheelchair dependent due to her ankle injury. On May 9, 2013, she experienced
shortness of breath while on the toilet and was taken to the hospital. Despite
emergency medical treatment, claimant suffered a severe anoxic brain injury and
passed away. The Claimant at hearing was Employee’s son, Michael. The
Employee’s dependent, her husband Karl, died before the hearing but after he
filed a motion for substitution of parties. Thereafter, Claimant attempted to
be substituted as a party on behalf of his father.
ALJ Decision:
The
ALJ found that the claimant failed to sustain his burden of proof that Employee
died as a result of her immobilization from her ankle injury on March 25, 2013,
which resulted in a blood clot and pulmonary embolism. The ALJ granted Claimant’s
motion and order to be substituted as the Claimant in this matter and was
deemed the personal representative of the dependent and the only person
entitled to the proceeds of the claim.
Analysis/Holding:
The
LIRC reversed the award and decision of the ALJ. They found under Section
287.020.3(1) that the prevailing cause of the Employee’s death was her March
25, 2013, ankle injury, subsequent immobilization resulting in venous stasis,
and ultimately resulting in fatal saddle pulmonary embolism. Sections 287.149
and 287.170 provide for payment of TTD benefits while an employee is engaged in
the rehabilitative process. Employee was underpaid TTD in amount of $116.48. Employer
was liable for death benefits to the spouse in the amount of $43,160.00. Further,
Employee’s husband filed a timely claim for dependent death benefits. Employee’s
husband subsequently passed away on July 15, 2015, in which Employee’s only
child filed a Motion for Substitution of Party and Suggestion of Death (Motion)
with the Division and was entitled to the proceeds of the workers’ compensation
claim pursuant to Section 287.580.
The Takeaway:
Parties can be substituted for the dependent of Employee. Even if there is no medical opinion finding a cause of death, it is not purely speculative to link a work-related injury as a cause of death.