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Worker can get disability after maximum medical improvement

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An injured worker can receive temporary total disability benefits for a work injury after he was deemed to have reached maximum medical improvement because a subsequent surgery extended the time that he was recovering from that injury, the Missouri Supreme Court ruled in an en banc decision Tuesday.

Carl Greer began working for Houston-based Sysco Corp. in 1989, first as an order filler and later as a forklift operator, according to court records. In February 2006, Mr. Greer's left foot was crushed when a coworker accidentally drove a forklift into a separate, stationary forklift that Mr. Greer was standing on.

Mr. Greer was treated by an orthopedic surgeon for a crushed ankle, including receiving pain medications and physical therapy, records show. He was released to work in August 2006, but his doctor determined in October 2006 that Mr. Greer could only perform “medium demand” jobs after he had trouble performing his usual work.

The orthopedic surgeon released Mr. Greer for full duty work in March 2007, and determined that he was a maximum medical improvement in April of that year, according to court records. At the time, the doctor found that Mr. Greer suffered a 5% permanent partial disability of his left ankle.

Mr. Greer continued to experience pain in his foot, and received physical therapy and various medical treatments over several years, medical records show. A doctor who evaluated Mr. Greer in March 2011 found that Mr. Greer was permanently and totally disabled, and that an ankle surgery he underwent in June 2010 was unsuccessful.

Mr. Greer filed an amended workers comp claim in 2006 against Sysco and Missouri's Second Injury Fund, which pays claims when a work-related injury combines with a worker's prior disability to create an increased disability, records show.

He also filed an amended claim for his ankle injury in March 2013, according to court filings. A hearing was held that year to determine issues such as whether Sysco was liable for Mr. Greer's future medical care, whether he should receive temporary or permanent disability benefits and whether the Second Injury Fund had any liability in Mr. Greer's case.

The Missouri Labor and Industrial Relations Commission found in March 2014 that Mr. Greer was 27.5% disabled by his ankle injury, records show. The commission also found that while Mr. Greer reached maximum medical improvement in April 2007, that he was eligible for TTD benefits for his ankle injury from June 2010 to February 2011, when he was recovering from ankle surgery.

On appeals from Sysco and Mr. Greer, the Missouri Supreme Court upheld the labor commission's ruling on Tuesday.

Period of healing

The high court found that Mr. Greer could receive TTD benefits past the date of maximum medical improvement for his ankle injury because Missouri case law shows that “temporary disability awards are intended to cover a healing period,” such as the one after Mr. Greer's surgery.

When “the commission is presented with evidence, as here, that a claimant has reached maximum medical improvement yet seeks additional treatment beyond that date for the work-related injury in an attempt to restore himself or herself to a condition of health or normal activity by a process of medical rehabilitation, the commission must make a factual determination as to whether the additional treatment was part of the rehabilitative process,” the ruling reads. “If the commission determines the additional treatment was part of the claimant's rehabilitative process, then he or she is entitled to TTD benefits ... until the rehabilitative process is complete.”

The Supreme Court also noted that the Missouri labor commission “is not required to accept maximum medical improvement as a bright-line date to terminate TTD benefits when there is substantial and competent evidence presented that a claimant continues to be engaged in the rehabilitative process beyond a date initially believed to be the end of the rehabilitative process. Cases that hold to contrary should no longer be followed.”