The Missouri Court of Appeals overturned a denial of benefits from the Second Injury Fund to a brewery worker with a lengthy history of injuries, finding the decision was not supported by competent, substantial evidence.

Mark Lynch worked as a laborer for the Anheuser-Busch Cos. Inc. for more than 35 years. In addition, Lynch sustained several injuries over the years. He hurt his neck and low back in a boating accident in 1990 and experienced ongoing pain thereafter, obtaining treatment from Dr. Al Vellinga before and after his retirement in 2009.

Mr. Lynch injured his low back twice while working for Anheuser-Busch. He filed workers compensation claims, which he later settled. Mr. Lynch underwent surgery on his left shoulder in 1991 and then settled a claim with the Second Injury Fund.

He sustained a work-related injury to his right shoulder in 1995, underwent surgery and settled his claim for that injury. Mr. Lynch sought treatment for pain in his right shoulder shortly before retirement and underwent a second surgery on his right shoulder immediately after.

In 2003, Mr. Lynch underwent total replacement of the hips.

He was diagnosed with osteoarthritis in the knees the year before he retired, and X-rays also revealed the progression of arthritis around his right hip.

After retirement, Lynch sought treatment from Vellinga for neck and back pain. The doctor’s notes from the visit indicate that Lynch also complained of weakness of the right upper extremity along with numbness and paresthesia of his right hand.

Throughout the spring of 2009, Lynch continued to report numbness and paresthesia in the hand. Vellinga noted that Mr. Lynch’s grasp was weak and referred him to Dr. Robert Margolis.

Mr. Lynch saw Dr. Margolis five months after he retired and was diagnosed with carpal tunnel syndrome.

Mr. Lynch sought treatment for carpal tunnel syndrome from Dr. Vic Glogovac in September 2009 and filed workers compensation claims for injuries to his hands and ears in December 2009.

Mr. Lynch underwent carpal tunnel release surgery in 2010.

In 2011, Mr. Lynch saw Dr. Mitchell Rotman. At this appointment, he complained that the surgery had not alleviated the symptoms in his hands.

In 2015, Mr. Lynch settled a claim for the injury to his hands for a 20% permanent partial disability of each wrist with a 10% loading factor.

Mr. Lynch filed a claim against the Second Injury Fund, asserting he was permanently and totally disabled as a result of a combination of his carpal tunnel syndrome and preexisting conditions.

In support of his claim, Mr. Lynch submitted the complete medical report of board-certified orthopedic surgeon Dr. Dwight Woiteshek and the report of vocational consultant Terry Cordray.

Dr. Woiteshek evaluated Mr. Lynch in 2011 and opined that he was permanently and totally disabled because preexisting disabilities affecting the back, neck, shoulders and hips had combined with the repetitive trauma injuries to create a substantially greater overall disability than their independent sum.

Dr. Woiteshek further articulated several permanent work restrictions for Mr. Lynch.

Mr. Cordray opined that Mr. Lynch was totally vocationally disabled because his significant physical limitations preclude all jobs in the competitive labor market. He reviewed medical records from nine doctors, including Dr. Woiteshek and Dr. Rotman.

Mr. Cordray included extensive excerpts from Dr. Woiteshek’s report and relied on the significant restrictions recommended to reach his conclusion.

Mr. Cordray also quoted part of Dr. Rotman’s report that suggested Mr. Lynch’s complaints were related to peripheral neuropathy, and Dr. Rotman said there was no evidence of a work-related injury.

No records, reports or testimony from Dr. Rotman were submitted into evidence.

An administrative law judge ruled in favor of the Second Injury Fund, and the Labor and Industrial Relations Commission affirmed. In doing so, the commission made no credibility findings regarding the testimony of either Mr. Lynch or Dr. Woiteshek.

The commission explicitly found Mr. Cordray’s opinion regarding total vocational disability neither credible nor persuasive because he stated that he did not consider Mr. Lynch’s subjective complaints, yet his report included a list of them.

Citing Mr. Lynch’s lack of diagnosis and treatment for carpal tunnel syndrome prior to retirement and bolstered by a purported quote of Dr. Rotman included in Mr. Cordray's report, the commission found Mr. Lynch’s carpal tunnel did not contribute to his overall permanent and total disability. Rather, it found that Mr. Lynch had retired and removed himself from the open labor market because of his preexisting disabilities.

The Missouri Court of Appeals said the commission erred when it ignored the only expert medical opinion in the record and substituted its own personal opinion regarding the medical causation of Mr. Lynch’s permanent total disability.

In its findings, the commission correctly noted that Mr. Lynch consulted Dr. Margolis for numbness and tingling in his hands in June 2009, five months after retiring. The commission does not mention, however, that Mr. Lynch reported problems with his hands to Dr. Vellinga in February 2009 or that he sought treatment from Dr. Glogovac in September 2009, the court said.

Aside from the disregard of the evidence of Mr. Lynch’s complaints and treatment, the court said the commission misstated the record in saying Dr. Rotman treated him. Dr. Rotman evaluated Mr. Lynch at the request of his employer.

Additionally, the court said, Dr. Rotman’s report was not part of the record. The court said the ALJ and commission cannot accept a purported excerpt from an examining physician's report, quoted in the report of a nonmedical witness, about what a worker allegedly told the physician.

In this case, however, the commission relied on a purported excerpt from Dr. Rotman’s report, cited by Mr. Cordray, despite finding Mr. Cordray neither persuasive nor credible, and despite the fact that the quoted language was “less than clear,” the court said. The court explained this was an error, as was the commission’s disregard of Dr. Woiteshek's testimony on causation.

“The sole expert medical evidence presented — the qualified medical opinion of Dr. Woiteshek — was that claimant is permanently and totally disabled because of a synergistic combination of his carpal tunnel syndrome and preexisting injuries,” the court noted. “The commission did not find Dr. Woiteshek lacked credibility or was not persuasive, and Dr. Woiteshek was not impeached.”

Given this record, the court said, the commission was not free to arbitrarily disregard and ignore Woiteshek’s testimony. “As a result, the commission's decision contrary to the only expert medical opinion in the record is not supported by sufficient competent evidence and is against the overwhelming weight of the evidence,” the court concluded.