Missouri: Punch In Mouth Aggravates PTSD For SIF Total

An unruly patient who punched the claimant in her mouth knocked her out of the labor market, according to the Commission which affirmed a total disability award against the second injury fund.  Seldon v St. Louis Psychiatric Rehab Center, 2014 Mo WCLR Lexis 110 (lexis.com), 2014 Mo WCLR Lexis 110 (Lexis Advance) (Sept. 16, 2014).  The employer had settled before the hearing.

A psych nurse was assaulted twice by different patients over a 6 month period.    In the first case she was trying to break up a patient fight and was stabbed in the side by a pair of scissors.  In a second assault she tried to stop a fight between a patient and the doctor and she had a superficial injury to her mouth.  After the first accident she was diagnosed and treated for PTSD and depression.  The second accident exacerbated her PTSD.  She returned to work for 10 months with the accommodation based on medical restrictions of no patient contact and then retired several years early. 

Second injury fund liability requires proof of synergy which historically has been problematic when injuries involve the same body part (back on back, for example) or the same diagnosis (PTSD on PTSD, in this case). The ALJ  relied upon expert testimony that the total disability was a combination of the two separate accidents to trigger second injury fund liability. The synergy is not fully explained.   Claimant’s expert concluded that the last accident alone rendered claimant 75% disabled.  He never rated anything for the first accident. Claimant returned to work after the second accident only in a highly-accommodated position.

Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug’s Mo. Workers’ Comp Alerts.

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