ST. LOUIS — The Missouri Court of Appeals upheld the Missouri Labor and Industrial Relations Commission’s decision denying a man's claim against the Second Injury Fund for permanent total disability benefits.
Robert Balliu, a printer repair technician, argued that his 1999 and 2015 work-related injuries combined to leave him permanently and totally disabled, according to the Jan. 8 opinion filed in the Missouri Court of Appeals, Western District.
The court affirmed the Commission’s finding that Balliu’s 2015 injury alone rendered him unemployable, absolving the SIF of liability.
Balliu’s troubles began in 1999 when he suffered a bilateral hernia while on the job. After undergoing successful surgery, he returned to work without restrictions.
A similar incident occurred in 2004, leading to another hernia and subsequent surgery, with Balliu again resuming his normal work duties. Despite these prior injuries, Balliu continued his physically demanding job, which involved lifting items weighing up to 75 pounds.
In 2015, while lifting a heavy document feeder, Balliu experienced excruciating pain in his right hip and groin. He was later diagnosed with ilioinguinal neuralgia, a debilitating nerve condition.
Multiple treatments failed to alleviate his pain, leaving him unable to work or perform basic tasks in his personal life.
Following the 2015 injury, Balliu reached a settlement with his employer and pursued additional compensation from the SIF.
The claim rested on the argument that his prior injuries, combined with the 2015 injury, rendered him permanently and totally disabled.
The case was presented before an Administrative Law Judge (ALJ), who heard testimony from Balliu, his medical experts, and a vocational expert. The Independent Medical Examiner (IME) acknowledged that Balliu’s 1999 hernia contributed to his vulnerability to subsequent injuries but concluded that his 2015 injury alone necessitated extensive work restrictions, such as reclining for hours daily to manage pain.
The vocational expert’s findings mirrored this assessment, stating that Balliu’s 2015 injury alone rendered him unemployable. Despite this, both experts inconsistently concluded that the combination of the 1999 and 2015 injuries caused his total disability.
The ALJ ruled that Balliu’s 2015 injury independently caused his permanent total disability, leaving the SIF without liability. The Commission adopted this ruling, prompting Balliu to appeal.
Court’s Findings and Affirmation
On appeal, Balliu argued that the Commission misapplied Missouri law by failing to recognize that his 1999 and 2015 injuries combined to create his disability.
He also contended that the commission’s decision was against the overwhelming weight of the evidence.
Judge Mark D. Pfeiffer, writing for the court, outlined the legal standard under section 287.220.3(2) of the Missouri Revised Statutes.
To hold the SIF liable, a claimant must prove that a preexisting disability combined with a primary injury to cause total disability, the judge wrote.
If the primary injury alone is sufficient to result in total disability, the SIF bears no responsibility.
The court found that the evidence overwhelmingly supported the conclusion that Balliu’s 2015 injury, considered in isolation, left him permanently and totally disabled.
The IME and vocational expert’s conclusions about the combination of injuries were deemed inconsistent with their primary findings. The court further emphasized that Balliu failed to follow the mandatory framework for challenging the commission’s decision, citing only evidence favorable to his claim.
The court underscored that the commission has the discretion to assess the credibility and weight of expert testimony. It ruled that the commission acted within its authority by crediting the portions of expert testimony that supported its conclusion.
The appellant was represented by Richard C. Wiles of Kansas City.
The respondent was represented by Attorney General Andrew Bailey and Assistant Attorney General Shelly L. Hinson.
The parties declined to comment further on the matter.
Missouri Court of Appeals, Western District case number: WD87032