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Final appeal: Fall at doctor’s office doesn’t get work comp, Supreme Court rules

The Missouri Supreme Court ruled April 14 that a woman who was treated for exposure to ant spray in the workplace, then hurt her knee at the doctor’s office while being treated, doesn’t qualify for workers’ compensation.

The unanimous opinion represents the last of repeated court reversals for the claimant, Lucille Schoen, a charge nurse at Mid-Missouri Health Center. In 2009, Schoen complained of throat and eye irritation and coughing after her employer sprayed the chemical Cypermethrin around its air conditioning system to treat for ants.

The center sent her to an occupational and environmental medicine specialist for additional evaluation. While escorting her to the exam area, the doctor tripped Schoen when he accidentally kicked her while trying to ward off a small dog belonging to another patient that was running loose in the office.

She fell and injured her left knee, left shoulder, back and neck. A doctor later declared her permanently and totally disabled, though only 5 percent of her disability stemmed from effects of the ant spray.

An administrative law judge agreed that Schoen was permanently disabled and found the center was liable for the payments. But a split Labor and Industrial Relations Commission concluded the Cypermethrin exposure wasn’t the primary cause of Schoen’s disability and that her fall at the doctor’s office wasn’t part of the course of medical treatment for her workplace injury.

Last year, the Court of Appeals Western District reversed the labor commission, finding Schoen’s injuries at the doctor’s office were the “natural consequence” of her medical treatment for a workplace injury. But the Supreme Court ruled that the commission’s majority was right after all.

“Employee’s assertion of simple but-for causation is not sufficient to demonstrate a causal connection with her work,” Chief Justice George W. Draper III wrote for the court. “For her injury to arise out of and in the course of her employment, Employee must demonstrate the accident is a prevailing factor of the injury and is not a risk that the claimant would have been exposed outside of and unrelated to the employment.”

Draper cited a line of cases that followed a 2005 law that required courts to strictly construe the state’s worker’s compensation statutes. To be compensated, injured workers must demonstrate that the injury stemmed from a hazard that workers would not be equally exposed to in their private lives.

Most recently, the court held in March that a woman who slipped and fell in the hallway of the high school where she taught could not show that her injury stemmed from her employment. In a footnote, Draper said Schoen’s claim was “even more attenuated because she was not injured on the worksite.”

That case, Annayeva v. SAB of the TSD of the City of St. Louis, was argued the same morning in February as Schoen’s case. It’s not clear why they were decided a month apart.

Truman E. Allen of Allen, Nelson & Wilson in Columbia, an attorney for Schoen, didn’t respond to a request for comment.

The case is Schoen v. Mid-Missouri Mental Health Center, SC98168.

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