An employer should not have cut an employee's disability benefits without first asking the state's Labor and Industrial Relations Commission, a three-judge panel of the state appeals court's Kansas City District ruled Tuesday.
The judges heard arguments in the case last month, during their visit to Lincoln University's campus.
Both sides agreed the facts are pretty straightforward.
Donnice Hartgrove, now 57, was a registered nurse at St. Mary's Health Center who sustained a work-related back injury when she was lifting a 300-pound stroke patient. She had surgery in November 2001, then returned to work.
But, the appeals court noted, she left work again after three weeks because of lower back and leg pain and an inability to concentrate.
After a Worker's Compensation hearing, she was determined to be permanently and totally disabled, and her employer - now known as SSM Health - was ordered to pay her weekly benefits of nearly $500 a week.
Last December, SSM told Hartgrove they had scheduled an independent medical exam with a board certified neurosurgeon, and they would stop paying her benefits if she failed to appear at the Jan. 21, 2014, appointment.
SSM stopped the benefits payments after she didn't go to the appointment.
The Labor and Industrial Relations Commission determined that SSM wrongfully terminated Hartgrove's benefits, finding last April that, as the appeals court explained it, the "plain language (of state law) makes clear" that the employee "is required to submit to a reasonable medical examination "during disability' at the request of the employer/insurer," but that the "employer/insurer is not authorized ... to take unilateral action to suspend permanent total disability benefits to [the] employee based on her alleged failure to attend a reasonable medical examination."
Additionally, the commission said Hartgrove "remains entitled to the receipt of permanent total disability benefits in the amount of $491.80 per week."
The hospital appealed, arguing that the commission "acted without or in excess of its powers."
But, the appeals court said in a nine-page opinion written by Presiding Judge Thomas H. Newton, SSM also needed to look at the section of state law in the same chapter that gives the commission authority to, "at any time upon a rehearing after due notice to the parties interested review any award and on such review may make an award ending, diminishing or increasing the compensation previously awarded."
Newton also wrote "Missouri case law appears to require Commission approval prior to an alteration of an employee's disability benefits" - approval that SSM didn't seek in the Hartgrove case.
"Furthermore, an employer's suspension of benefits without the Commission's prior approval does not appear to be supported by Missouri law," Newton said.
The court said SSM should have asked the commission to review the case "without suspending the employee's benefits."