That is, not only did you suffer an injury or illness, but that the injury or illness was the direct result of a workplace accident or condition.
In some cases, this can be especially difficult when the pain or injury does not immediately manifest. Even pre-existing medical conditions can be compensable under workers’ compensation laws, but there has to be a showing that the employment aggravated or accelerated the condition or combined with the it to produce the condition for which workers’ compensation benefits are sought.
In these situations, it is critical to present expert witness testimony from medical doctors who can testify as to the actual or most likely cause. This kind of testimony is essential to meeting the “medical probability” or “medical certainty” standard. More than the assertion that it is a mere probability, it has to be likely from a medical standpoint.
Such was the case with In re Worker’s Comp. Claim of Guerrero, recently before the Wyoming Supreme Court.
In June 2011, claimant was a welder for an iron company when he suffered a work-related injury. He was welding a valve on the pipe when the valve came loose and struck him on the lower left front side of his body with a great deal of force.
He was immediately transported to a local hospital emergency room, where he was diagnosed with abdominal trauma. He had bruises, bleeding and abrasions to his left lower body. He later had to undergo surgery for these injuries.
He was later approved for workers’ compensation benefits for injury to his left groin, abdomen and knee. He was unable to work for three months. During that time, he received temporary total disability and received prescription pain medication to treat the pain.
Even three months after the accident, he did not complain to his doctor of any back pain.
But around the three-month mark, he began physical therapy and at that time, began to experience back pain that radiated down his lower extremities.
An MRI was ordered the following month, and there were findings of degenerative change and disc tears, along with some central narrowing and disc protrusion. He had trouble lifting, carrying objects, driving sitting, standing or exercising. He was given steroid injections, which greatly relieved his pain.
He sought workers’ compensation coverage for these injections and treatment. However, the company denied the claim, arguing the back pain was not caused by the work injury. The hearing commissioner agreed. Although depositions from his doctors were submitted, neither testified. The only person who testified on claimant’s behalf was claimant.
His claim was denied.
On appeal, claimant argued expert medical testimony was not necessary in light of the fact that his back pain was absent prior to to the accident. But the district court – and later the Wyoming Supreme Court – disagreed.
Although the deposition of the doctor was submitted, the doctor in those instances testified as to the possibility that the back pain could have been caused by the work injury, based on the timing, but did not opine it was a medical probability.
If you have been injured at work, contact the Lee Law Offices at 800-887-1965.
In re Worker’s Comp. Claim of Guerrero, June 19, 2015, Wyoming Suprem Court
More Blog Entries
Workers’ Compensation Lawsuit Over Pain Killer Addiction, May 31, 2015, Asheville Workers’ Compensation Attorney Blog