Traumatic Injury Symptoms Can Have More Than One Major Contributing Cause
The human body is complex, and all but the youngest and healthiest among us have symptoms that could be due to more than one cause. This is especially true with traumatic injuries that cause intermittent pain for years afterward. Does your back hurt today because of a work accident you suffered three years ago, or is today’s backache the result of carrying a fast asleep second grader from the car to his bed when you arrived home after a road trip this past Christmas? In workers’ compensation law, the doctor often decides “yes” or “no.” In other words, your injury is either work-related, or it isn’t, and that determines whether your employer will pay your workers’ compensation claim. When it is obviously impossible to attribute your symptoms completely to a single incident, it is a case for apportionment. The doctors decide that your symptoms are X percent work-related and Y percent non-work related, and therefore workers’ compensation pays X percent of the cost of your treatment. If you have suffered multiple injuries to the same body part, and your employer intends to pay little or nothing for your treatment, contact a South Florida workers’ compensation lawyer.
When a Poolside Injury Aggravates a Work Injury
In September 2008, a school employee named Maryann injured her left knee when she slipped and fell on a slippery walkway at her workplace. The workers’ compensation doctor, Dr. Goldsmith diagnosed her with a torn medial meniscus; the tear was located in the posterior horn of the meniscus. Maryann underwent arthroscopic surgery and physical therapy, and the function of her knee returned almost to pre-accident levels.
In July 2009, Maryann injured the same knee while walking on the deck of her swimming pool at home. She filed another workers’ compensation claim and went back to Dr. Goldsmith, thinking that the injury was compensable because the new incident had aggravated her work injury. Dr. Goldsmith’s original assessment was that the at-home accident simply aggravated the work injury, and therefore the treatment was compensable. When he received the radiologist’s report, he changed his diagnosis. The images showed a new meniscus tear in a different place from the September 2008 injury. Dr. Goldsmith performed another arthroscopic surgery to repair this injury, and what he saw during the arthroscopy confirmed this diagnosis. Therefore, the employer denied Maryann’s claim related to the 2009 surgery.
Another issue in this dispute was the timeliness of the employer’s denial. If an employer wishes to deny a claim, they must do so within 120 days of the claim being filed. If the employer does not deny the claim during this timeframe, it is automatically accepted.
Let Us Help You Today
A Sunrise workers’ compensation lawyer can help you make a strong case that your knee injury is the result of a work accident and not a pre-existing condition or other non-work-related cause, so that you can get your workers’ compensation claim paid. Contact the Law Offices of David M. Benenfeld for help.