A worker suffering from degenerative joint disease was advised by his doctor to undergo a hip replacement procedure. The employee, who loaded and unloaded trucks for a living, decided he wanted to put off the surgery for as long as he could so that he could continue to work. Before getting the procedure, however, the employee slipped on ice inside of a delivery truck. Safety News Alert reported the worker ultimately was able to have his hip replacement surgery covered by workers’ compensation because of the fall that occurred at work. The surgery was covered, despite the pre-existing condition.
Pre-existing ailments do not preclude workers from getting coverage through workers’ compensation as long as their injuries are exacerbated by their work duties. However, in situations where your work made your injury worse, you could find yourself facing an uphill battle to get the workers’ compensation insurer to actually pay for your benefits. An Atlanta workers’ compensation lawyer can help those with pre-existing conditions to demonstrate that they should be entitled to benefits.
Employees Can Get Workers’ Comp Benefits for Exacerbation of Pre-Existing Conditions
The employee who broke his hip had previously walked with a small limp due to his degenerative joint disease, but he was able to perform his job duties at an acceptable level. Unfortunately, an orthopedist indicated “some degree of exacerbation” of the employee’s hip necrosis occurred as a result of the fall. The hip needed to be replaced right away as a result of the additional injuries.
The evaluating doctor for the employee also diagnosed the worker with “acute traumatic injury to the left hip.” The doctor noted the employee had previously been able to work with no restrictions because his hip necrosis was asymptomatic. However, after the injuries resulting from the fall, the employee could not bear weight on his hip without substantial pain.
The employee subsequently made a claim for workers’ compensation to cover the cost of the hip surgery and to provide wage loss and disability benefits. The employer, however, denied coverage for the injury and the evaluating doctor for the insurer found the employee had not suffered permanent effects as a result of the fall.
The denial of workers’ compensation benefits was appealed to an administrative law judge, who concluded the fall had caused significant aggravation of the pre-existing injury. As a result, the employee was entitled to temporary total disability compensation and entitled to surgery and other medical care.
The workers’ compensation insurer appealed the decision to the Workers’ Compensation Commission and, after the Commission upheld the award of benefits, the insurer appealed to the local state court. The state court held the surgery was reasonably necessary to repair the hip fracture, and that the worker was entitled to compensation.
The case is a clear example showing employees can, and should, be entitled to benefits even when they have a pre-existing impairment or ailment if their work makes their injury worse. However, they may need to pursue their claim and continue making legal arguments through multiple levels of appeal to get the benefits they deserve. A workers’ compensation lawyer can help.
Parsons & Associates, P.C. is an Atlanta workers’ compensation law firm serving Atlanta, Savannah, and surrounding areas throughout Fulton County. Contact Parsons & Associates, P.C. today at 770-422-9000 or contact us online if you have been injured at work.