Does It Matter Which Injury Caused Your Symptoms If Both Injuries Were Work-Related?

Sometimes employers interpret workers’ compensation laws as if they only apply to workers who were in perfect health before the accident and whose symptoms can only have one possible cause.  Your employer might look for any excuse to blame your symptoms on your age, your weight, or any aspect of your health history that they can classify as a pre-existing condition, just so they can get out of paying for your treatment.  It can be very frustrating to try to get your employer to pay for surgeries or other major treatments, especially since all the doctors who have a say in the decision are chosen by your employer and their workers’ compensation insurance company.  It is easy to feel like you are just one person trying to challenge a huge bureaucracy, and no one has your back.  If your employer argues that your work injury is not the real reason for your symptoms, a South Florida workers’ compensation lawyer can help you get the compensation you need.

The Employer Who Refused to Pay for Surgery After Not One but Two Work Accidents

In 2005, a UPS delivery driver named Frank suffered a neck injury at work.  His employer’s workers’ compensation insurance paid for the treatment of this injury, which included a surgery in which a fixation plate was inserted in his cervical spine.  He responded very well to the surgery, making a full recovery and returning to his pre-accident work duties when medically cleared to do so.  On October 23, 2005, his treating physician determined that he had reached maximum medical improvement, and for the next year and a half, he did not have any symptoms.

On February 21, 2007, two incidents during Frank’s shift at work aggravated his injuries.  First, a chain that he was pulling snapped; after this incident, Frank experienced pain in his neck and shoulder but kept working.  After he lifted a 90-pound package later that day, the pain became unbearable.  He saw Dr. Glasser, the same doctor who had treated him for his 2005 injury.  Dr. Glasser determined that Frank had suffered degeneration of his cervical spine.  Dr. Glasser recommended that Frank undergo another surgery to remove the old plate and implant a new one.  He opined that the 2007 accident was the main contributing cause of Frank’s need for the surgery.  The employer refused to pay for the surgery and sought the opinion of Dr. Cassidy, an independent medical examiner.  Dr. Cassidy determined that Frank’s symptoms were the result of age-related degeneration instead of the 2007 accident; Frank was 56 years old at the time Dr. Glasser recommended the second surgery.  Frank appealed the case, and the appeals court ordered the employer to authorize payment for the surgery that Dr. Glasser recommended.

Reach Out to Us Today for Help

You might need the help of a Sunrise workers’ compensation lawyer to get your employer to authorize treatment of a work injury that aggravated an old injury, even if both injuries were work-related.  Contact the Law Offices of David M. Benenfeld for help today.

Resource:

scholar.google.com/scholar_case?case=9287524278390781623&q=workers%27+compensation+medically+necessary&hl=en&as_sdt=4,10&as_ylo=2010&as_yhi=2020