In filing a Tuscaloosa workers’ compensation claim, employees need to be mindful of the fact that their medical history could become a significant matter for the court’s consideration.
In securing workers’ compensation, it is key to establish that not only did you suffer a job-related injury, but that this injury was disabling to some extent and that the work injury was the sole cause of that disability – or at least that it was a significant contributing factor.
Such was the challenge for the plaintiff in Gore v. Lafarge North America Inc., whose Shelby Circuit Court complaint was recently reviewed by the Alabama Court of Civil Appeals.
The trial court had granted the claimant, a former construction worker, a disability rating of only 10 percent, following a work injury he suffered while operating a bulldozer in 2008. The worker appealed this finding, alleging the court erred in giving too much weight to his prior medical history. The appellate court affirmed the earlier decision in part, reversed in part and remanded in part.
The worker was reportedly injured on the job when he was operating a bulldozer at a quarry in Shelby County. Although he worked inside a closed cab, at some point, crushed rock was dropped from a height of about 30 feet directly onto the bulldozer. Some of those rocks, measuring upward of 12 inches in diameter, fell into the cab, striking the worker on his right side, shoulder leg and neck. He finished his shift, but visited the company’s workers’ compensation doctor the next day, saying he had pain in his neck, right shoulder and upper back. An x-ray did not reveal any detectable injuries, but he was given a prescription for pain medication and ordered to return to light duty.
The next day, he went to his own family physician, complaining of pain. At the time, he did not mention the source of the pain and did not mention he had just been to the workers’ compensation doctor. He was given a refill of pain medication he had been on prior to the accident.
Several months after the incident, his primary care doctor advised he could no longer work, as his pain had become unbearable.
Later, when the trial court weighed his claim for workers’ compensation, it noted a prior criminal conviction for so-called “doctor shopping.” It was also noted that he had been on pain medication for some time, had complained of similar pains as the ones reportedly caused by the incident, and had taken short-term disability leave three times prior to the accident.
The claimant countered that his prior leave was for multiple surgeries on his elbow and later for a collapsed lung. He didn’t deny the doctor shopping charge or that he had grappled with chronic pain prior to his injury. However he noted he was fully capable of working – and did so – prior to the incident.
Subsequent to his work injury, he was diagnosed with arthritis in his spine, bone spurs and a pinched nerve. The surgeon believed the pinched nerve was the result of the work injury, and multiple surgeries were conducted to help relieve the pain.
Following these surgeries, his doctor gave him a permanent partial impairment rating of 20 percent, specifically indicating that his ability to drive, turn or do anything with mechanical operations would be very challenging, if not impossible for him. Even on light duty his doctor said, he would need to take frequent breaks.
The trial court did find that he had suffered permanent partial disability as a result of the work accident. And while it did find him to be disabled, it granted a disability rating of just 10 percent, finding that the evidence had offered several alternative theories for his current state.
Upon his appeal, the worker stated that the trial court had applied the incorrect evidentiary standard with regard to his preexisting conditions. He asserted that the accident was a determining factor in his disability, and that per the decision in Easterly v. Beaulieu of America Inc., one need only prove that the work-related incident was a contributing cause of the permanent and total disability.
The appellate court rejected this argument, however, stating that the issue was not whether the work injury caused him to suffer disability, but rather to what extent. Disability alone, the court ruled, does not equal causation. The defendant did not argue that the complainant was unable to work. Rather, it contended that the inability to work was primarily due to preexisting conditions, which were well-documented.
The only issue on which the court reversed and remanded was on the question of his loss of ability to earn. The lower court failed to determine this figure. The case was remanded with an order to do so.
Gore v. Lafarge North America Inc., 2013 Special Term, Alabama Court of Civil Appeals, Appeal from Shelby Circuit Court
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