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Fighting for Ongoing Medical Coverage for Work-Related Injury

A worker who suffers an on-the-job injury may feel the physical and emotional effects of that incident for many years to come.
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But even when a worker successfully secures the initial benefits, obtaining coverage for subsequent treatments can be tough, unless your Atlanta workers’ compensation lawyer can help you prove that the ongoing medical issues are directly related to your earlier work injury.

It will be important in these cases to have ample medical documentation and witness statements connecting your current medical problems to the previous work injury. The case of Delacastro v. State ex rel., Wyo. Workers’ Safety & Comp. Div., reviewed recently by the Wyoming Supreme Court, shows what can happen when you aren’t prepared.

The case started in 2007 when the plaintiff, the director of human resources at a hospital, was carrying boxes of personnel files up the stairs when he felt a pinch or tear in his right leg. Hoping that it was not serious, he waited several weeks before seeking treatment.

In the interim, his right hip and leg continued to bother him, and he eventually field a report of injury with the state’s workers’ compensation division. A doctor diagnosed him as suffering from right hip strain and lateral femoral cutaneous nerve irrigation. Physical therapy was prescribed. The plaintiff attended all but the last session, at that point declaring he didn’t have any more pain and therefore didn’t feel it necessary to continue.

However, the next month, he was back for more therapy, complaining of weakness and pain in his hip. After five sessions, he was discharged by the doctor, who noted that the worker’s symptoms were 90 percent improved. He’d been able to jog and hunt and even saddle a horse with minimal pain.

The worker later left his position at the hospital without receiving additional treatment for his hip. (He had reported to a doctor in 2008 that he had tingling in his feet, but the physician reportedly attributed that to a certain medication and ordered him to stop taking it.)

Then in 2009, the worker returned to his previous doctor with complaints of pain in his back and both thighs and numbness in his feet. He told the physician that the symptoms were a progression of the discomfort he’d felt following his initial work injury, from which he stated he’d never fully recovered. The doctor indicated in his notes that the symptoms were “possibly related” to the work injury. He was referred to a neurosurgeon. Several tests were conducted, but aside from some mild abnormalities, there was no clear diagnosis.

The worker in the meantime had filed a claim to have his medical bills covered under workers’ compensation, as he contended that his current treatment related to his previous injury.

The state denied coverage, finding that the new treatments weren’t related to his old injury.

Upon appeal, the worker underwent an independent medical examination, after which the doctor concluded that the initial hip injury was work-related, but the new back pain was unrelated.

At the hearing, doctors testified on both sides, but ultimately, the court found the plaintiff had failed to meet the necessary burden of proof to show his current symptoms were related to his two-year-old work injury.

In reviewing that decision, the state supreme court upheld but modified the ruling, saying the lower court had erred in determining that the worker was allowed no additional compensation for future treatment of his hip injury. As the hip injury was clearly work-related, he is entitled to receive compensation for future treatment of it. However, he will have to show that the treatment being received is in fact related to his original injury, and not the new back injury.

For information on Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-303-7770.

Additional Resources:
Delacastro v. State ex rel., Wyo. Workers’ Safety & Comp. Div., March 21, 2014, Wyoming Supreme Court
More Blog Entries:
Delayed Crane Safety Requirements Increase Georgia Construction Accident Risks, March 30, 2014, Atlanta Workers’ Compensation Lawyer Blog