A common issue of contention in a workers’ compensation claim can be whether an injury or illness is work-related. Of course, the purpose of workers’ compensation is to provide financial and medical support for those hurt in the course of employment, regardless of who was at fault.
Proof of causal connection between work and an injury or medical condition is a requirement for benefit eligibility. While sometimes the connection is clear, such as a broken bone from a fall on a worksite, at other times, it is less so.
On April 26, 2018, the Kentucky Supreme Court issued an opinion called Ford Motor Company v. Jobe. in which the court agreed with a previous decisions in the case that substantial evidence supported a finding that later back impairment was sufficiently related to an earlier hip injury incurred in a workplace accident.
Donald Jobe had worked for Ford for 11 years when his right hip was injured in the company’s Louisville plant by tripping while on the assembly line. Ford covered this injury, but balked at covering later “low back impairment” that the claimant said was connected to the original hip injury.
An administrative law judge (ALJ) found the hip and back problems were both work-related. He noted that an independent doctor who examined Jobe felt “there could have been degenerative changes in Jobe’s back which were dormant prior to the work injury, but ‘brought into disabling reality by the work incident.'” Further, this neutral physician had noted that the claimant had back surgery because his treating surgeon thought it could help the hip pain.
The ALJ granted temporary total disability benefits for the time Jobe missed work as well as medical coverage for both injuries. The ALJ also awarded 14 percent permanent partial disability: three percent for the hip injury and 11 percent for the low back impairment.
Ford continued to dispute the causal connection between the hip and back problems in appeals to the Workers’ Compensation Board and then to the Kentucky Court of Appeals. Both affirmed the ALJ’s decision.
The Supreme Court found that the ALJ’s decision was supported by substantial evidence. The ALJ had said the only reason Jobe had back surgery was to attempt to alleviate hip pain from the hip injury, which was hard to diagnose. “As such, the low back impairment resulting from the surgery is related to the plaintiff’s work-related right hip injury and is therefore compensable.”
The Supreme Court looked at older cases to shed light on the concept that all harm that flows from an original work injury is also compensable. In Beech Creek Coal Co. v. Cox, the claimant had surgery for a work-related fracture. He was ordered to walk following the operation to expedite healing, but he fell and suffered a second fracture. While the two fractures were not “physically connected,” the surgeon felt that Cox was more likely to have fallen because he was stiff from the first surgery. The Board was “justified in concluding” that the first injury was a “highly contributing factor in causing” the second fracture.
Following this reasoning, the Supreme Court found Jobe’s back surgery to alleviate hip pain from the original injury was comparable to cases like Cox. The court concluded that the ALJ based his finding that the back problem was work-related on substantial medical evidence.
Questions of causation can be complicated in work injury cases, so anyone facing impairment from work, even if the cause is questionable, should speak as soon as possible with an experienced workers’ compensation lawyer.
The attorneys at Landrum & Shouse LLP with offices in Louisville and Lexington represent people throughout Kentucky in workers’ compensation claims and third-party lawsuits, when appropriate.