Work injury worsens osteoarthritis, yields benefits

In Tennessee, if a work injury advances the severity of a preexisting condition or if, as a result of the preexisting condition, the employee suffers a new, distinct injury other than increased pain, the work injury is compensable.

Case name: Trosper v. Armstrong Wood Products, Inc., No. E2007-00816-SC-WCM-WC (Tenn. 12/30/08).

Ruling: The Tennessee Supreme Court upheld the trial court's judgment, which awarded the claimant 40 percent permanent partial disability to each hand and temporary total disability benefits for the recovery periods associated with his surgeries.

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What it means: In Tennessee, if a work injury advances the severity of a preexisting condition or if, as a result of the preexisting condition, the employee suffers a new, distinct injury other than increased pain, the work injury is compensable.

Summary: A welder developed intense pain in both hands after his job duties were changed and he was required to stack heavy boards by hand. Although the employer agreed to place the claimant in a position that would lessen the stress on his hands, the claimant was still required to lift 45 to 70 pound buckets to shoulder level. He was diagnosed with a joint disease characterized by the degeneration of cartilage in the joints of the hands and underwent two surgical fusion procedures.

The trial court awarded benefits, finding that the claimant's underlying osteoarthritis was worsened and advanced by his work activities, necessitating surgical intervention. The Special Workers' Compensation Appeals Panel reversed the award on the grounds that the claimant's condition was neither caused nor aggravated by the work he performed for the employer. The Supreme Court reinstated the trial court's award.

The Supreme Court clarified that an injury is not compensable where the work activity aggravates the preexisting condition merely by increasing the pain. Although it was undisputed that the claimant's pain increased because of his new job duties, the Supreme Court credited the testimony of an independent medical examiner, who explained that the claimant's job duties gradually stretched and loosened his thumb ligaments. This regular activity caused the cartilage between the bones to deteriorate.

The Supreme Court found that while the causation evidence was "particularly close," the claimant's testimony -- that he could no longer fully extend his thumbs, had trouble making a pinching motion, had diminished grip strength, and had continuous pain in his hands -- along with the medical evidence was sufficient to establish that his work activities "did not merely increase the pain in his hands, but advanced the severity of his pre-existing arthritic condition."

February 10, 2009

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