Disability application that indicates injury not work-related sinks claim

In Alabama, in cases involving a sudden and traumatic event, an employee must produce substantial evidence showing that the alleged incident occurred and that the accident caused or was a contributing cause of the injury.

Case name: Grund v. American Trim, LLC, No. 2090322 (Ala. Civ. App. 09/17/10).

Ruling: The Alabama Court of Civil Appeals held that a worker was not entitled to benefits for tears in her rotator cuff.

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What it means: In Alabama, in cases involving a sudden and traumatic event, an employee must produce substantial evidence showing that the alleged incident occurred and that the accident caused or was a contributing cause of the injury.

Summary: A worker was racking door handles when she suddenly felt a burning pain in her shoulder. An orthopedic surgeon diagnosed her with a tear in her rotator cuff. The worker did not tell him the injury was work-related. After surgery, she questioned the surgeon about whether it could have been work-related, but he could not make the determination because he did not examine her until three months after the alleged incident. After her surgery, the worker applied for short-term disability benefits. On the application, she indicated that her condition had not arisen out of her employment and that she did not intend to file a workers' compensation claim. She suffered a second rotator cuff tear and again indicated on her application for disability benefits that the condition was not work-related. The Alabama Court of Civil Appeals held that the worker was not entitled to workers' compensation benefits for either of her rotator cuff tears.

The worker failed to establish a causal connection between the alleged accident and the injuries. As to the first rotator cuff tear, the court stated that the surgeon could not relate the injury to the alleged work incident and the worker failed to indicate that the injury was work-related on her disability application.

The court noted that the worker had not worked for seven weeks when she was diagnosed with the second rotator cuff tear. Additionally, the worker had an office visit with the surgeon after her last day of work and the surgeon found no weakness in her rotator cuff.

Read more at the WorkersComp Forum homepage.

December 23, 2010

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