A registered nurse for a hospital regularly worked in an operating room. She was asked to assist in postsurgery recovery and transport in a different department. As she was reaching out her hand to help a 300-pound patient transfer from a gurney to a bed, she felt pain in her back. The nurse returned to her usual workstation and sat at a desk for the last hour of her shift and her pain gradually increased. She reported the injury to her supervisor the next morning.
She completed an injury report, and risk management staff reported that her claim fell under the hospital's workers' compensation policy. She saw a physician assistant, who diagnosed her with a low back and joint strain.
While the nurse was on restricted duty, she reinjured her back on three occasions while performing lifting duties. A workers' compensation claims adjuster interviewed the nurse and told her that, because neither she nor the patient she was assisting slipped, tripped or fell, the first incident was not covered under workers' compensation. The hospital denied her claim.
The nurse saw a doctor after continuing to have pain. Her diagnosis was pre-existing spondylolisthesis, and her restrictions remained unchanged. The doctor noted that the nurse reported back pain and spasms from lifting a casserole out of the oven at her home that were so severe she had to lie on the floor. Later, a neurosurgeon performed a surgical fusion. The nurse's doctor stated that it would take months for the nurse to reach maximum medical improvement.
The Workers' Compensation Commission found the nurse suffered a work-related injury and ordered the hospital to pay temporary total disability benefits, as well as incurred and future medical expenses relating to the injury. The hospital appealed.
Was the commission correct in finding the nurse's back injury was compensable?
A. No. The nurse's back condition, need for surgery, and resulting disability were due to the nonwork-related casserole-lifting event.
B. Yes. The nurse's medical condition was causally related to her compensable injuries.
C. No. The aggravation of a preexisting condition that results in a loss of wage earning capacity is not compensable.
How the court ruled: B.
The North Carolina Court of Appeals held that the nurse was entitled to benefits. Cawthorn v. Mission Hospital, Inc., No. COA10-748 (N.C. Ct. App. 04/19/11).
The court explained that the nurse's statements to her doctor were reliable despite the hospital's argument that the nurse provided incorrect information to her doctor. The court said the doctor had all of the pertinent information in forming his opinion that the nurse's disability was due to her work injury.
The court also concluded that the hospital's denial of the nurse's claim and defense at the hearing were not reasonable. The court found the hospital engaged in a conscious attempt to mislead the nurse regarding her entitlement to workers' compensation benefits. The court sent the case back to determine the amount of attorney's fees the nurse should be awarded.
A is incorrect. The court explained that the nurse's diagnosis went unchanged before and after the casserole-lifting incident.
C is incorrect. The aggravation of a pre-existing condition that results in a loss of wage earning capacity is compensable.
is the legal editor of the WorkersComp Forum.
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May 26, 2011
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