Degenerative condition scuttles worker's coverage for knee surgery

In Mississippi, a treating physician's opinion that a worker can return to regular duty with no impairment rating can undermine benefits.

Case name: Ball v. Ashley Furniture Industries, No. 2010-WC-01627-COA (Miss. Ct. App. 10/11/11).

Ruling: The Mississippi Court of Appeals held that a worker was not entitled to benefits for her knee injury after her physician released her to return to regular duty.

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What it means: In Mississippi, a treating physician's opinion that a worker can return to regular duty with no impairment rating can undermine benefits.

Summary: A worker suffered injuries to her chest and knee after she slipped and fell while working for a furniture company. The next day she went to the emergency room, where she was told that her chest was bruised and that there were no abnormalities in her knee. She complained of continuing knee pain, and her treating physician determined that she suffered from a preexisting degenerative condition. The physician said that the knee pain was not related to her work injury and released her to regular duty with a zero percent impairment rating.

When her knee pain continued, the physician recommended surgery. The company denied covering the surgery. The worker sought benefits for her knee injury. The Mississippi Court of Appeals held that the worker was not entitled to benefits for her knee after she was released to return to regular duty.

The worker argued that the aggravation in her knee was permanent and required ongoing treatment. The court pointed out that the worker's treating physician said that her knee problems were related to a degenerative process and not her work injury. The physician concluded that her work injury was a temporary aggravation of a preexisting injury and that she had returned to her "baseline" medical condition. The court found nothing in the physician's testimony to indicate that the worker's alleged disability was connected to her work.

The court also declined to consider a medical opinion from another physician because the worker failed to comply with a requirement to provide the company with notice of the opinion.

Read more at the WorkersComp Forum homepage.

November 28, 2011

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