Nurse scores comp for 'unusual' hernias resulting from same incident

In Tennessee, for a hernia to be compensable, the worker must show it was caused by an incident at work, it appeared suddenly accompanied by pain immediately following the incident, and it did not exist prior to the incident.

Case name: Rhodes v. Careall, Inc., et al., No. W2010-02192-WC-R3-WC (Tenn. 12/20/11, unpublished).

Ruling: In an unpublished decision, the Tennessee Supreme Court held that a nurse was entitled to benefits for right- and left-side hernias.

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What it means: In Tennessee, for a hernia to be compensable, the worker must show it was caused by an incident at work, it appeared suddenly accompanied by pain immediately following the incident, and it did not exist prior to the incident.

Summary: A field nurse was lifting a 5-year-old patient from a transport van when she felt "intense abdominal pain." A doctor performed an emergency right-side hernia repair. After surgery, she indicated that she still had pain on her left side. The nurse informed her employer of her pain that stemmed from the incident, but it took no action. The nurse sought additional medical treatment on her own. Another doctor found a defect in her left abdominal wall in an "unusual location" and performed surgery to repair a left-side hernia. She sought workers' compensation. The Tennessee Supreme Court held that she was entitled to benefits for right- and left-side hernias.

The employer argued that the left-side hernia did not result from the work-related incident. The doctor who performed surgery for the left-side hernia said the hernia was consistent with an "older" hernia. The doctor explained that the type of procedure used to repair the more severe right-side hernia and the nurse's obesity masked the left-side hernia. The doctor also said that it was "unusual" but "possible" for the nurse to have suffered both hernias in the same incident. The court concluded that the nurse established causation.

The court found that the nurse sustained a 16 percent impairment for the right-side hernia and 35 percent impairment for the left-side hernia. Although two doctors opined that she suffered no impairment, the court noted that the doctors were not familiar with the American Medical Association Guides to the Evaluation of Permanent Impairment.

Read more at the WorkersComp Forum homepage.

February 23, 2012

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