Teacher's failure to show prosthesis was replaced blocks benefits

In Virginia, when a prosthesis is removed but not replaced during surgery, the 24-month limitations period for the review of an award does not apply.

Case name: Saffert v. Fairfax County School Board, No. 0870-11-4 (Va. Ct. App. 01/17/12).

Ruling: The Virginia Court of Appeals held that a teacher's application for benefits was untimely filed, so she was not entitled to benefits.

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What it means: In Virginia, when a prosthesis is removed but not replaced during surgery, the 24-month limitations period for the review of an award does not apply.

Summary: An elementary school teacher suffered a compensable injury when she stepped in a hole at the school playground and fractured her ankle. She underwent a total ankle replacement surgery, and a titanium prosthesis was placed in her ankle. Years after her wage-loss benefits ended, her range of motion was poor and her pain continued. Her doctor recommended a second surgery to remove the prosthesis and fuse the joint into a fixed position. The teacher filed a change in condition application, alleging that her total ankle replacement prosthesis was replaced during surgery. The school board asserted that her request was untimely. The Virginia Court of Appeals held that the teacher's application was untimely, and she was not entitled to benefits.

In Virginia, an award can be reviewed within 24 months from the day that a worker undergoes a compensable surgical procedure to repair or replace a prosthesis. The court explained that the teacher's interpretation would allow the 24-month limitations period to apply in situations where a prosthesis is removed but not replaced during surgery.

The court said that just because a prosthesis was removed does not mean it was replaced. To replace a prosthesis, a substitute must take the place of the prosthesis that was removed. The court found that the teacher's ankle prosthesis was not replaced. No evidence suggested that the materials used during the second surgery were designed to simulate motion in her natural ankle joint. After the procedure, her joint was immobile. Therefore, the 24-month limitations period did not apply. The teacher's change in condition application was untimely filed because it was filed more than 24 months after the last day the board paid her compensation.

Read more at the WorkersComp Forum homepage.

March 8, 2012

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