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Recommendation for surgery before work injury undermines claim

In Kansas, evidence that pain from a preexisting condition exists independent of a work-related injury does not support compensation for an aggravation of the preexisting condition.

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Case name: Sturdivant v. Plaza Real Estate, No. 106,163 (Kan. Ct. App. 06/29/12).

Ruling: The Kansas Court of Appeals held that a receptionist was not entitled to medical benefits for her knee and back pain.

What it means: In Kansas, evidence that pain from a preexisting condition exists independent of a work-related injury does not support compensation for an aggravation of the preexisting condition.

Summary: A receptionist suffered a broken left hip when she fell down stairs at work. She eventually underwent hip replacement surgery. As a result, she limped when she walked. At the time of her injury and treatment, she did not complain to her surgeon about pain in her left knee. Before her injury, she was treated by her family physician for arthritis pain in her left knee and was recommended surgery. After she settled her workers' compensation claim for her hip injury, she saw her family physician for knee pain. X-rays revealed patella femoral rheumatoid arthritic cartilage depletion. The receptionist sought medical expenses for her back and knee pain. The Kansas Court of Appeals held that she was not entitled to benefits for her back and knee problems.

The receptionist argued that her surgeon's opinion that her hip injury contributed to her symptoms of back and knee pain showed that the work injury accelerated her need for treatment. The employer asserted that her claim was not compensable because her symptoms related to her preexisting arthritis and were not the natural and probable consequence of her fall. The court agreed with the employer, explaining that the surgeon's testimony supported a determination that the receptionist's back and knee pain existed independent of her work-related hip injury.

The court pointed out that the receptionist was recommended to undergo knee replacement surgery before she injured her hip. Also, she did not immediately complain of knee or back pain after her fall. The court said her back and knee problems reemerged well after her fall and hip replacement surgery.

Read more at the WorkersComp Forum homepage.

September 6, 2012

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