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Is HIV Scare Enough to Warrant Disability Benefits?

After a health care worker is exposed to HIV, is the mental stress enough to warrant temporary total disability benefits?

By Christina Lumbreras

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A patient services assistant for a medical center was assisting a nurse when fluids from an HIV-positive patient splashed in her eye. She was prescribed an antiretroviral medication as a preventive measure. She returned to work the following week but was later told to leave because she didn't want to do patient care. She received temporary total disability benefits.

Her primary health care provider's treatment plan was stress management and relaxation. The assistant also saw a licensed clinical social worker. An independent medical examiner diagnosed her with adjustment disorder and opined that it was connected to her work-related HIV exposure. The examiner said she was able to work. The examiner also thought it was appropriate to consider that if her three-month HIV test was negative the work factors were no longer the main contributing cause of her ongoing need for treatment. The assistant's primary health care provider agreed with the independent medical examiner's assessment and said she could return to patient care after a three-month negative HIV test.

After her three-month HIV test was negative, the medical center controverted benefits, saying it offered to place her back into her position, but she did not want to do so. She sought additional TTD for a physical-mental injury. The Workers' Compensation Board denied her benefits. The Workers' Compensation Appeals Commission affirmed the board's decision. The assistant appealed.

Was the board correct in denying benefits to the assistant?

A. Yes. The assistant did not show that her HIV exposure was the substantial cause of her inability to return to work.

B. No. The assistant suffered from a compensable mental-mental injury.

C. No. The assistant was unable to work.

How the court ruled: A. The Alaska Supreme Court held that the assistant was not entitled to further TTD. Renstrom v. Alaska Native Medical Center, No. S-14294, No. 6694 (Alaska 07/20/12).

The assistant was concerned about whether she might become HIV-positive or whether she might be exposed to HIV again. However, the court found that she did not present evidence from health care providers to contradict her primary health care provider's statement agreeing with the independent medical examiner's opinion that she could return to work.

The court also found that the medical center's controversions were in good faith. The controversion was not filed until after the assistant's primary health care provider said she could return to work in patient care.

B is incorrect. The court explained that the assistant suffered a physical-mental injury. Her claim arose from a physical injury for which she was treated. The exposure to a disease generally is classified as a physical claim. Her mental stress followed from the physical event of HIV exposure.

C is incorrect. The court explained that the medical center did not dispute that the assistant initially was unable to work because of her work-related injury. However, the medical center rebutted the presumption that she continued to be unable to work. The independent medical examiner opined that she was able to return to work and that if her three-month HIV test was negative she was medically stable.

Editor's note: This feature is not intended as instructional material or to replace legal advice.

September 13, 2012

Copyright 2012© LRP Publications

 
 
 
 
 
 
 
 
 
 
 
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