Failure to tell doctor pain was work-related doesn't curb benefits
Case name: Dunn v. Lakewood Quarters Retirement
Community, No. 12-548 (La. Ct. App. 11/07/12).
Ruling: The Louisiana Court of Appeal held that a maintenance supervisor was entitled to benefits for his bilateral inguinal hernias.
What it means: In Louisiana, the fact that a worker failed to tell his doctor that his complaint was work-related is not a false statement made for the purpose of obtaining benefits.
Summary: A maintenance supervisor was helping other maintenance workers lift a heavy sign that had been blown down in a storm. He claimed that he attempted to lift a corner of the sign and felt intense pain in his lower abdomen. The pain subsided shortly thereafter, and he thought he pulled a muscle. The supervisor did not immediately report the incident to the employer. The next day, he completed a questionnaire in which he denied having a disability or having a work-related accident. The supervisor developed a knot in his groin and experienced symptoms of a sexually transmitted disease. When he visited a doctor, he denied that his injury was work-related. He explained that he was more concerned about his STD symptoms. The doctor diagnosed him with an inguinal hernia.
Five days after the incident, the supervisor informed the employer that he was injured at work. The employer sent him to a medical center, and a doctor confirmed the diagnosis of a hernia. Later, the supervisor reported to the emergency room with abdominal pain, and a physician noted that he had bilateral hernias. He underwent hernia repair procedures. The employer terminated his indemnity benefits. The supervisor sought a reinstatement of his benefits and recovery of medical bills. The Louisiana Court of Appeal held that the supervisor was entitled to benefits.
The employer asserted that the supervisor failed to prove that he was involved in a work-related accident because he denied that his complaints were the result of a work accident to his doctor and he did not disclose the incident to the employer until five days after it happened. The court said that no other evidence cast doubt on the supervisor's version of events. A doctor explained that the hernias were small and had no scar tissue surrounding them, which indicated that they were recently formed. The court pointed out that the supervisor was experiencing symptoms of an STD when he visited the doctor. The fact that the supervisor did not report to the doctor that his problem was work-related was not a false statement made for the purpose of obtaining benefits.
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February 25, 2013
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