What Are Some Complex Workers’ Compensation Cases That You Have Handled?
The most complex cases I have handled involved traumatic injuries, such as those resulting in paraplegia, quadriplegia, life-threatening burns, or traumatic brain injuries. These types of cases are complex for a number of reasons, primarily because of the magnitude of the medical treatment and coordinated care that is involved. There is a great deal of coordination that will have to take place in order to make sure the injured party receives the necessary care in an ICU, inpatient setting, rehabilitation facility and then home.
For a traumatic brain injury, the injured party will have to go through cognitive rehabilitation as well as treatment for any physical injuries. Determinations will need to be made such as the degree of cognitive impairment and the level of financial and physical assistance that will be necessary in the future. If an injured party is never going to be able to work again, then future medical expenses, lost wages, and care will need to be accounted for. In most cases, individuals who have been injured to this degree will be eligible for Social Security or PERA disability benefits.
Repetitive injuries are called occupational diseases, and they differ from acute injuries (e.g. tripping and falling) in that they occur over time from certain repetitive actions, such as typing or sorting boxes at a very fast pace. Once it’s determined that a repetitive use injury is compensable, meaning that it should be treated as a workers’ compensation claim, the person is entitled to the same medical benefits as they would be for a traumatic work-related injury.
Anderson v. Brinkoff is a 1993 case that said in order for an occupational disease to be covered by workers’ compensation insurance, four criteria must be met. The first is that there must be proof that the disease was due directly to the conditions of employment or the conditions under which the work was performed. Secondly, it must be shown that the repetitive use injury followed as a natural incident of the work or as a result of the exposure to the nature of the employment. Thirdly, it must be shown that the occupational disease can be fairly traced to the employment as the proximate cause. Lastly, it must be shown that the occupational disease did not result from a hazard to which the employee would have been equally exposed outside of the employment.
The last criterion can be difficult to prove, particularly when the disease is something like cancer. For example, if a firefighter develops lung cancer but is also a smoker, it may be difficult to prove that the lung cancer was a result of years’ worth of fire-related inhalation from the job as opposed to the choice to smoke cigarettes. Such cases are complex and involve a significant amount of expert examination and testimony.
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