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Difference between revisions of "Introduction to Compensation Claims for Injured Workers (7:III)"
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Introduction to Compensation Claims for Injured Workers (7:III) (view source)
Revision as of 00:17, 5 August 2017
, 00:17, 5 August 2017→(1) Injury or Disease or Both?
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Policy #C3-12.00 has a helpful section on the distinction between an “injury”and a “disease”. Some conditions, like tendonitis or hearing loss, can be either an injury or a disease, depending on the circumstances of the injury. For example, hearing loss from a single occurrence like an explosion is treated as an injury while gradual loss of hearing due to occupational noise is treated as a disease. | Policy #C3-12.00 has a helpful section on the distinction between an “injury”and a “disease”. Some conditions, like tendonitis or hearing loss, can be either an injury or a disease, depending on the circumstances of the injury. For example, hearing loss from a single occurrence like an explosion is treated as an injury while gradual loss of hearing due to occupational noise is treated as a disease. | ||
Sometimes, a worker is disabled by a combination of a slow developing disease followed by a single event. The combination results in a significant disability, although neither event by itself would have been disabling. This is a difficult causation case. While the single event may not be sufficient to injure a healthy person, the worker is “working hurt” so a minor event is sufficient to disable him. This is the compensation version of the “thin skull” victim in tort law. The Board will likely not accept work causation in the initial decision and deny the claim as not meeting the causal standard under section 5. On appeal, the best way to address this matter is to have good evidence, preferably medical evidence, of the worker’s medical condition prior to the single event. | Sometimes, a worker is disabled by a combination of a slow developing disease followed by a single event. The combination results in a significant disability, although neither event by itself would have been disabling. This is a difficult causation case. While the single event may not be sufficient to injure a healthy person, the worker is “working hurt” so a minor event is sufficient to disable him. This is the compensation version of the “thin skull” victim in tort law. The Board will likely not accept work causation in the initial decision and deny the claim as not meeting the causal standard under section 5. On appeal, the best way to address this matter is to have good evidence, preferably medical evidence, of the worker’s medical condition prior to the single event. The concept for a finding of work causation under s.5 is "causative significance". Further, it is noted in court decisions that only if personal or non-employment factors are so dominant or exclusive that the compensable injury is not a significant causal factor would compensability be denied (WCAT #2009-02226). | ||
In some cases, the worker’s pre-existing condition is actually a developing OccD, such as gradual onset repetitive strain or gradual hearing loss. In these cases, you may wish to ask the Board to accept the pre-existing condition as a compensable OccD under section 6. If the Board denies this aspect as well, you may appeal this denial and join the two appeals together at the RD or WCAT so an appeal panel may consider the “whole worker”. | In some cases, the worker’s pre-existing condition is actually a developing OccD, such as gradual onset repetitive strain or gradual hearing loss. In these cases, you may wish to ask the Board to accept the pre-existing condition as a compensable OccD under section 6. If the Board denies this aspect as well, you may appeal this denial and join the two appeals together at the RD or WCAT so an appeal panel may consider the “whole worker”. | ||
===== (2) Compensable Aggravation ===== | ===== (2) Compensable Aggravation ===== | ||
