The recurrence of a disability arises when a claimant has returned to work but then finds him or herself unable to work due to a spontaneous change in a medical condition that had resulted from a previous injury or illness without an intervening trauma or new exposure to the job risk factors that caused the illness.
When this happens, the claimant has the burden to prove that the recurring disability is related to the previously accepted employment injury. Claimants should consider satisfying this burden by producing medical evidence from a treating physician and by ensuring that the medical doctor has the complete and accurate factual and medical history. With the assistance of a workers’ compensation attorney, the claimant should ensure that the medical opinion includes a finding that explains the connection between the employment injury and the cause of the disabling condition. There should also be particular attention to specific details so that it is evident that the medical conclusion is based on sound medical rationale.
Causation – Dot the i and Cross the t
Consider, as an example, a claimant who strains his or her knee while pulling a delivery cart on the job. The claimant stops work and files a workers’ compensation claim, which is then accepted and honored. After some physical therapy, the claimant heals and returns to work. Subsequently, after a few months on the job, the claimant again stops work due to knee pain. The claimant files for workers’ compensation benefits and alleges a recurrence of her initial disability.
The claimant consequently undergoes further medical treatment and a doctor concludes that the claimant’s recurrent pain left knee pain is a direct and sole result of the initial injury sustained while at work. And it is at this critical juncture that the claimant should seek the advice of a workers’ compensation attorney. It can be expected the the workers’ compensation panel will be thoroughly examining the doctor’s opinion for a rationalized medical explanation. A key issue would be how the initial injury medically caused this recurrent disability. Any medical opinion that lacks a detailed and accurate history or scientific discussion would have limited probative value in answering the question of causation.
In light of the claimant’s burden to establish the recurrence of a medical condition, he or she should consult with a workers’ compensation attorney to help with collecting and furnishing a complete and accurate medical history, establishing causation and testing for reliable medical opinions. A skilled workers’ compensation attorney can help ensure that the claimant’s medical evidence is complete and sufficiently establishes a causal relationship between the initial injury and the recurrent disability. The medical conclusion that the claimant’s knee pain was caused or exacerbated by the job’s duties and that the claimant is totally disabled is certainly helpful. But it is most helpful when additional explanations are also included. A skilled workers’ compensation lawyer can help navigate the hurdles of a claim and avoid the traps of medical conjecture, surmise or speculation.