I got worse after my workers compensation surgery! What are my workers compensation rights? In this latest post, you’ll hear from the Law Offices of Marc Francis, your Workers Compensation Attorney in Santa Rosa.
The short answer is that the effects of medical treatment causing disability or need for additional medical treatment are compensable in monetary benefits and further medical treatment in your California workers compensation case without apportionment to pre-existing factors such as other health problems. Now it gets a bit complicated, so stay with me here. The Law Offices of Marc Francis in Santa Rosa – serving all of Sonoma County and the North Bay area – can help.
There are several ways in which medical treatment for your work comp case can affect entitlement to benefits. First, if the medical treatment causes disability, that disability is covered as part of your permanent disability monetary award, without apportionment to pre-existing medical problems. Let’s say that you had a carpal tunnel wrist surgery for repetitive use of the arm at work. And unfortunately, the surgery leaves you with more problems than you had before the surgery. In a recent case in our office, an injured worker developed an infection during surgery which required amputation of the arm and other problems. The insurance company claimed that it was not responsible for the part of our client’s disability that they tried to blame on pre-existing health problems, including diabetes. But in the recent case of Hikida v. Workers’ Compensation Appeals Board, the California Court of Appeal held that disability caused by medical treatment is 100% compensable and there is no apportionment to pre-existing factors. This makes a very significant difference in the value of such a case. In the Hikida case itself, the injured worker developed complex regional pain syndrome (CRPS) from the carpal tunnel surgery and was rendered 100% totally disabled. The insurance carrier and a doctor blamed other factors for part of the disability, but the Court said no, all of Ms. Hikida’s total disability was caused by the carpal tunnel surgery, and none was apportionable to pre-existing factors.
The same analysis would apply in cases of total joint replacement, such as for a hip or knee. Under the Hikida case, there would be no apportionment of disability benefits to the cause of the injured worker’s need for the surgery (such as pre-existing arthritis in the knee joint) and the disability would be rated only based on how well the worker is doing with that knee after the knee replacement surgery. This can make a very significant difference in your entitlement to disability benefits.
Next, the medical treatment might cause the need for other medical treatment. For example, if medicines given for a workers compensation back or neck injury cause gastro-intestinal problems which in turn cause disability or need for additional treatment for the GI problems, all of that is 100% compensable in the workers compensation case, without apportionment to other factors, such as pre-existing medical problems in that area.
Additionally, in your California workers compensation case the employer and its insurance carrier are responsible for paying the cost of treating pre-existing conditions as necessary to treat the work injury. For example, if you break your ankle at work and you have pre-existing diabetes problems, the insurance carrier in the workers compensation case must provide all medical treatment necessary to get the diabetes under control so that the work injured ankle can be repaired.
As you can see this can get complicated, so you should seek the advice of a legal specialist in workers compensation in order to protect your rights.
Call the Law Offices of Marc Francis in Santa Rosa today 707-664-9675 (serving all of Sonoma County and the North Bay area) for a free consultation from a workers compensation attorney in Santa Rosa.