How an Injured Employee’s Statements to a Company Nurse Sank his Workers’ Comp Claim – Stire v. West Virginia Office of Insurance Commissioner

A person who seeks workers’ compensation benefits for an injury on the job typically needs to provide a clear and convincing record of how the accident happened and the extent of the injuries that it caused. As a recent ruling from the West Virginia Supreme Court shows, that means identifying any and all potential injures as soon as possible.

band-aid-1210666-m.jpgMr. Stire was injured on the job while working as a heater. In February 2011, he was driving a golf cart when it struck a chain posted from one side of the road to the other. The chain caught Stire’s neck and pulled him backward, according to the Court. He later told a company nurse practitioner that he’d suffered injuries to his neck, throat, tongue, and spine. Stire told the nurse that the accident didn’t worsen a pre-existing back condition.

As the Court later explained, Stire had a history of herniations and disc problems that caused him lower back pain that radiated to his legs since at least 2003. The condition stemmed at least in part from two previous injuries incurred on the job. At some point after the accident, however, a doctor who treated him concluded that that the golf cart accident had also caused him to suffer another herniation in his lower back. Although Stire asked the Office of Insurance Commissioner to reopen his workers’ compensation benefits claim and add the back injuries to it, this request was denied.

An independent doctor who performed a second evaluation of Stire in December 2011 disagreed that the back injuries were caused by the golf cart accident. Dr. Langa concluded instead that any new injuries were the result of progressive degeneration overtime and were not made worse by the accident. She noted in particular that Stire didn’t complain of back pain or injury when he was treated by the nurse practitioner directly after the accident and noted that back injuries like those he’d previously suffered often progress over time.

Following various administrative rulings and appeals, including a decision by the Office of Administrative Judges, finding that the herniation was caused by the accident, the West Virginia Workers’ Compensation Board of Review concluded that the back injuries weren’t compensable. The state Supreme Court later affirmed this decision on further review. The high court relied in particular on Stire’s statements to the nurse practitioner about the extent of his injuries. It also noted that he didn’t complain of any back injuries when was treated again later the same month. Finally, the Court pointed out that the herniation at issue was in the same disc as a prior herniation for which Stire was already compensated.

As this case makes clear, workers’ compensation claims often come down to a battle of experts, competing doctor opinions, and even the statements of the worker himself. If you have been injured in an accident on the job, it is important to seek experienced legal counsel as soon as possible to be sure that nothing you do or say later comes back to hurt your claim. The West Virginia workplace accidents lawyers at the Wolfe Law Firm can help. Call us at 1-877-637-5756 or contact us online for a free consultation.

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