Workers’ compensation is a form of insurance system in which employers pay premiums to an insurance company so that their workers are covered for injuries sustained on the job. An injured worker can file a claim for benefits, covering medical costs and missed wages due to time away from work, which the insurer is required to pay out for covered injuries. Unfortunately, some insurers are often reluctant to pay out claims or seek to reduce the amount of any claims that they do pay.
One of the main issues that regularly arises in these cases has to do with what the courts call “preexisting conditions.” In other words, the question is: did the worker suffer a particular injury during the workplace accident, or did the worker already have the injury at the time? West Virginia’s Supreme Court recently took on this issue in a case involving a worker injured in a workplace accident less than a year after being injured in an off-duty motorcycle crash.
Mr. Steyer was working as a coal miner “when he was jarred while operating a shuttle car” on the job, according to the Court. A claims administrator found that Steyer was entitled to workers’ compensation benefits for various back injuries sustained in the incident. The administrator denied benefits, however, for pain in the thoracic spine and other acute pain. Steyer had sustained a spinal fracture and disc bulges in a motorcycle accident seven months earlier, and the administrator noted that Steyer had complained of thoracic spine pain radiating to his legs after the bike crash. On appeal, the Board of Review agreed and concluded that those injuries were not compensable because they were all related to the motorcycle crash.
Although Steyer argued that his motorcycle accident injuries had completely healed prior to the jarring incident, a doctor who reviewed the treatment records concluded that Steyer’s symptoms after the work accident were nearly identical to those sustained in the motorcycle collision. The doctor also found that Steyer had been unresponsive to treatment that would be expected to improve injuries sustained in the workplace accident. As a result, the doctor found that Steyer returned to work too soon after the bike accident and that this had worsened his injuries from that crash. A second doctor found that Steyer may have suffered a soft tissue injury in the workplace accident, but that the bulk of the injuries were related to the bike crash.
Affirming the decision on further appeal, the Supreme Court said the evidence supported the Board’s decision. “The medical records indicate that [Steyer’s] current symptoms are the same as those he experienced after his motorcycle accident, and diagnostic tests show that his spine has remained stable since the motorcycle accident,” the Court explained.
As this case makes clear, there is often a fine line between a successful and unsuccessful workers’ compensation case. If you or a loved one has been injured on the job, the West Virginia injury 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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