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Can I get Workers’ Compensation benefits if I did not have an actual accident, but where performing my job duties caused disability?

workers compensation attorney west palm beach

Proving the happening of an accident under Florida’s workers’ compensation law is not always an easy thing, but it is even more difficult when there was no actual accident or incident that you can pinpoint. In other words, if you fell off of a ladder, tripped or slipped, and fell and suffered an injury then there would be a concrete event or distinct accident. Usually, accidents like these are reported right away and/or are witnessed making it less likely that an employer will challenge whether the event occurred.

However, when no such event exists but you feel like you suffered an injury from performing your job duties, such as when you experience pain from a sprain or a strain or a pulled muscle from repetitive use of your arm, or back pain from the constant lifting or carrying of heavy objects; then it can become much more difficult to prove a compensable accident took place. By the way, the pain you suffer in your back or in your arm is still referred to as an “accident” under the Florida Workers’ Compensation Law, even though you may not think of it as being such.

These types of injuries are referred to as repeated exposure or repetitive trauma injuries and are more difficult to prove and require more evidence. In order to prove a compensable injury from exposure and/or repetitive trauma, you need to show (1) prolonged exposure, (2) the cumulative effect of which is injury or aggravation of a pre-existing condition, and (3) the job subjected you to a hazard greater than that to which the public is exposed.  Essentially, you need to prove that “but for” the employment the resulting injury would not have occurred.

Prolonged exposure does not necessarily mean that the problem was created over the course of a long period of time. The exposure does not even have to be repeated but can just be from a single exposure. But, the result has to be an injury or aggravation of a pre-existing condition and there must be medical evidence demonstrating a causal relationship between the exposure and the resulting injury. For a pre-existing condition to be compensable, it must be exacerbated by a job-related physical exertion or repeated physical trauma, (as opposed to psychological).

In Florida, there is a heavy burden on injured workers to prove compensability in general.  For all injuries, an injured worker needs to prove disability by a reasonable degree of medical certainty based on objective relevant medical findings; and also that the accident is the major contributing cause of any resulting injuries.  (Fl. St. 440.09(1)).  Objective findings are those beyond just the subjective complaints of an injured worker. There must also be medical findings on physical examination or diagnostic tests to confirm any complaints of pain.

In addition, in cases involving repeated exposure or repetitive exposure, both causation and sufficient exposure to support causation must be proven by clear and convincing evidence. Clear and convincing evidence is a very high burden of proof, which basically means beyond any doubt.

To demonstrate how these requirements play out in real cases in front of a Judge of Compensation Claims, (“JCC”), we are going to look at a few real-life examples.

In the first, the injured worker, a police officer, claimed that he suffered back problems from his long career which involved altercations with suspects and car accidents.  The JCC denied compensability. The JCC explained that the injured worker was not precise or explicit regarding the job activities or “cumulative traumatic events” that led to his back complaints. Just being involved for many years in recurrent and consistent police activities alone was not precise enough to meet his burden of proof. There was no isolated or traumatic event that caused an episode of back pain and no specific activity brought on the onset of back symptoms. The injured worker was unable to pinpoint any specific event that led to the onset of back pain or other subjective indication of a back injury. He was also unable to state that any of his everyday work activities, such as wearing his gun belt or getting in and out of his police cruiser, caused any back pain or limitation in function.  In addition, he never advised any of his physicians that work activities were causing any pain or problems in his back. The JCC concluded that the injured worker came to believe his back problems were the cause of his work activities.  Unfortunately, this alone was not enough.  It also did not help that the doctor testified that his activities could have been the cause, without identifying any specific activities.  The JCC found that the injured worker did not meet his burden to prove by clear and convincing evidence that the cause of his low back injuries was the prolonged exposure to activities at work.

Similarly, in another case, the injured worker was a truck driver whose job regularly required heavy lifting, pushing, and pulling and “physical manipulation of the truck”–using hands and legs for the pedal and gears. It was argued that the contributing cause of the back injury was “all of the heavy job requirements of getting in and out of the truck, loading, unloading, moving gears, etc.  Yet, the JCC denied compensability because there was no evidence that he told any doctor that any of these activities were the cause of his back pain.  Further, the doctor testified generally that these activities caused the injury, instead of identifying specific activities which caused the injury.  The JCC found that the injured worker did not meet the clear and convincing evidence standard for repetitive trauma.

Compare those two situations with the following case involving a plumber who claimed a right knee injury from kneeling:

The JCC found that the plumber met the requirements for proving a repetitive trauma injury by clear and convincing evidence.  He established through the testimony of a doctor that the cumulative effect of this work was the right knee bursitis caused by his work duties. Specifically, the doctor testified that the most common cause of bursitis is an injury from pressure or repetitive use and kneeling as a plumber.  In addition, the JCC noted that the plumber was a credible witness who testified that his job required him to work on his knees up to two-thirds of a workday.  Therefore, the JCC found that the plumber established that he had a prolonged exposure and was subjected to a greater hazard than the general public given the kneeling work by clear and convincing evidence.

Another issue that can arise when trying to prove a repetitive trauma, exposure case is the timing or reporting requirement.  Whenever a workplace injury is claimed, an injured worker must report it to his or her employer within 30 days.  (Fl. St. 440.185).  Ordinarily, when dealing with a concrete and discrete accident with a known date and time such as a slip and fall this is not a problem.  But, when dealing with repetitive exposure and trauma cases it becomes less clear when an actual injury occurred.  The Law accounts for this by counting the 30 days from the initial manifestation of the injury.  This presumes that the injured worker knew of the injury and knew that it was related to work.  But, if the condition was one where the cause was unknown absent a medical opinion, and that medical opinion indicated that the condition was caused by the employment, then the 30 days would count from when that opinion was rendered.  Thus, it is best to report these types of injuries early on so as to avoid any challenges to timely reporting.

As demonstrated in this article, if you become injured from a repeated exposure or trauma type of injury; it is often more difficult to prove a compensable accident.  An experienced workers’ compensation attorney can help you navigate the system and ensure that you not only obtain the benefits that you are entitled to but help maximize your benefits.  If you have suffered a work-related injury, contact us at the LaBovick Law Group to see what benefits you may be entitled to.  We provide free consultations where we will review the facts of your case to determine the right course for you.  Call us today at (561) 625-8400 for your free evaluation.

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