New Symptoms: Are They Covered?

Posted in Workers' Compensation

Under Workers’ Compensation, the employer is responsible for medical care and treatment that is reasonable and necessary as a result of the work injury.  What happens when new symptoms arise sometime after the actual work incident?  Are the new symptoms considered part of your work injury?

When new symptoms arise from a work injury, the burden of proof to establish that the work-related symptoms and medical treatments are related depends on whether the connection between them is “obvious”.  An “obvious” causal connection is one involving a “nexus that is so clear that an untrained layperson would not have a problem” in concluding the new symptoms are related to the work injury.

If the new symptoms and the work injury are obviously related, than the employee receives the presumption that the new symptoms are related to the work injury, and the employer has the burden to establish they are not related. If the connection is not “obvious,” then the employee has the burden of establishing this connection through unequivocal medical testimony.

Here is a recent example:

The Facts:

  • The employee was injured while she was cleaning a knife at work and bleach splashed into her eye.
  • The employer accepted an injury to the left eye only.
  • The employee’s initial symptoms included: burning, redness and light sensitivity.
  • Over time, the employee began to experience the following:  difficulty seeing at night; irritation from dirty working conditions and severe headaches.

The Court’s Decision:

  • The Court characterized the work injury as a mild chemical burn.
  • There was no obvious causal relationship between the employee’s symptoms and the acknowledged work injury.
  • Therefore, the employee had the burden of proving the new symptoms, and any medical treatment of those symptoms, were causally related to the work injury.
  • The employee must present competent and credible medical evidence to establish that her symptoms are related to the acknowledged injury.

The Lesson:

  • If you develop new symptoms it is important that you report them immediately to your treating doctor.
  • You may need the testimony of your doctor to establish your right to medical care and treatment.

If you have questions regarding your rights under Workers’ Compensation, please contact the experienced attorneys in Stark & Stark’s Workers’ Compensation group.