Can an employer challenge workers' compensation on causation?

Workers’ compensation insurance is supposed to provide benefits without a determination of fault. However, disputes can still arise. For example, an employer may disagree with a proposed recuperation plan, regarding some therapies or treatments as unnecessary. Disagreements may even arise over causation, as in a recent example.

The worker, a Walmart employee, was a zone merchandising supervisor whose work duties included some lifting. However, the worker’s injury did not occur during that lifting, but while she was walking around the workplace shortly thereafter. The worker reported the pain that she had felt in her lower back to her supervisor, but for reasons that remain unclear, the supervisor did not require the worker to fill out an accident report.

However, the pain did not subside; it became more severe. The woman took leave from work and underwent diagnostic imaging. The MRI revealed that the woman’s lumbar spine had two protruding discs and mildly displaced nerve roots. The woman saw a chiropractor, but the pain continued. The pain may also have contributed to a subsequent slip-and-fall in the workplace, which required the woman to take more leave and ultimately led to her termination.

The woman filed a claim against her employer, and experts for both sides testified. Notably, the experts agreed on the diagnosis of the woman’s injury but disagreed whether the lifting at work had contributed to it. At that stage, the court required the woman to prove that she would not have been otherwise injured, save for the performance of her work duties. Failing to meet that standard, the woman’s claim was dismissed.

Source: workerscompensation.com, “Court Finds Popping Incident In Low Back While Walking Not Work Related,” Dec. 29, 2015

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