CHAIN REACTION: ONE WORK ACCIDENT CAN LEAD TO MULTIPLE INJURIES

September 28, 2017

When a woman fell off a chair at work, she suffered a lower back injury. But then a series of other injuries followed and she claimed workers compensation for multiple impairments, securing an entitlement to lump sum compensation that probably amounted to more than $145,000. This case shows how important it is to consider all injuries right from the start of a workers compensation claim and to be on the ball about making further claims if subsequent injuries arise.

Workers Compensation - One accident can lead to multiple injuries

Background – workers compensation injuries

In 2010, the woman was at work when she sat on a broken chair. It gave way and she fell to the ground. Initially she suffered a lower back injury. Within an hour of the fall she developed a severe headache and the following morning she had neck pain.

Other injuries subsequently developed and it appeared that the fall had severely affected her right side. She had an issue with dragging her right leg which caused plantar fasciitis to develop in her left foot. She had a damaged shoulder which needed surgery. Later, she was diagnosed with a complete tear of her right bicep muscle.

She then developed carpal tunnel syndrome and surgery was unsuccessful in treating this. She developed anxiety and depression. Due to her prolonged use of pain medication, she also developed dry mouth, which caused her to suffer dental, eating and digestive impairments.

She fell frequently because she had trouble walking. In 2014, whilst at home, she fell onto her left shoulder.

The woman had previously had whole person impairment (WPI) assessments for her injuries. A WPI assessment is carried out if a person has a permanent physical impairment arising from the work injury. The percentage of permanent impairment that a person suffers to their whole body will dictate both their entitlement to lump sum compensation, as well as whether they are entitled to greater periods of income maintenance and medical expense entitlements.

If a person is assessed as suffering between 5 percent and 29 percent of impairment to their whole body, they are entitled to a maximum of 2 years of income support and three years of payment of medical expenses. (Workers assessed with less than 5 percent WPI aren’t entitled to these payments).

Workers whose WPI is assessed as 30 percent or more are categorised as Seriously Injured Workers and they receive income support entitlements until they reach retirement age. Payments of their medical expenses have no limitation date.

The woman was unhappy with the WPI assessments for her shoulder and carpal tunnel injuries and also the assessments for the injuries to her neck, legs and the scarring. She also said that the WPI assessments should be combined, arguing that all the injuries arose from the same workplace trauma. The effect of this would be that her WPI would be in excess of 30 percent, putting her in the category of Seriously Injured Worker. The insurer disagreed that the assessments should be combined.

The woman applied to the South Australian Employment Tribunal to have these issues determined.

Decision

The Tribunal said that parts of the medical evidence were unreliable because some of the reports had been “cut and paste” from previous reports. It preferred the medical evidence of the doctor who had had the most experience with the woman’s impairments.

It looked carefully at the injuries in dispute to work out whether they arose from the fall, or whether they had been caused by something else. This was relevant because injuries could be combined where there was :

  • A WPI that was caused by the original workplace trauma; or
  • An injury or impairment that arose from reasonable treatment or therapy that was required to improve the effects of the original injury.

The effect of combining would usually be to increase the WPI percentage.

The Tribunal decided that:

  • The shoulder injury arose from the fall.
  • The wrist injury was a combination of the fall, physio and overuse during rehabilitation. Rehabilitation was an additional event to the initial fall, so this impairment wasn’t combined with the other injuries.
  • The anxiety arose from the initial fall.
  • The medication caused digestion and eating impairments and so should be combined with the lower back impairment.
  • The neck injury arose from the initial accident: the woman had a headache within one hour of the fall and neck pain had set in the following morning. This was combined with the lower back impairment.
  • The plantar fasciitis arose from consequences of the initial fall.

The Tribunal found that the woman had 16 percent WPI for the carpal tunnel injury and 11 percent WPI for the shoulder injury.

Taking into account all of her other injuries, the woman’s WPI was also assessed at 36 percent, putting her into the category of Seriously Injured Worker. The likely outcome of this was that not only did she secure income maintenance payments until retirement and payment of medical expenses for the rest of her life, but she was probably also awarded a grand total of more than $145,000 in lump sum compensation.

The lump sum was compensation for non-economic loss. Non-economic loss is, in essence, pain and suffering, inconvenience and physical impairment. It is the opposite of economic loss which includes loss of earnings and medical expenses. It’s much more difficult to put a dollar value on non-economic loss and so it can often be much more contentious than economic loss.

What does it mean?

This case shows how an accident that may have initially appeared to be fairly minor, can lead to a raft of injuries and impairments. This made the woman’s workers compensation claim far more complicated and there were even more complexities when further injuries subsequently arose.

That’s why it’s essential to have a good workers compensation lawyer on board as soon as possible after being injured. Not only is it important to ensure that all injuries are included (no matter when they occur) but if WPI becomes relevant, it’s crucial to get proper advice to ensure that you’re not compromising your claim.

At Websters Lawyers, we have an outstanding workers compensation team who have great experience in WPI and subsequent injuries. Contact us today for a free initial consultation. Because the sooner you act, often the better off you’ll be.

Graham v Return to Work South Australia [2017] SAET 69 (13 July 2017)