An employee says he was injured at work. But wait: He had previously suffered a similar injury and was being treated for it. Does the employee get workers’ comp benefits for the injury?
Charles Spencer was a cook at the Hyatt Regency Crystal City in Virginia.
One day at work, Spencer slipped on wet floor in the men’s restroom and fell backward, hitting his right shoulder against a sink. He immediately sought treatment.
He applied for workers’ comp benefits.
Hyatt sought to deny those benefits, noting that Spencer had received treatment for right shoulder pain before his fall.
The Workers’ Compensation Commission awarded benefits to Spencer. Hyatt appealed to a state court.
In its appeal, Hyatt argued that Spencer didn’t report his medical history, including preexisting shoulder pain, to two doctors and therefore the commission shouldn’t have relied on those doctors’ opinions to award comp.
The company also argued that the commission erred in finding that Spencer’s shoulder condition wasn’t related to his preexisting condition. Hyatt claimed that Spencer’s treatment for shoulder pain was essentially the same before and after the fall.
At the request of Hyatt, Spencer went to a third doctor for an independent examination and opinion. That doctor said his shoulder pain was related to his preexisting condition.
On top of that, at a hearing, Spencer testified that he didn’t recall any previous injuries or problems with his shoulder before his fall.
Hyatt also claims that Spencer hid his preexisting condition from the two doctors that treated him.
While it would seem that Hyatt had multiple reasons to deny comp coverage to Spencer, none of the company’s arguments stuck.
The appeals court said Hyatt couldn’t show that Spencer had hid his preexisting condition. It also said it would defer to the commission’s decision to give more weight to the opinion of the two doctors who said it was a work-related injury rather than to the one who said it wasn’t.
Finally, the court said there was enough difference in the treatment for Spencer’s shoulder pain before and after the fall to establish that the work incident had created a separate, compensable injury.
Decision: It was a separate injury. Spencer should receive workers’ comp benefits.
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(Hyatt Regency Crystal City v. Spencer, Court of Appeals of VA, No. 1007-10-4, 1/25/11)