A worker was injured when he was hit on the head with a heavy object. Five months later he required emergency surgery for an aneurysm. Were the two events related? Would the worker receive permanent and total disability benefits?
On Aug. 6, 2009, Joseph Jackson, an employee of T.K. Stanley in Louisiana, was working to put a post in the ground. While he was holding the post-hole digger above his head, he lost his balance, and the heavy, iron object hit his head.
Jackson was wearing a hard hat, but the impact still caused him to suffer a large raised area on the top of his head and forehead.
A doctor diagnosed Jackson with a contusion (a heavy bruise), prescribed ibuprofen, and told him he could go back to work on Aug. 12.
On Jan. 10, 2010, Jackson was admitted to a hospital with complaints of headaches, shortness of breath and dizziness. A CAT scan found a brain hemorrhage. He was transferred to another hospital for emergency treatment.
A neurosurgeon who specializes in brain aneurysms operated on Jackson. The procedure included a “resection of a myotic fusiform aneurysm.” He spent over three weeks in the hospital.
Later that year, Jackson filed for workers’ comp benefits in connection with the aneurysm operation. Stanley contested the filing, and the case went before a hearing officer.
The neurosurgeon who operated on Jackson filed affidavits stating the cause of the hemorrhage was the head trauma he suffered in the work-related incident in August 2009.
Stanley chose another neurosurgeon to evaluate Jackson. The second doctor said the work-related injury was unrelated to the aneurysm and hemorrhage.
Given the dispute between the two doctors, the hearing officer appointed a third neurosurgeon as an independent medical examiner. That doctor didn’t think the aneurysm was caused by the work injury.
After weighing the testimony of all three doctors, the hearing officer decided Jackson had established his work-related injury caused him to develop the aneurysm. Jackson was found permanently and totally disabled, and was entitled to corresponding workers’ comp benefits.
Stanley appealed the hearing officer’s judgment.
Doctor vs. doctor
The company argued:
- the overwhelming weight of medical evidence showed the work injury wasn’t related to the aneurysm
- the hearing officer failed to give proper legal weight to the opinion of the independent medical examiner, and
- the hearing officer gave improper weight to the surgeon who performed the operation.
The Louisiana Court of Appeal reviewed the hearing officer’s written reasons for her judgment. “In weighing the evidence,” the hearing officer wrote, “Mr. Jackson’s treating physician/surgeon, Dr. Arthur Ulm, [had] more insight, knowledge and surgical experience in addressing aneurysms and specifically addressing fusiform aneurysms.”
The hearing officer noted, “Dr. Ulm discussed the uniqueness of the location [of the aneurysm] and the process … used to conclude Mr. Jackson’s initial head trauma suffered on the job lead to the development of the fusiform aneurysm.”
Long story (or document) short: The hearing officer placed more confidence in the diagnosis of the neurosurgeon who performed the operation on Jackson.
The appeals court noted:
“The hearing officer gave greater weight to the testimony of Dr. Arthur Ulm because she was impressed with his credentials and experience with aneurysms, as well as the fact that he was the treating physician … great latitude is given to fact-finders in a workers’ compensation trial, especially the weight given to a finding concerning the testimony of doctors.”
For that reason, the appeals court upheld the hearing officer’s decision and awarded Jackson workers’ comp benefits for the aneurysm.
What do you think about the court’s ruling? Let us know in the comments.
(Jackson v. T.K. Stanley, State of Louisiana Court of Appeal First Circuit, No. 2013 CA 1686, 5/30/14)