A recent workers’ compensation case demonstrates just what the law means when it calls for the “objective symptoms of an injury.”
The Missouri Court of Appeals upheld a lower court decision awarding benefits to a nurse with a back injury because the symptoms of her injury would have been apparent to individuals other than herself.
Pulling sensation in her back when she moved cart
Jeannie Harper was a nurse employed by Springfield Rehab and Health Care Center.
On June 22, 2018, she was working a night shift and at around midnight she was helping a technician hand out medication to patients. The tech left the medicine cart jutting out into the hallway, posing a safety hazard to patients because it prevented use of a handrail mounted on the wall.
Harper hurried over to the cart, which was as tall as her and weighed about 100 pounds. She had never had to push a cart like this one before. When she attempted to move the cart, it took all of her effort to push it out of the way.
Because of weakness in her arms, Harper, who was 67 years old at the time, had to use her whole body to get enough force behind the cart in order to move it. As she pushed the cart, she felt a pulling sensation in her back.
Pain later in her shift made it difficult to walk
Despite the sensation and subsequent pain, Harper continued to work her shift. As time went on, the pain worsened and by the time she left for home she could barely walk.
When she got home she took some Tylenol and went to bed, hoping the pain would be gone when she woke up. But when she got up to get ready for work that night, the pain was still present and much worse than it had been.
She reported the injury to her supervisor that night and filled out an injury report. Harper continued to work, but found she could no longer do her job the same way she did before.
Harper would ask her supervisor for help because of her injury, but she worked in a department that was short-staffed so she often didn’t have anyone to aid her in her job duties. The pain medication she was prescribed also caused her to be groggy, but if she didn’t take it she said she’d be in too much pain to work.
In early November 2018, Harper quit her job because the pain had become too much to bear and she felt as though she’d become a hazard to her patients.
Judge, commission award benefits
Harper filed a workers’ compensation claim, which was contested by Springfield Rehab and Health Care Center.
On Nov. 2, 2020, an administrative law judge awarded Harper workers’ compensation benefits. The Missouri Workers’ Compensation Commission upheld the judge’s decision on Sept. 13, 2021, based on substantial evidence.
The judge had found that Harper “suffered an ‘unusual strain’ in her lower back when she pushed the heavy medicine cart … which produced objective symptoms of injury” based on her testimony that she felt a pull in her lower back that caused her to have difficulty walking later in her shift. This injury was work-related since Harper didn’t push large carts in her non-employment life, the judge said, so Harper was entitled to benefits since her occupational injury left her permanently and totally disabled.
The commission agreed and upheld the award.
Injury + difficulty walking = objective symptom
On appeal with the Missouri Court of Appeals, the employer argued that the judge and commission erred in finding Harper had sustained a work-related injury because the facts “failed to establish objective symptoms of an injury at the time and place of occurrence.”
The court disagreed, pointing out that the commission stated, “(Harper) suffered an ‘unusual strain’ in her lower back when she pushed the heavy medicine cart … which produced objective symptoms of injury” and led to difficult walking later in her shift.
Under the “plain and ordinary meaning” of the state’s workers’ compensation law, the statutory phrase “producing at the time objective symptoms of an injury” should be interpreted in this case to refer to Harper’s unusual strain.
The fact that Harper had difficulty walking later in the same shift served as the objective symptom of the injury that was perceptible by individuals other than the injured person.
That meant there was no legal error in the prior decisions and the appeals court had no reason to deny Harper’s workers’ compensation benefits.