If an injury occurs immediately after a workplace incident, is it necessarily work-related and does it qualify for workers’ comp benefits? It’s the question in this case of the gangrenous groin.
Danny Ray Grooms worked in the sanitation department for the City of Trenton, TN. On Jan. 23, 2009, he was working on a trash truck when he slipped and fell. He landed on a bed frame which struck him on the inner part of his right thigh near his groin.
Shortly after his fall, Grooms examined this area of his body. He didn’t observe any broken skin, bleeding or bruising.
His fall happened on a Friday. Over the weekend, Grooms developed burning, itching and swelling in the area the bed frame struck. On the following Monday he reported his injury to his supervisor and saw his primary care physician. His doctor referred him immediately to a urologist, and Grooms got an appointment for the next day.
The urologist diagnosed Grooms with acute scrotal gangrene. He recommended surgery to remove dead skin and tissue and performed the procedure later the same day. Grooms was hospitalized for seven days.
The next month, the urologist applied skin grafts to the area. Grooms was cleared to return to work with no restrictions on April 23, 2009, exactly three months after he fell at work.
After a follow-up appointment in October 2009, Grooms was discharged from the urologist’s care without restrictions placed on his activities. However, Grooms reported a pulling sensation in his groin.
Grooms’ sought permanent partial disability benefits for an on-the-job injury. His employer denied the request.
A Benefits Review Conference was held. The company agreed to pay for Grooms medical care and his temporary disability benefits, but Grooms and his employer weren’t able to come to an agreement on the issue of permanent disability payments.
Grooms brought a lawsuit against the City of Trenton seeking the permanent partial benefits. The trial court found his groin injury wasn’t related to his work injury and dismissed his suit. Grooms then took his case to the special workers’ comp appeals panel of the Tennessee Supreme Court.
What caused the gangrene?
Grooms’ urologist testified he hadn’t determined the cause of the gangrene, but he thought it was unlikely it was related to the fall.
The doctor said the type of gangrene experienced by Grooms was a “spontaneous thing” and that there was usually no known cause for it. Trauma to the area could cause it, according to the doctor, if there were a laceration where bacteria could enter.
But the doctor found no lacerations in the area when he examined Grooms.
A rehabilitation specialist independently examined Grooms on his request. That doctor said that, to a reasonable degree of medical certainty, the fall and resulting injury reported by Grooms was “consistent and compatible” with the gangrene diagnosis.
It was the urologist’s testimony on which the trial court based its ruling that Grooms’ gangrene wasn’t work-related, specifically that a laceration was needed for it to be caused by a traumatic injury. Grooms testified himself that he found no cuts on his body.
Among the arguments Grooms made to the supreme court panel on why he should receive permanent partial disability benefits:
- His employer paid for his medical treatment and temporary disability benefits and that would preclude it from later saying the injury wasn’t work related, and
- The medical evidence shows the gangrene was related to his fall.
On the first issue, the court rejected Grooms’ argument, saying:
“It would place employers in the position of having to choose between voluntarily paying for medical care or benefits and risk waving the issue of causation in the future, or refusing to voluntarily pay for any care or benefits in order to preserve the right to contest that issue.”
On the medical evidence, Grooms argued his doctor’s opinion should be given more weight than that of the urologist.
But the court noted the urologist examined Grooms just three days after his fall and the gangrene was within his medical specialty. Grooms’ doctor’s specialty was rehabilitative medicine and he didn’t have the same expertise.
So the supreme court panel concluded the trial court was correct to give more weight to the urologist’s opinion that Grooms’ fall while working was unrelated to his development of gangrene. It denied Grooms’ request for permanent partial disability benefits.
We have no way of knowing whether the outcome of this case would have been different had Grooms reported his work injury to his supervisor on the day it happened, not three days later, and sought a medical exam immediately. It’s a good reminder for workers: Even if you think your injury is minor, report it to your supervisor the day it happens.
(Grooms v. City of Trenton, Supreme Court of TN, No. W2012-01872-WC-R3-WC, 9/12/13)