Powerful sneeze leads to messy comp case
February 15, 2010 by Fred HosierPosted in: Back/lifting injuries, Special Report, Workers' comp
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Imagine this: A worker has surgery to insert metal plates and screws to repair damaged discs in his neck. He says his injury happened at work … when he sneezed.
And since he claims it happened at work, the employee wants workers’ comp (WC) benefits.
Joseph Hopper says he was injured at work when he reached to grab a tire while unloading a truck. He claims he didn’t report the injury because his supervisor wasn’t at work.
Hopper says ten days later, he was opening the shop when he sneezed and heard a popping sound in his back. The pain was so bad, according to Hopper, that he had to leave work.
After having the neck surgery, Hopper applied for WC benefits.
His boss testified that Hopper didn’t report a work-related injury, but told him that he’d injured his neck at home.
A doctor testified in support of Hopper, saying “when the sneeze happened [it] finally sort of put him over the edge.”
However, hospital records show that when Hopper went to the emergency room because of pain, he said the sneeze “happened at night,” which would have put him at home at the time of the incident.
At one point, Hopper was awarded WC benefits, but his employer appealed. The state WC commission reversed its ruling, then Hopper appealed.
Now a state appeals court has upheld the commission’s second opinion that comp benefits should be denied. Since Hopper didn’t report a work injury and he was on record as saying the sneeze happened at night, the court said there wasn’t enough evidence to prove the injury happened at work.
What about the claim that a sneeze can cause a neck or back injury? This season, LA Clippers coach Mike Dunleavy reported that he aggravated a herniated disc in his lower back by sneezing. And we found several articles on the Web that say a sneeze can cause a back injury.
What’s the strangest injury claim you’ve ever heard? Let us know in the Comments Box below.
Cite: Hopper v. Krevinec, Crt. of Appeals of MS, No. 2009-WC-00206-COA, 1/19/10 (PDF).
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Tags: neck injury, sneeze, surgery, Workers' comp
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February 15th, 2010 at 8:52 am
The guy should be fined for such a ridiculous claim!
February 16th, 2010 at 7:21 am
As this case may not get WC, I had extensive lower back surgery in 2007, and if I start sneezing, it will put me to my knees in a hurry.
February 16th, 2010 at 7:47 am
I agree 100% with you, John.
February 16th, 2010 at 8:33 am
This is a weird one!, but I’ve heard crazier…an employee (who worked in a smoke house) claimed she was in the hospital for 5 days as the result of an asthma attack brought on by walking past a closed break room door and smelling cigarette smoke (the break room was a negative pressure, vented room…this was back when smoking was allowed in-doors). Of course, she failed to mention she had been in a nightclub for 6 hours prior to the attack…she was initially awarded benefits, but the company appealed and the ruling was overturned.
February 16th, 2010 at 8:55 am
Years ago was walking home at night when I broke out into a heavy coughing spell. I coughed so hard that my back almost seized and I was in terrible pain. Went to the emergency room the nest morning and all they could find was some inflamation in my muscles back there. I was disabled for almost a week before I began to recover. Years later I realized that what happened is my back “went out of place” ( called a sublaxaton, spellin?) due to the severe cough. A chiropracter could have fixed that immediately.
Howver, I did not know about chiripractic doctors then. I do go to one now and then when I need to, an the fix is almost immediate!
February 16th, 2010 at 9:30 am
Just because you sneeze at work doesn’t mean that the sneeze was “caused” by your work. I find this case pointless and a waste of valuable time and resources. The claimant should be fined for having filed a fraudulent claim for work comp benefits. The employer had to pay a lawyer to fight the case, but the employee didn’t pay a dime. He was represented by someone who is paid with taxpayer dollars.
Case law has determined that an injury that happens at work must also have been caused by the employees work in order to be compensable under worker’s comp. I realize that some get away with filing claims for injuries that happened at work even though they are not work related. HR Managers, Safety Managers, and Work Comp Specialists beware……Just because it happens at work doesn’t always mean it is work-related.
February 16th, 2010 at 9:36 am
What happened to the standard question of “but for the job, would the injury have happened”? The man would have sneezed anywhere. Unless something at work caused the sneeze, how can they say this is a compensable injury? Its like having a heart attack at work - you have to prove that stress from work in some way caused the heart attack.
I had a worker slip on a single patch of ice in the parking lot coming in to work. She broke her butt bone and evidently jarred her back. She had permanent restrictions whereby she had to be able to alternate between sitting and standing (although she only wanted to sit) and she could not work more than 8 hours per day. She would walk perfectly normal until she thought someone was watching and then she would limp.
February 16th, 2010 at 9:48 am
according to how the article was written, this case was “Frivilous”. The problem here the american justice system is out of control and everyone appears to be suit happy which is compounded by ignorant settlements because it is less costly. This case should have ended with the employee which attempted to defraud the company and it’s WC being liable for all legal and attorney fees.
This is a prime example why both Health Care and Insurance Costs are out of control in America and why the U.S.Gov. need to step up and make repairs to each of these items, I don’t mean Socialized Medicine/Insurance either.
February 16th, 2010 at 9:58 am
I have not had to deal with a strange claim as this, but have been tagged for an injury by an employee playing basketball at lunch in the employee parking lot and blew his knee out. The Labor Commissioner decided that the injury happened during the course of employment. Now the state legislature is trying to pass a law that would dis-allow these types of claims if an injury happened during a non-working company sponsored event or the employee was not actually working when the injury took place. I hope it makes it through to being signed into law…
February 16th, 2010 at 10:04 am
There are many causes of sneezing. One, and the one that may have cause the sneeze, is of course Airborne Particles. If you have never set foot in the back of a semi trailer then you would not understand. Semi trailers, or any other trailer for that matter, are filled with airborne particles just waiting to find their way into your nasal cavity. When they do, you will sneeze. If the dust was in the trailer, and he was performing a work duty, then he should receive comp. However, his story was misleading in the fact that his stories changed. Therefore, he should not receive comp. If his story was constant, and had reported the injury right away, then he should have received comp.
February 16th, 2010 at 10:42 am
First of all, I disagree with the characterization that this is frivolous. A man has a broken back. Sneezing has been documented as causing or exasperating many such injuries.
Second of all, my experience has been that Workers Compensation tries to grant coverage whenever they can. It keeps them those injured employees off of welfare and other state funded programs that governors like to always show a decrease in numbers and costs. That is why in our state they generously grant unemployment, so also workers compensation (both are employer paid insurance plans).
Finally, if the hospital did not document his comment that it happened “at night”, I’m sure that he would have won the claim.
February 16th, 2010 at 10:48 am
Good to see we’re all on the same page, and particularly agree with TB in MI. If the sneeze was cause by work the injury would be compensatory, such as Brake dust, or any other air borne particle…I have seasonal allergies, and once sneezed so hard it took me to my knees. I thought I had a heart attack. I went to ER and discovered I pulled a pectoral muscle, and had to indure limited duty for 3 wks. I in no wise tried to blame it on the job, would never have thought so…BTW, just like JUSTmy2cent says, This Is Sue Happy America…
February 16th, 2010 at 10:48 am
Just curious, D.P., what state are you talking about? Thanks.
February 16th, 2010 at 11:24 am
Angelia, Iowa is looking at passing this legislation. I am hopeful but, realistically, organized labor has historically shot down these attempts to limit what employers are laible for.
BTW, to all, I am in agreement: if the sneezing happened during the course of employment then it should absolutely be compensable.
February 16th, 2010 at 11:35 am
My problem with this scenario is that the employee did not report the initial injury to his supervisor. In fact he didn’t report it until after he had surgery (after the sneeze). Any injury should be reported immediately to a supervisor, or someone else, if the supervisor isn’t there that day. And what about the next day, or the next? Why didn’t he report it at all? We now have a policy that all employees sign at the beginning of their employment that states they should report ANY injury, no matter how minor, to their supervisor or the safety coordinator.
We are a small company (50 people) and claims like this one really hurts us. We have had three of back injuries requiring surgery, which I believe in all cases were bogus. Our mod, as well our premiums, went up pretty drastically as a result of three such injuries in two year’s time. What I think is sad, is that employees don’t realize that playing the WC system hurts everyone. We could not afford raises partly because of increased costs, especially in these economic times.
February 16th, 2010 at 11:36 am
And people wonder why jobs get sent overseas! This guy was a first rate scamster and thought that work comp was the perfect place for it. I agree with the person who said the employee who filed the claim should be fined, I think that would stop a lot of B.S. claims!
The weirdest injury I ever had to investigate was an employee who claimed he injured his back while zipping up at the urinal, said he slipped on a wet spot on the floor and it caused his upper body to turn all of the way around. It was 2:00 AM and I was called into work to investigate it. I never thought I would see that injury, fortunately it didn’t go very far and it turned out the young man was trying to pull a scam, I would still have to call it a career low-point.
February 16th, 2010 at 11:42 am
My last employer removed a tennis court, a basketball court and a wieght room due to WC liability. It is a shame that when we have the option of health insurance coverage for the injury and WC all too many immediately revert to WC. Strangest one I ever had involved a desk lamp and a workers inability to walk. He walked into the lamp on the way out to his car cracking a tooth. The resultant dental work, (root canal), was covered by WC even though we had great cental insurance. Net result was 2 weeks off and a lost time injury. He later sued claiming extreme pain and suffering. (The case was filed the day after he left for a new job). He didn’t get anywhere but it was a true example of karma when his new job didn’t work out and he came back to apply for his old job. Needless to say his resume got something less than the consideration it might have gotten otherwise. (It helped that he had no degree and the job description called for one).
February 16th, 2010 at 11:49 am
I have a gent that stubbed his big toe while cleaning snow off cars, which means was wearing his snow/work boots. He has been off 3 months in unbearable pain……….nothing has shown on MRI ultra sounds. NOT a darn thing! But since he is doing a great job at…. the pain is to bad to deal with we have to send him to a pain management doc $$$$$ oh forgot to mention he said he did this at work on a Thursday but did not report until the following Monday to his supervisior, he claims the supervisior is just to mean to deal with. We should have let him go when we had the chance!
February 16th, 2010 at 12:04 pm
You’re right, Christina. I don’t think many people who are not in the profession (Safety or HR) realize that WC is not free…it comes from the pockets (no matter how shallow or deep) of the employer. When costs go up, pay increases and benefits go down… bogus claims hurt us all.
February 16th, 2010 at 12:26 pm
I agree the guy was looking fo a payout!! In my past 15 years working with WC claims, I can honestly say that about 1/4 to 1/2 are bogus!!! That is extremely sad. My belief is that people are trustworthy until proven the opposite. However, when it comes to worker’s Comp all bets are off. It amazes me too how Employer’s hands are tied and the employee has the upper hand when it comes to WC claims- especially in states where the employee has the right to choose care. I once had a guy- a young guy-late 20′s early 30′s who claims he hurt is back at work. He doctored off and on for two years - another case where he would “work the system” when it was in his favor. he worked for a volunteer fire department, bowled, and had other extra cirricular activiites that he enjoyed. After about two years of care, he TOLD his health care provider he WANTED back surgery!! Since when is the employee educated enough to diagnose when back surgery is warranted, necessary or in the best interest of the paitient. The treating phyisican moved forward and conducted back surgery. During the recovery period, the employee went on a bear hunt in northern WI - if any of you are hunters and know the strength and endurance it takes to hunt bear, you understand the issues - climbing trees, riding a 4-wheeler to get to tree stand, pulling a bow back and holding it prior to the shot and then once killed, lugging this 350 lb animial through brush and terrain that even a 4-wheeler cannot manage. All activities of which are not good for someone who recently had back surgery. To top it off - the employee had the bear mounted. This was all reported to the WC carrier - who BTW was a Nationwide, very well known TPA. The TPA dismissed it b/c they said they did not have evidence. I, of course, continued my investigation and provided the TPA with the data - the county and the Taxidermist where the bear was mounted (his co-workers were not so loyal) and still they did not persue or check into the fact b/c it did not hinder on the fact that the employee stated he was hurt at work. His co-workers verbally told me that was not true but none of them would go on record to testify otherwise. Too bad b/c my Employer could have save a WC claim of about $350K by the time it was all said and done. One of the biggest let-downs of my career. I have learned that people never cease to amaze me!!
February 16th, 2010 at 12:27 pm
How about a claim for a bee sting which allegedly occurred as the employee was leaving the property to go home. The employee claimed that the sting caused a reaction, which then led to a number of serious complications. The employee regrettably passed away prior to the resolution of this case so I am not sure how it would have been decided.
February 16th, 2010 at 12:34 pm
Understanding this was clearly a case of a liar trying to abuse the system (to add payroll to his recovery time and to avoid his out of pocket on his private medical), the question is what if it wasn’t.
What if the sneeze really had aggrevated a condition and the sneeze was caused by workplace dust and it happened during the course of his job? Should it be WC covered? Under current law, it would be in every state. But I didn’t ask that, I asked SHOULD it. If the workplace was so ridiculously dusty that it caused constant sneezing I can find fault. But we all know employees that really shouldn’t be in our workplaces doing what they are doing. It’s called FITNESS FOR DUTY and it is not evaluated enough, nor in many cases can it be thouroughly done. In this case, if a sneeze is enough to cause a back injury, I contend the employee wasn’t fit for duty. It’s not just a matter of giving a PFT to a respirator user to say you have a fitness for duty program. Even office workers need to be able to exist without hurting themselves. I put a huge responsibility on the employer for controlling the hazards they expose their workers to, but I don’t believe this particular burden should be on the employer. The laws should be changed (Calling all cars, calling all cars). What we drive toward if we don’t is only employing age 18-45 workers with no medical history at all. The whole world has dust and is not HEPA filtered, just because the workplace does too doesn’t make it the employers fault. If the employer has performed the reasonable steps to provide a clean work environment (relatively hazard free), then their obligation should be considered done. Anyways, a mute point when the care gets socialized anyways (except for the lost wages - that would be communism).
February 16th, 2010 at 12:58 pm
I was working in a warehouse job picking up 50lb inconel steel parts and lifting them above my shoulders. I was 5’3″ 120lbs. I told my supervisor that my neck and shoulders were really sore and he told me if I wanted to work there I needed to Do the work required. I went back to work. Someone said somthing to me, I turned my head to look at them and felt a snap in my neck. Result, I ruptured a disc in my neck and had to have cervical disc removal and bone on bone replacement surgery. There were some people that did not believe me.
Several years later, at another job, I was deburring parts, my hand slipped and I got whiplash. I herniated the disc below the one that I had surgery on. The company denied to WC that there was any way I could have injured my self deburring parts so WC came in to my place of employment and found out that the way I was positioned and was trained to deburr was ergonomically a disaster for anyones neck whether having prior injury or not.
I am now working as a Safety Focal with a clear concience that I did not scam, nor do I automatically assume any one that is injured is automatically scamming.
Having 2 neck injurys before I can say YES absolutely you can injure your back or neck (spine) by sneezing!
February 16th, 2010 at 1:50 pm
In the early 1980′s a co-worker who had been a heavy smoker for decades started a HEAVY coughing spell while sitting at her desk, stood up and was bending over her desk, bracing herself on it. When the coughing spell stopped, she was in lots of pain and was taken to the hospital. Turned out she had broken a rib while coughing! But she knew better than to claim it was work-related.
February 16th, 2010 at 2:06 pm
A key reason why the company might win this one is the conflicting story of the worker. My company’s WC carrier recently suggested, in addition to conducting our investigation, having the employee write a statement in their own handwriting about the events leading to the accident. Once we have it on paper, it will be hard for the worker to recant the testimony.
February 17th, 2010 at 2:34 pm
The Fitness for Duty certification remark is appealing to me, because I’ve seen so many people file Workers’ Comp from doing things that should not have hurt them (turning to get a file off the bookshelf, for example). However, then you would have to contend with accusations of unfair hiring practices and be worried about the ADA. We do have people sign that they will report injuries, but then they “forget”.
February 19th, 2010 at 4:06 pm
In a past life we had an actual test process in the pre employment screening which tested for fitness within the job description as well as testing for preexisting CTS. It never was challenged while I was there. We had a 20 - 30% failure rate, mostly due to the CTS testing. We then put employees through a “toughening” period where they were put through simulated production process work starting with 30 minute sessions and ending with 2 hour sessions. Within 18 months of the implementation of the testing/tougheniing we started to see a decided drop in CTS and a marked reduction in sprains, strains and other soft tissue injuries. The drop out rate in the classes was in the order of 15 - 30 %. Net result was that 40 - 50% of accepted applicants washed out leaving us with much better prepared workers and fewer injuries.
February 22nd, 2010 at 3:37 pm
Years of experience and lots of weird claims have made Safety Proffessionals cinical, so if some of you would be as patient with us as we have been with you. I have learned to push the physician for MRI’s at the first sign of back or neck injury claim they can usually tell if it is a new injury, previous or nothin, it cost a little more but saves ALOT in the long run, I also have an investigation form that requires a written statement from the injured employee and any witnesses to filled out seperately and by themselves in their own words. Also implemented BBS (behavioral based safety). So yes a sneeze could cause an injury but most likley not to the extent this employee claimed and Linda what you were doing was totally different from what the other claim was and you did the right thing in bringing it to your supervisors attention right away (I am sorry they did not listen to you), we have to put tools in place to counter act false claims and still be able to help the legitimate ones. This guy should have to pay, he took time, care and money from someone who was legitimately hurt.
February 23rd, 2010 at 1:55 pm
Hello Safety in TX,
Not sure what you truly get out of your MRIs since in most states Work Comp and under OSHA recordability, aggrevation of an existing condition is both compensable and recordable. Under recordability, you could possibly tie it back to a previous recorded claim (so as not to double count) if you were actively still managing the condition (requires numerous things including being still under the doctor’s care and not released to full duty). Under WC, it really is irrelevant. Whether you pay for it on the old claim (because as you know in TX you have lifetime medical on a WC claim for a specific condition if not awarded a partial or total disability and basically pay the lump sum out for the damage) or pay for it on a new claim, if the injury happened at work whether the initial injury or aggrevation of pre-existing (and yes I understand this specific claim was fraud), then it’s compensable and recordable under current law. If you choose to employ an individual with a frail condition, you put your company at risk, that’s why I talked about fitness for duty. You can’t after the fact say, I’m not paying for it because I shouldn’t have let them work here because they had an old injury. If you could, we’d all put little old ladies on our loading docks and say “yeah, but she’s old”.
April 27th, 2010 at 9:49 pm
The other day I had a pretty violent sneeze as I sat in my car in the morning, got the worst back spasm I’ve ever felt. Sure enough, I couldn’t drive, nor could I walk. After looking at x-rays, the diagnosis was a severely sprained lower back. Still hurting pretty bad, have to go to therapy the rest of the week, and hopefully that’s it, but the pain from any minor movements is intense right now, as I lay in bed.
April 28th, 2010 at 1:21 pm
Floyd Sanders, I feel your pain. See my notes above dated Feb 16…Good luck my friend, and Stay Safe…
October 13th, 2010 at 11:27 am
A sneeze can cause severe back issues. I once sneezed while showering. I went to work and after about two hours, I was so hunched over that I barely made it home. Once home, I went to bed. Then I realized I couldn’t get up out of the bed. My wife rolled me over and I was able to roll off the bed where my knees rested on the floor. From there I was able to stand up and get into the car. My doctor gave me some musle relaxers and after just one, I was able to straighten up. Dangest thing I had ever seen.
I was at work when I started to hunch over but I didn’t say it was work’s fault. Sometimes things happen at work that are not work related. Then, it depends on the honesty of the person. Unfortunately, there are many that try to get over on the system and cause issues for people with real needs. I guess that’s just life.