October 25, 2016
What happens if another body site starts hurting after your initial injury? For example, let’s say you injured your right knee. You had surgery a few months later, and recovery is not going well. You spend months in physical therapy and develop a limp. Because you have been favoring your right leg, your left knee or left hip starts hurting. For workers’ compensation purposes, this is called a consequential injury. The courts have long recognized that a consequential injury is compensable, provided there is “a sufficient causal nexus between the initial work-related injury for which a claim is established and the subsequent injury” ( see e.g. Matter of Barre v Roofing & Flooring , 83 AD2d 681 ; Matter of Pellerin v N.Y.S. Dept. of Corrections , 215 AD2d 943 , lv den 87 NY2d 806 , Matter of Scofield v City of Beacon Police Dept. , 290 AD2d 845 ).
What should you do? First, report the symptoms to your doctor as soon as possible. The doctor will need to be sure his or her medical notes include an opinion on whether the new condition developed as a consequence of the initial work related injury. If he or she feels that is the case, they should include in their report a diagnosis, a medical opinion on the underlying cause of the condition, and how he or she feels the condition is related to the work related compensable injury, i.e., is it an expected consequence of the injury you have. Second, this note needs to be sent to the workers’ compensation board, insurance carrier, and attorney so a hearing can be requested to address this additional body site. The carrier has the right to send you for an independent medical exam for that doctor to evaluate whether they believe you have a consequential injury. Finally, once this is done, and the site has been accepted by the carrier and added to the claim, you will have full medical coverage, and potentially an additional award, for this injury as well.
If you think you may have developed a new condition as a result of your work related injury, or if you have questions about this process, contact the Zea Proukou team today.
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