A work related injury is compensable under Pennsylvania workers compensation laws even if it is an aggravation of a pre-existing condition such as osteoarthritis. In Brand Energy Services, LLC v. Worker’s Compensation Appeal Board , an employer appealed an award by a workers compensation judge arguing that causation had not been established for aggravation of bi-lateral carpal tunnel syndrome, osteoarthritis and other conditions.
The employee, a union carpenter, was employed to build, modify and dismantle scaffolding for the employer’s clients. His employer was paid by the foot for the scaffolding erected. The employee had been working days. When he was transferred to a night shift, his work assignment increased from eight hour shifts to ten to twelve hour shifts. He worked thirteen days in a row and had only one day off. Not only was he expected to work longer hours, but to meet the needs of the plant where he was working, they had to erect more scaffolding per shift. He testified that in an eight hour shift, the workers would assemble 300 leg feet of scaffolding. In the night shift, he was building between 1000 and 1200 leg feet.
The worker’s hands became swollen under this new work regimen. He sought treatment for his hands, as they continued to be numb, swollen, and tingly. His doctor diagnosed work-related bilateral carpal tunnel syndrome, osteoarthritis, and left scapholunate advanced collapse (SLAC) wrist. When the worker submitted a note from his family practice to his supervisor outlining his diagnoses, he was laid off.
On appeal from the workers compensation tribunal, the Court faced two issues: (1) whether the doctor’s testimony was equivocal as to the causal connection between the work and the work-related aggravation of underlying conditions; and (2) whether the doctor had a sufficient understanding of the work, and consequently, a proper factual foundation for a medical opinion such that his opinion was competent.
In terms of the former question, the court held the causal connection was a question of law and worker’s burden to present unequivocal medical testimony. At issue was whether the doctor’s use of “probable” with respect to causation of one of three diagnoses rendered the entire opinion insufficient to support any award. The court disagreed with the employer’s argument in this regard. It found that the doctor’s testimony as to the aggravation of carpal tunnel syndrome and osteoarthritis was sufficiently supported. However, because the doctor testified that there was a “probable SLAC wrist,” that diagnosis was insufficiently proven.
In terms of the latter question, the Court considered Pennsylvania case law that held proffered medical opinion can be rendered incompetent if the medical professional does not have a complete grasp of the patient’s work, such as if the medical profession demonstrates a lack of knowledge as to his or her patient’s tasks. While the Employer argued the doctor did not have a complete grasp of the job duties, the Court rejected its argument because the doctor reviewed his patient’s testimony and took a history from him. Given this testimony, the Court considered the doctor competent to render an opinion.
Thanks to Lauren Berenbaum for her contribution.
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