Employee entitled to compensation for pre-existing condition: Court of Appeals Arkansas
Through a recent judgment, the Court of Appeals of Arkansas, Division Four, has made it clear that employment circumstances which aggravate an employee’s pre-existing medical condition are compensable.
The long legal battle fought by Joey Hopkins against its employer Harness Roofing, Inc. has finally come to an end. After an Administrative Law Judge (ALJ) and the Workers’ Compensation Commission (WCC) had denied Hopkins’ claim for additional medical treatment, finding that he had failed to prove the treatment was causally related to his 2010 injury, Hopkins filed an appeal.
Joey Hopkins had been employed with Harness Roofing, Inc. for 11 years of which he worked as a foreman for 6 years. During his employment, he suffered compensable injuries to his knee in 2007 and 2008 which was corrected through surgeries. The injuries were severe in nature and were described as medical meniscus tears with effusion and cartilage damage.
In 2010, while Hopkins was stepping onto a higher elevation on a roof, he felt a tear and pain in his right knee which was promptly reported to the employer. After several scheduled medical visits, failed responses to rest, anti inflammatory medications and home exercises, the surgeon recommended arthroscopic surgery of the right knee to Hopkins.
Hopkins testified that after December 2010, he waited for surgery approval from the employers. He further mentioned about checking with his boss without obtaining an answer. After a continuous checkup with the employers regarding the approval of the surgery, he was told that the report is in review.
By 2011, the authorities were reluctant in approving the surgery, as it was unclear whether his approval of surgery was considered or denied by Harness Roofing or Gallagher-Bassett, Harness Roofing’s third-party administrator. In May 2011, he left the office and joined taxidermy school and pursued a career that would be easier for his body. He did not get knee surgery till 2013, and in April 2013 he visited Dr. Christopher Arnold. Dr. Arnold saw the test and recommended Hopkins to undergo the cartilage restoration procedure and noted that if he did not, he would eventually need a knee replacement.
The Court of Appeals found that an aggravation of a preexisting, noncompensable condition by a compensable injury is, itself, compensable. The major-cause analysis is applicable only in gradual-injury cases and when the employee is seeking permanent disability benefits.
The court further stated that The Workers’ Compensation Act provides in Ark. Code Ann. § 11-9-508(a) that the employer must promptly provide that medical care as may be reasonably necessary in connection with the injury received by the employee. What is reasonably necessary medical treatment, and whether it is causally connected to the compensable injury, are questions of fact for the Workers’ Compensation Commission. For a work-related accidental injury, it is not necessary that the claimant prove that the injury is the major cause of the disability or need for treatment. It is the claimant’s burden, though, to establish by a preponderance of the evidence that he is entitled to additional medical treatment. Because employers take an employee as he finds him, employment circumstances that aggravate preexisting conditions are compensable.