Is it Workman's comp?

Hello All. I have a question that I need some reponses on.

We had an employee who fell down a flight of stairs. It would seem a easy case for Workman's comp. However, he had preexisting conditions of Diabetes and was on Heart medication that had recently been recalled.

The company wants to take care of the employee no matter what but what is the recourse if the Doctors find that the prexisting condition caused the fall. Is there any way to reverse what has already been paid by Workman's comp?

Comments

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  • Workers' comp is usually limited to treating the injury or illness that occurred in the workplace plus any secondary issues that develop as a result, and not compensating for underlying conditions. If your worker was on the clock when the fall occurred and sustained injury, your w/c should compensate the treatment of the injury. The underlying condition should not be w/c, unless there is evidence of some sort of chemical exposure that led to the event.

    To be sure about the limitations of w/c, your w/c carrier (unless you are self insured) may pay the costs of medical evals to confirm that an underlying condition caused the event.

    Check your state reg on w/c as well and see if there is anything specific contained in the regulation.

    best wishes
  • Funny you should mention this - I just read an article on this exact situation.

    See Hutton vs Manpower, Inc. (Idaho Supreme Court, No. 32160, 7/20/07)...the court had some interesting findings on the relationship between preexisting conditions (specifically diabetes) and on the job injuries (specifically getting light headed and falling).

    Good luck!
  • I always submit the claim to our w.c. carrier and let them decide what they will/won't pay for. If there are extenuating circumstances, I advise them of such and they take it from there.
  • NC. . .can you tell me where you read about this? I have searched extensively and can't find anything. We just had WC deny a claim for an ee with diabetes. I was very unhappy. Curious to read about this case.
  • I read about it in a Benefits & Compensation newsletter I receive (don't think MLee Smith would appreciate me plugging a competitor here!) but if you just do a Google search on "Hutton v Manpower" about the first 10 or so hits have great information.
  • Got it, thanks. I must have been mis-googling yesterday.
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