Virus Sequencing Useful to Establish Causal Relationship

A recently reported technique maybe prove extremely helpful to establish causal relationship in workers’ compensation cases. Whether a healthcare worker’s severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is community or hospital acquired affects establishment of compensability of a claim. 

Termination and the lingering cloud over a disabled worker

Injured workers are in constant fear of losing their jobs as a result of absenteeism caused by injuries incurred at work. NJ Supreme Court Justice LaVecchia noted in a recent concurring opinion in a Law Against Discrimination (LAD) case, that termination based on absenteeism challenges the remedial social intent of the workers’ compensation act.

Weighing Genetic Factors in Cardiovascular Cases

Cardiovascular cases involving occupational risks are complicated causation proof issues in workers' compensation cases. The association of the work exposure and/or effort is usually a challenging proof battle where literature and medical experts are caught in a contentious duel.

Substantial Credible Evidence Remains the Rule

Despite the informality of  a workers compensation hearing, the evidence relied upon by the hearing official must be substantially credible in order to meet the burden of proof to assess disability. When the claimant has had a history of a multitude of back injuries, sorting out the claims maybe a complicated and difficult process. The compensation judge is compelled to ascertain which accident  is the ultimate triggering incident that resulted in permanent disability. 

The last back claim of a worker did not meet the evidential standards to sustain a claim for disability when the diagnostic tests, as interpreted by the treating physician, did not support the evidential requirements to establish the assessment of permanent disability. 

A worker in New Jersey, who has a long history of back injuries, both at work and at home, was unable to meet the evidential requirements to to establish a case for increased disability. An MRI, interpreted by the treating physician, demonstrated no change in the injured workers medical condition following the last incident at work.

Accordingly, The NJ Appellate Division sustained the ruling by the compensation judge, who had held that proofs offered at trial were insufficient to meet the requirement of the statutory credible evidence standard. The trial judge was held to have correctly relied upon the treating physician’s diagnostic MRI taken subsequent to the last accident to rule out the final incident as the triggering episode that generated the claimant’s disability. 

Beausejour v Chamberlin Plumbing & Heating, Inc.,  2014 WL 300929 (N.J. Super. A.D.), Jan. 29, 2014

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NJ Court Sets the Evidentiary Proof Standard for a Pulmonary - Cardiovascular Claim

A NJ Workers' Compensation Court affirmed the dismissal of a pulmonary claim ruling that the evidence presented was lacking, and that the statutory limitations of expert medical fees do not act to the detriment of the injured worker in the proof of a workers' compensation claim.

"In her written opinion, the compensation judge found the testimony of Dr.Kritzberg more credible than that of Dr. Hermele. The judge found that petitioner's counsel “trie[d] to make it appear that petitioner presented to Dr. Hermele on his own for treatment. That is simply not true. Petitioner's counsel sent petitioner to Dr. Hermele. Dr. Hermele did not treat petitioner.” Additionally, of great significance to the compensation judge was the fact that petitioner had been treating with a cardiologist for twenty-three years, testified that he believed his breathing difficulties were related to his heart condition, and had never been treated for any pulmonary condition, despite testifying that his pulmonary complaints worsened in 1988, while continuing to work for respondent for eleven more years. The judge inferred that petitioner's cardiologist never referred him to a pulmonary specialist for treatment.

The Court also held that an "adverse inference" could be drawn when the injured worker does not offer supporting medical records into evidence to prove a claim.

"The compensation judge drew an adverse inference “from the fact the petitionernever produced a certified copy of the records from his treating cardiologist orhad Dr. Hermele review said records as part of his evaluation[,]” noting that Dr.Hermele readily admitted “there is a relationship between the heart and thelungs.”

Furthermore, the medical evidence presented at the time of trial, support the lack of causal relationship of a pulmonary medical condition caused by a pre-existing cardiovascular condition, rather than an independent pulmonary condition cause by exposure to industrial air pollution.

"Critical for the court were the chest x-rays taken of the petitioner which
showed that he did not have bi-lateral flattening of his diaphragm. If he
truly had pulmonary disease unrelated to his heart condition[,] you would expect
to find bi-lateral flattening of the diaphragm. Only the left side of petitioner's diaphragm was flattened[,] which is to be expected since both doctors
agreed petitioner has cardiomegaly (enlargement of the heart).....