Falls are one of the top causes of injury in the workplace. The Centers for Disease Control and Prevention reports 43 percent of falls over the last decade have involved a ladder. Among construction workers in particular, ladders are involved in 80 percent of all falls that land them in the emergency room.
Workers who suffer injury as a result of a ladder fall should pursue workers’ compensation to cover the cost of medical expenses, as well as lost wages for the amount of time they are unable to work.
This was the case in Hildebrant v. State ex rel., Dep’t of Workforce Servs., where an HVAC technician suffered a bad fall while working on a college campus construction project. The worker fell about 20 feet off the ladder, and was taken to a local hospital by ambulance. He complained of pain in his lower back, right shoulder and right leg.
After receiving emergency care, he was discharged but received ongoing care from a physician. The doctor indicated that a small compression fracture in the man’s back appeared to be chronic, but he couldn’t rule out the possibility that it was caused by the fall. He also had some bone bruising, torn tendons and other issues, but no acute traumatic changes to the lumbar spine. Although he noted patient had ongoing pain, he did not see anything that warranted surgical intervention.
Technician applied for workers’ compensation benefits, and the division did find he’d suffered a compensable injury as a result of his fall off the ladder at work. Body parts covered under the claim were worker’s lower back, mid back and right shoulder. Much of the treatment he continued to receive involved pain management, which included high doses of narcotics. Doctors noted this wouldn’t be a good long-term solution.
Worker was referred to another doctor, who recommended steroid injections to quell the pain. After two sessions without improvement, this doctor recommended surgery to implant a spinal cord stimulator. The doctor sent a request for pre-authorization to perform the surgery. However, the division sent the case for independent review by two physicians. One said the surgery wouldn’t be unreasonable, but he didn’t believe the leg and back symptoms of which worker complained were due to the work injury. The other indicated surgical intervention wasn’t warranted, and other less invasive forms of treatment had not yet been tried. Further, he said the patient needed to quit smoking and undergo a psychological evaluation before he could be considered a good candidate for surgery.
Based on those two independent reviews, the division denied the pre-authorization request for surgery.
Worker requested a hearing. Prior to this hearing, evidence was submitted showing worker had suffered a number of other substantial workplace injuries to his back. He’d undergone at least four back surgeries from 1986 to 1997. He had also been deemed 100 percent disabled by the workers’ compensation division in another state. However, he again joined the workforce in Wyoming (where this case unfolded) and 10 years later again injured his back at work. He was still receiving pain treatments for that when he suffered his fall in 2011.
Ultimately, the hearing examiner determined the requested surgery was not reasonable or necessary, a determination affirmed by the district court, appeals court and finally, the Wyoming Supreme Court.
Workers do have the right to be compensated for medically necessary, reasonable care. However, proving that will take more than a doctor’s note. You will need an experienced workers’ compensation attorney to help further your case.
For information on Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-303-7770.