Deny Medical Condition in L&I Claim: Work Injury Causation vs Degenerative – Workers Compensation Legal Blogs Posted by Tara Reck, Esq.
As we all get older with age, our bodies tend to wear out. As with all things human, the frequency and severity of wear and tear from aging varies from person to person.
Age-related degenerative diseases
From a medical point of view, many refer to the term aging of the musculoskeletal system as “degenerative” or “arthritic” changes. Most human adults will experience these changes. However, they don’t always cause symptoms such as pain, restricted mobility, and others. In general, doctors can determine the severity of the changes with an X-ray or MRI test.
As we age, our bodies may also be more prone to injury or illness, including occupational accidents and diseases. If you are injured at work, our age and degenerative changes can sometimes complicate matters. In fact, they can make it harder to find the cause of a particular disease. For example, did the work accident after an injury at work cause the medical condition? Or is it the age of the person and the natural aging process?
Denial of medical condition in L&I claim
Personally, it is very common for the Department of Labor and Industry (L&I) to reject these physical changes as part of an employee compensation claim. This is because L&I regards the changes as degenerative. In other words, they often argue that the cause is not occupational injury or occupational disease (or work-related exposure). In my opinion, however, this assessment is wrong in many cases. In addition, the Industrial Insurance Act contains clear legal principles on the cause of damage in connection with aging.
Washington State Workers Compensation Eligibility: The Act
In Washington state, workers’ compensation covers all workers regardless of their age or previous health. When examining the effects of an occupational accident or workplace exposure on a person, the basis for the examination must be the individual worker. Therefore, it doesn’t matter what impact similar workplace injuries or illnesses might have on some other people. However, we have to take into account existing conditions. And when we do this we need to examine their status, that is, how each condition was before.
For example, suppose a person with an L&I or employee compensation claim had a condition that was not causing problems. According to the law, the condition is causal if the accident at work or the occupational disease has made it symptomatic. Similarly, take another example where a person with an occupational accident claim had a condition that was causing problems. If the accident at work or the illness made the condition worse, this is also causal.
The age factor
Therefore, in any employee compensation claim, we must pay particular attention to conditions that can worsen with age. As we get older, more diseases can emerge with our natural aging process. However, it does not preclude L&I from accepting the medical condition under an L&I claim. Most importantly, for any employee comp claim, the facts concerning the individual applicant, including his / her conditions, now and in the past are examined.
Further information: https://tarareck.com/l-and-i-claim-condition-denied/
~ * ~ * ~ * ~ * ~ * ~ * ~ * ~ *
Ms. Tara Reck is the executive L&I attorney at Reck Law – Workers’ Compensation Attorneys in Washington State. If you would like further information, please contact Ms. Reck via:
* Seattle | Bellevue | Mercer Island Office: (206) 395-6141
* Tacoma Office: (253) 999-9828
* Renton office: (425) 800-8195
* Port Orchard Office: (360) 876-4123
* Email: [email protected]
* Your Workers’ Compensation blog at https://tarareck.com/contact/ or their company website at https://recklaw.com/contact/