Can Nurse who Returned to Work Post-Injury, then Stopped, Get PTD Benefits?

What Do You Think?

Courts generally weigh multiple factors when determining whether an injured employee is unable to return to work for purposes of a PTD award. A Kentucky case involving a hospital nurse illustrates some of the factors that may come into play.

The 65-year-old registered nurse was considered professional and intelligent. Nursing was the only type of work she had performed for the previous 40 years. One day in December 2021 she injured her shoulder and neck when she fell backwards while helping transfer a patient from an ambulance.

She received treatment but could not have surgery due to a heart condition. Although her pain persisted following the injury, she went back to work from May 2021 until January 2022. After that, she stopped working completely. She later explained she returned to work because her husband needed her health insurance benefits to continue his cancer treatment.

A doctor found a 5% whole body impairment and concluded that the claimant could go back to working as a nurse but placed significant restrictions on her ability to work. Those included such things as: no frequent, repetitive, or sustained activities; and avoiding prolonged sitting and walking with position changes.

An ALJ awarded her PTD benefits. An appeals court upheld that decision, and the hospital appealed to the Kentucky Supreme Court.

The Supreme Court explained that for a claimant to be entitled to PTD, an ALJ must find, among other things, that the claimant is unable to perform any kind of work. Relevant considerations are: 

1. The worker's post-injury physical, emotional, intellectual, and vocational status.
2. The likelihood that the particular worker would be able to find work consistently under normal employment conditions, including whether her physiological restrictions prohibit her from using her job skills.

Was the nurse really entitled to PTD benefits?

A. No. She could have started over in a different field, especially with her education.

B. Yes. Her age, state of health, and limited ability to move, sit, and walk bolstered the ALJ’s decision.

If you selected B, you agreed with the court in Pikeville Medical Center v. Baker, No. 2024-SC-0214-WC (Ky. 02/20/25), which upheld the PTD award.

The court noted that the  statutory definition of "work" does not require a worker to be homebound in order to be found to be totally occupationally disabled.

It was true, the court stated, that no doctor said she could not return to work and that the examining doctor gave her a minor impairment rating. It was also true that she was educated and that she returned to work for several months after her injury. But the doctor’s failure to restrict her from any type of work did not preclude the PTD award. 

Further, the ALJ specifically found that the claimant’s age, employment history, and work restrictions carried greater weight than her impairment rating and education level. It was clear she could not return to her prior job. And, according to the ALJ, her ability to retrain for another line of work or find an entry level job given her age and state of health was a near impossibility.

In addition, the fact that the claimant returned to work for several months did not bar her from a PTD award. The ALJ, the court noted, accepted her explanation that she did so for her husband’s sake and despite her pain. 

“[W]e agree with the Board that, based on the evidence of record, ‘the ALJ could reasonably infer [the claimant] was working beyond her physical limitations solely for the purpose of ensuring her husband could continue treatment of his cancer and ultimately ceased work due to her inabilities resulting from the work injury,’" the court wrote.

Noting that its review was limited to whether the ALJ flagrantly erred in assessing the evidence, the court affirmed the award of PTD benefits.

Share This Article: