Medical Records Link Worsening Foot Injury to Job Removing Trees

A worker for a tree removal company in Corson v. John Lucas Tree Experts, No. App. Div. 21-0002 (W.C.B. Me. 08/24/22), established that his employment combined with his 2015 preexisting bilateral foot injury to create an eventual disability in 2018. 

The worker’s compensation board, in both parties’ appeals from an ALJ’s decision, explained that if a work-related injury aggravates, accelerates, or combines with a preexisting physical condition, any resulting disability is compensable only if the employment contributed to it in a significant manner.  

Medical Causation 

A “combined effects” case, the board observed, requires, in part, a showing of medical causation. An employee can show medical causation by establishing that: 1) the work activity or incident does in fact produce the symptoms; or 2) the work increases the disabling effects of an already symptomatic preexisting condition. There is no requirement that the preexisting condition be work-related, the board added. 

The board pointed out that the ALJ found the medical records clearly showed the worker’s symptoms started worsening in November 2018. The worsening symptoms resulted in disability in 2018, requiring the worker to be off his feet for 94 percent of his workday.  

Additionally, the ALJ found that the increase in symptoms was caused by the employee’s work, which required him to be on his feet, working outdoors and walking on rough, uneven terrain. The board was not persuaded otherwise by the fact that the employee’s two doctors did not settle on a medical diagnosis for the increased foot pain. “There is no requirement in … that the preexisting condition be work-related, thus there is no requirement for a medical diagnosis attributing the preexisting condition to the employment,” the board wrote. 

Further, even without a diagnosis, the evidence established that the work activity produced the onset of symptoms and increased the disabling effects of an already symptomatic preexisting condition. 

The board thus found sufficient evidence to establish that the worker suffered a work injury and that the injury contributed to the disability in a significant manner. The ALJ thus did not err by finding the injury compensable, the board concluded. 

Post-injury Earning Capacity  

However, the board found that the ALJ’s decision fell short with respect to assessing the worker’s post-injury earning capacity. Specifically, the ALJ did not connect the employee’s retained imputed earning capacity to his age, education, time out of work, and lack of computer skills. Further, the board stated, the ALJ failed to specify how many hours per week the worker remained able to work. 

The board vacated the decision in part and remanded it so that the ALJ could clarify the factors she considered in assessing the worker’s retained hourly earning capacity, and the number of hours he was able to work in a week