I&F Prevails where IWCC Arbitrator Finds Intervening Accident Breaks Chain of Causation

In an Illinois case recently tried by I&F Partner Colin Mills, the claimant was seeking over six months of medical benefits, as well as PPD benefits, resulting from a lifting injury that occurred while working as a nurse for the insured. However, the Arbitrator agreed with our position that the claimant’s treating medical records clearly showed that she suffered an intervening accident which broke the chain of causation regarding any work-related conditions and the need for further medical care.

Under an independent intervening cause analysis, compensability for an ultimate injury or disability is based upon a finding that the employee’s condition was caused by an event that would not have occurred “but-for” the original injury. To that end, the Courts have held that increased complaints of pain coupled with new and different symptoms will support a finding that a second accident constitutes an independent, intervening cause that breaks the chain of causation between an original work-related accident and condition of ill-being. In this matter, the claimant alleged that she injured her back while lifting soiled linens as part of her job duties as a nurse on October 30, 2014. During initial medical treatment rendered subsequent to the accident, the claimant complained of only right-sided pain to the spine, hip, and leg. She made no complaints of radicular symptoms, numbness, or tingling. However, at a medical appointment on November 10, 2014, the claimant described an event at home the day prior (November 9) that caused her to  twist her back and result in symptoms down the bilateral lower extremities. It was evident in the medical records that followed that the claimant’s symptomatic and clinical presentation had changed dramatically in that she had new symptoms, increased symptoms, and new treatment recommendations from her treating physicians. As time went on, the claimant reported that the pain was at that point actually worse on the left side than on the originally affected right side.

Given the claimant’s myriad of increased symptoms and complaints following the November 9, 2014 intervening accident, the Arbitrator found that the record clearly demonstrated that there was clearly not a “but-for” relationship between the claimant’s diagnoses rendered subsequent to November 9, 2014 and the injuries sustained while working on October 20, 2014. Therefore, the November 9, 2014 incident constituted an independent intervening accident that broke the chain of causation.  The claimant was awarded minimal PPD benefits and medical benefits through November 9, 2014 only. The claimant did not seek Commission review of the Arbitrator’s decision.

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Congratulations to Colin Mills on this favorable outcome!

 

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