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WORKERS COMPENSATION CASE WATCH

The claimant was injured at the auto glass company he owns.   The business had a workers’ compensation insurance policy but the insurer argued that the claimant was not an employee as defined by the Act so he was not subject to the policy’s coverage.

WORKERS COMPENSATION CASE WATCH

In Morres v. Earth Treks Crystal City Climb, the claimant worked at a recreational climbing gym.  The employer required employees to clock in before their shifts and prohibited employees from performing personal climbs while on the clock.  Before clocking in for her shift, the claimant did a warm-up climb, which she said was in preparation for performing rope maintenance.  She climbed with another co-worker, who was not scheduled to work that day.  During her warm-up climb, she took a practice fall.  She was injured in the fall.

The Deputy Commissioner found that the claimant was engaged in personal, recreational rock-climbing and was not in the course of her employment when the injury occurred.  On Review, the full Commission agreed, stating “…we do not find whatever ephemeral benefit the employer might receive from the claimant sharpening her climbing skills sufficient to bring

WORKERS COMPENSATION CASE WATCH

On January 6, 2020, the Commission briefly addressed the issue of telemedicine in the treating physician relationship.  In Carter v. Mondelez International, the claimant was injured in a motor vehicle accident and was treating with a psychologist for PTSD. 

WORKERS COMPENSATION CASE WATCH

In Sorour v. Avalon Transportation, the claimant, a limousine driver, was injured in a single vehicle accident. At his supervisor’s request, the claimant was driving to the company’s office.  As he exited the highway he hit the guardrail on the exit ramp at a low speed, causing his injuries.

WORKERS COMPENSATION CASE WATCH

In a November 19, 2019 Review, the Full Commission held in Bayne v. Horizon Behavioral Health that the claimant did not establish a mechanical change as a result of her accident, and therefore, did not establish a compensable injury. 

The claimant, a clinical mental health examiner, alleged an injury to her low back as a result of an eight-year old child charging into her ten to fifteen times, causing her back to strike a horizontal door handle.  The claimant had a history of four lumbar surgeries prior to this incident.  The claimant testified that she felt a sharp increase in pain as a result of this incident.  In affirming the Deputy Commissioner’s denial, the Full Commission cited Dr. Vanichkachorn, who treated the claimant before and after the alleged work accident.  The doctor opined that there was no evidence of any structural or mechanical change in comparing diagnostic studies taken before versus after the incident.  He opined

Workers' Compensation Case Watch

In Manion v. Northwestern Regional Adult Detention Ctr., the claimant needed a new physician because her doctor was no longer providing pain management. The employer asked a nurse case manager to find a new doctor for the claimant and to obtain a Functional Capacity Evaluation (“FCE”) from the physician. The nurse got an FCE referral from the new doctor and scheduled the appointment. She told the claimant about the appointment in person and left her several message about it. The claimant said she would not attend and cancelled the FCE.                                                                                                                                   

The defendant filed an Employer’s Application for Hearing alleging refusal of medical treatment because the claimant did not go to the FCE. The Deputy Commissioner denied the Application because the scheduled FCE was not medically necessary treatment. On review, the Full Commission cited the longstanding principal that the claimant’s medical treatment is directed by the treating physician and not the defendants. They noted that a

Workers' Compensation Case Watch

In Ross v. Cumberland Hospital, the claimant sustained a severe brain injury. Her doctor said it was medically necessary that she have a home health aide or family member oversight to assist her with activities of daily living and monitor safety concerns. The claimant filed a claim asking that her spouse be paid to provide home health care to her.

The Commission found that spousal care should be authorized. In reaching that conclusion,

Workers' Compensation Case Watch

In Umana v. Clark Construction Group, the claimant was injured in a work accident.  The claimant saw a doctor for his work-related injuries.  In his report, the doctor outlined the claimant’s light duty restrictions but also said “there is no light duty work available, so he remains unable to work at this time.”  In his office notes each month, the doctor repeated that because there was no light duty available, the claimant remained unable to work.  The Deputy Commissioner found that the claimant was totally disabled during those periods.

Workers' Compensation Case Watch

In Clarke v. Hughes Center, LLC., the claimant established a treating physician relationship with a pain management doctor in Danville, VA. The claimant later moved out of state, but continued having appointments with the same treating physician. The claimant was traveling 320 miles round-trip to see the doctor. The defendants filed an Employer’s Application for Hearing seeking a change in treating physician. The Deputy Commissioner denied the Employer’s Application.  

On review, the Full Commission listed the six-factors it considers to justify a change in treating physician: 1) inadequate treatment is being rendered; 2) a specialist’s treatment is needed but

Workers' Compensation Case Watch

In Williams v. CJ Designs, Inc.,  VA00001427406 (July 8, 2019), the Virginia Workers' Compensation Commission found that a claim arose out of the employment when an employee was injured while straightening up after bending from the waist with nothing in her hands.

The claimant, a Certified Nursing Assistant, was helping a patient into a car when she injured her back. The claimant bent straight forward from her waist, with her arms in a U-shape so she could scoop them under the patient’s legs and pivot the patient’s feet in front of her. She had already touched the patient’s feet, did not have anything in her hands, and was straightening from the waist when she felt a pop in her back. The claimant confirmed that she had performed this action many times and that it was not in any way awkward or unusual. The Deputy Commissioner found that the claimant’s injury did not arise out of the employment.

The Commission REVERSED, finding that the claimant was required to