Aggravation Injury Denied in Court Case

 

In the Worker’s Compensation arena, what many injured employees fail to understand is that the concept of aggravation is a critical factor in determining what injuries are work related and which are not. The insurance carriers will often deny injuries as pre-existing, when in fact the employee had no previous problems or the previous injury may have resolved or lessened to an extent that it was no longer a factor. The employee may have suffered an aggravation to the prior injury or a pre-existing condition which has rendered the employee unable to work and in need of urgent medical care.

 

Texas Worker’s Compensation law provides for coverage for aggravations of pre-existing conditions. The law requires that the employees show that the injury was a substantial contributing factor without which the injury would not have come about as a clinically significant condition in the time and manner in which it did.

 

This has several components. The injury must be a substantial contributing factor. Note that there may be more than one substantial contributing factor. And the substantial contributing factor of the injury need not be the most severe of the multiple factors involved in developing the condition. For example, age, other conditions such as diabetes, a prior injury, and other medical factors such as obesity or smoking may contribute to the Bella meant of a condition but as long as the injury was one of the substantial contributing factors, the injury is covered.

 

In this case, the Utah court found that the employee failed to prove that the injury was aggravated by the event occurring on the job. This meant there was no coverage for the injury. In Texas, there will be a similar burden to show that the injury was a substantial contributing factor in giving rise to the condition.