Pre-existing Conditions: The Straw that Broke the Camel’s Back

Frequently, workers compensation claims boil down to medical causation.  That is, whether your condition is, in part, related to your industrial injury or occupational disease/repetitive trauma. The key here is the “in part” requirement. There can be several factors contributing to your condition, such as age, arthritis, smoking, obesity, etc.  However, only part of your condition must be due to the industrial injury or occupational disease/repetitive trauma.  This is true even if the injury accelerates your need for a surgery you were destined to undergo in the future, regardless of the on the job injury.  Workers compensations benefits are not limited to those workers in good health.

Lighting up doctrine:  If you have a pre-existing condition that is “lit up” (aggravated or exacerbated) by the industrial injury or occupational disease/repetitive trauma, then it is an allowable condition.  The fact that you had a pre-existing condition, or a predisposition toward a problem, does not prevent your workers’ compensation benefits.

A parallel can be drawn to the old adage about the straw that broke the camel’s back.  Camels are great pack animals, and can carry a significant load for their size.  One can keep loading the camel’s back and, instead of gradually bending under the load, the camel appears to suffer without complaint until the last, tiny additional weight (a straw), in which case the camel suddenly collapses.  Thus, the straw that broke the camel’s back.  Likewise, you may sustain a normally minor on the job injury, which is your last straw, causing that area of your body to completely give out.  This would be an allowable condition. This makes sense because pre-existing conditions may make a person more susceptible to injury or cause their injury to be worse than if a person in good health sustained the same injury.

Our Supreme Court has stated that “The worker whose work acts upon a pre-existing disease to produce disability where none existed before is just as injured in his or her employment as is the worker who contracts a disease as a result of employment conditions …. The worker is to be taken as he or she is, with all his or her pre-existing

frailties and bodily infirmities.” Dennis v. Department of Labor and Indus., 109 Wn.2d 467, 745 P.2d 1295 (1987).

For example, if you have a significant amount of arthritis in your knee and you have a small misstep at work, causing additional injury to your knee requiring a knee replacement, then the surgery should be covered under workers compensation.  This would be true even if you were destined to have a knee replacement in the future. The misstep was the straw that broke the camel’s back.

Line of Duty Disability Benefits – LEOFF

The Washington State Court of Appeals for Division 2 recently ruled in favor of our client, Frank Shaw, in an appeal we had taken from a decision of the Department of Retirement Systems.  The issue involved in the appeal was the correct legal test the Department of Retirement Systems is required to apply to determine whether a fire fighter or law enforcement officer is entitled to line-of-duty disability benefits.  The Department of Retirement Systems had found, in its original decision, that performance of authorized duties had to be the sole cause of a particular disabling condition.

We argued, on behalf of Mr. Shaw, that it would be sufficient if the line-of-duty activities had aggravated a pre-existing condition and caused it to become disabling.  The Court of Appeals agreed and reversed the Department of Retirement Systems’ decision and remanded Mr. Shaw’s claim back to the Department of Retirement Systems to consider the case under the correct legal standard.  The case is Shaw v. Department of Retirement Systems, 193 Wn.App 211, 371 P.3d 106 (2016).

2015 COLA Increase

2015 Cost of Living Adjustment (COLA)
For period of 7/1/15 to 6/30/16

The Department recently announced that the:

• The July 1, 2015 cost of living adjustment is a 1.04168 percent increase, and

• The new maximum time loss rate is $5,482.90/month or $183.00/day

Cost of living adjustments are not effective until the second July 1st following the injury. So the cost of living adjustment does not apply unless the date of injury is prior to July 1, 2014.

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