GQ Corner
Q: Claimant walked over to a co-worker to give her a sympathy card and when she turned around to walk back to her desk, her left ankle buckled causing her to fall forward. She injured her left ankle, lower back and neck. Can I deny the claim since there was no nexus between her injury and her employment other than the fact that it occurred on the employer’s premises?
A: We do not recommend a denial. The current state of the case law shows this incident to be compensable. The floor is the instrumentality of the employer and the injury was caused by the employee’s placement of her foot on the floor. This provides the necessary nexus and as such, the injury can be said to arise out of the employment. However, even if it could be said that the ankle were not compensable, case law dictates that the neck and low back injuries, which were caused by the subsequent fall onto the floor, are compensable.
Q: Claimant was released to return to work full duty by his treating doctor and returned to work. Several months later, Claimant called in to work, stating that he could not come back to work due to his compensable back injury. The employer told him to follow up with his treating doctor. During the course of the phone call, the claimant quit his job. Can I dispute disability? If I dispute disability and then I receive documentation from the treating doctor taking him off work or releasing him on restrictions which previously could not be accommodated, would I need to reinstate TIBs?
A: Yes, you may dispute disability. The claimant quit while under a full duty release and he has the burden of proof to show resumed disability. You would not to start TIBs until he proved up disability. Claimant will need evidence of a substantial change in condition to support disability after he was released to full duty and returned to work.
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