Injuries Covered by Worker's Compensation

INJURIES COVERED BY WORKERS' COMPENSATION


Overview

In addition to weekly compensation, an injured worker is entitled to compensation for any disfigurement on his/her body as well as compensation for loss of use of a body part (hand, arm, leg, etc.). An injured worker is entitled to this type of compensation even if he/she did not lose any time from work because of the injury.

Disfigurement is defined as any disfigurement of the body such as a scar or swelling, limp, etc. The amount of compensation for disfigurement is entirely subjective. Loss of use is expressed by a physician as a percentage degree of impairment of a body part. The amount of compensation for loss of use is calculated according to a formula based on the percentage degree of impairment expressed by the physician.

Read full text of statute » 28-33-19

Aggravation of Pre-Existing Condition

An employer takes its employees as it finds them. Therefore, an employee’s pre-existing condition that is worsened by a work related injury is covered for workers’ compensation, regardless of whether or not the pre-existing condition itself was work related. This is commonly referred to as an aggravation of a pre-existing condition. The determining factor is whether the work injury or activity contributed to the injury by accelerating or aggravating the pre-existing condition. The work injury or activity can be a specific incident or the constant stress or nature of the job that worsens the pre-existing condition over a period of time.

Recurrence of Injury

A recurrence is a prior work related injury which has resulted in a return of disability without being aggravated by a new injury. There is often a dispute between insurance companies as to whether a disability is the result of an aggravation or a recurrence. The dispute arises because the determination of whether a disability is the result of a recurrence or aggravation determines which insurance company is responsible to pay workers’ compensation. If the prior injury becomes disabling without being aggravated by a new injury or work activity, then the insurance company for the employer where the original injury occurred pays workers’ compensation for disability as a recurrence. On the other hand, if there is a subsequent work related injury or activity that worsens the prior injury, then the insurance company for the employer where the subsequent injury occurred pays workers’ compensation as an aggravation.

If an injured worker returns to work for at least 26 weeks, after having collected compensation for an injury, and then suffers a recurrence of disability from the previous injury, the weekly compensation rate for the recurrence is recalculated based on the average weekly wage for the period of time prior to the date of the recurrence.

Flow-From Conditions

A “flow-from” is a term used to define an injury or medical condition that results from a work related injury. For example, if an injured worker suffers an injury to his right hand and, as a result, begins to overuse the left hand to compensate for the useless right hand, then any injury to the left hand that results from overuse is considered an injury that “flowed from” the original work related injury. Other examples would be a knee injury caused by a person who fell when their leg gave out because of a work related back injury and depression which resulted from the psychological effect of a work injury.

A “flow-from” injury is covered just like any other work related injury. In fact, if an injured worker recovers from the original work related injury but continues to be disabled as a result of the “flow-from”, then weekly benefits will continue.
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