Virginia Claimant Awarded Benefits for Right Knee Condition More than 10 Years after Injury to Left Knee

Stressing that a workers’ compensation claimant may recover not only for injuries that directly result from an employment accident, but also for subsequent, consequential injuries that are causally connected to the original injury, a Virginia appellate court affirmed a decision by the state’s Workers’ Compensation Commission that awarded medical benefits to a claimant who developed a right knee condition more than ten years after sustaining a left knee injury [Nanochemonics Holdings, LLC v. McKinney, 2019 Va. App. LEXIS 158 (July 9, 2019)].

Background

Claimant sustained a compensable injury to his left knee on July 26, 2006 in the form of a meniscal tear. He was awarded lifetime medical benefits. In January 2018, he sought to expand the medical award to cover a compensable consequence injury to his right knee. Claimant contended that the left knee injury changed the way he walked. He limped, supporting his weight with his right leg. He stated that his right knee began to hurt again in 2016 or 2017. In January 2017, claimant underwent a total left knee replacement.

His treating physician indicated claimant’s right knee difficulties were a consequence of the injury to his left knee. The physician also indicated that claimant would require total right knee revision surgery. The Commission determined that the mechanical change in claimant’s right knee was “sequelae” that flowed from the primary injury.

Consequential Injuries

Quoting an earlier decision, Morris v. Badger Powhatan/Figgie, Int’l., Inc., 3 Va. App. 276, 348 S.E.2d 876 (1986), which in turn had quoted Larson’s Workers’ Compensation Law, the court stressed that “every natural consequence that flows from the injury likewise arises out of the employment, unless it is the result of an independent intervening cause attributable to claimant’s own intentional conduct” [3 Va. App. at 283].

The court added that the evidence in the record supported the Commission’s decision that claimant’s right knee injury was a compensable consequence of his earlier left knee injury. Claimant testified that the injury to his left knee caused him to put his weight on his right leg when he walked. His primary care doctor stated that the alteration to claimant’s gait had caused additional stress to his right knee. Claimant’s orthopedic surgeon stated that claimant’s right knee difficulties were a consequence of his left knee injury in 2006 and that the right knee surgery was required. Given this evidence, the court could not say that the Commission had erred in awarding benefits.

Commentary

While neither the Commission nor the appellate court indicated that obesity was a significant factor in either the claimant’s condition or the legal decision awarding benefits, it should be noted that the claimant here was morbidly obese. That factor likely complicated the claimant’s medical condition and accentuated the problems associated with claimant’s gait alteration. Note, however, that the legal issue here isn’t one of apportioning blame or even causation. The employer is responsible for all “sequelae” that flowed from the primary injury. This is consistent with the general rule that the employer takes the worker as it finds him or her. Obesity, may be a co-morbid factor; it is not a disqualifying one.