The Tennessee Supreme Court held up a decision that a worker was not entitled to benefits for the brain hemorrhage he ended up suffering after he had a surgery for a work-related neck injury. The worker had received workers’ compensation benefits and future medical benefits for his work-related injury. However, a dispute arose concerning his medical treatment.
The man’s physician recommended that he undergo surgery. However, the man’s workers’ compensation insurer wouldn’t pay for the recommended surgery until the man agreed to undergo an evaluation by a second physician. The man had problems getting a second opinion, so he went ahead and had the surgery and tried to seek reimbursement through his wife’s insurer. The man had a brain hemorrhage four days after he underwent surgery, and the insurer refused to pay for the expenses related to the hemorrhage, even though his neck injury was a workplace injury.
The Tennessee Supreme Court upheld that the insurer was not responsible for the treatment costs for the hemorrhage. The Court reportedly upheld the decision because it stated that expert opinions differed as to the causation of the hemorrhage. The physician who treated the man stated that he believed the symptoms were caused by the man straining to defecate because he was constipated because of the medication he was prescribed. An independent examiner, however, believes that conclusion was a ‘stretch.” Both physicians did agree that the cause of brain hemorrhages is unknown. Therefore, the man was not given compensation for the medical expenses he incurred for the hemorrhage.
Personal injury lawyers might be able to assist people who are injured on the job and want to seek workers’ compensation benefits. They might also be able to help them gather the evidence they need to prove their claims, if need be.
Source: Risk and Insurance, “Worker’s brain hemorrhage isn’t related to surgery for work injury”, July 08, 2013
