Getting injured at work is a stressful experience. Not only do you have to deal with the pain and other physical consequences of an injury, but you may also find yourself unable to work and worried about how you will pay your bills.
Thankfully, workers’ compensation insurance exists to allay some of these fears. It will pay for medical care and will, in many cases, provide wage loss benefits until the injured worker recovers.
But what happens to an injured worker who thinks she has fully recovered, only to suffer a worsening of her injury several months later? Is she still entitled to benefits? What if she can’t return to work?
The Colorado Court of Appeals took up this issue in a recent case and decided that the worker would be eligible for total temporary disability workers’ compensation benefits.
Benefits Available to Workers Who Reached Maximum Medical Improvement
The case centered on the claims of a woman named Elaine Loofbourrow, who worked as a manger at a Kentucky Fried Chicken restaurant. In November 2008, a cook walked off the job and Loofbourrow had to perform the cook’s functions. In the process, she suffered work-related back injuries.
For a month, Loofbourrow was treated by a doctor recommended by her employer. She got injections and physical therapy and never needed to take time off work. In December 2008, the doctor declared that she had reached maximum medical improvement and discharged her from care.
Loofbourrow never challenged the doctor’s determination that she had reached maximum medical improvement. Then, in March 2009 her back pain began to get worse. She saw her personal doctor, whose examination revealed a bulging and torn disc. Over the next few months, Loofbourrow’s pain became so severe that she required emergency care. Her doctor ultimately told her that she could no longer work.
Loofbourrow then requested temporary total disability benefits to make up for her lost income. Her employer denied her claim, arguing that because Loofbourrow did not challenge the initial determination of maximum medical improvement – essentially a finding that she improved as much as possible – she could not claim that she needed further benefits.
The court ultimately sided with Loofbourrow. It held that a determination that an injured worker had reached maximum medical improvement does not necessarily prevent that worker from later claiming that her condition had gotten worse.
Although Loofbourrow did ultimately receive the benefits she was entitled to, she had to endure a lengthy court battle to get them. If you have suffered an on-the-injury, don’t take chances by trying to go up against your employer’s insurer alone. Contact an experienced Colorado worker’s compensation attorney who can help protect your rights.
Source: Risk & Insurance Online, “Maximum Medical Improvement Does not Foreclose Benefits,” Nov. 14, 2011.