On May 12, 2007, Plaintiff was working as a tire builder for Defendant-Employer, and sustained injury to her right shoulder. Defendants accepted the right shoulder as compensable. Plaintiff underwent surgery and returned to work. Plaintiff sustained a number of exacerbations to the right shoulder over the course of her claim. Following one incident in 2010, Plaintiff began treating with Dr. Robert Carroll. Dr. Carroll assessed Plaintiff at MMI on March 14, 2012.
On September 6, 2013, Plaintiff was lifting at work when she again injured her right shoulder. She returned to work briefly from October 3, 2013 to October 23, 2013, but again reported pain. Plaintiff was written out of work and was diagnosed with proximal biceps tendinitis. Defendants argued this new diagnosis of biceps tendinitis was not causally related to the May 12, 2007 injury. Although Plaintiff was written out of work, Defendants did not initiate TTD benefits, contending the biceps injury was a new injury unrelated to the 2007 accident. Plaintiff’s three physicians, Dr. Kevin Speer, Dr. Christopher Barnes, and Dr. Carroll, testified that it was unclear whether the September 6, 2013 injury to the biceps tendon was related to the original injury.
The Deputy Commissioner issued an Opinion and Award finding that the medical opinion testimony was insufficient to establish that the biceps tendon was causally related to the original injury and denying Plaintiff’s claim for TTD benefits. Plaintiff appealed to the Full Commission. The Full Commission reversed the Deputy Commissioners’ Opinion and Award. Citing theParsons presumption, the Full Commission concluded that Defendants had the burden to prove the September 2013 injury was not directly related to the 2007 injury. It also determined that Defendants had failed to meet their burden and ordered Defendants to pay Plaintiff TTD benefits.
Defendants appealed to the Court of Appeals, which agreed with the Full Commission. Defendants’ argued that because the biceps tendon is a complete and separate body part than the rotator cuff, theParsons presumption should not apply. The Court of Appeals rejected Defendants’ argument, noting Defendants accepted the compensability of the right shoulder, and could not say the right bicep tendon, part of the right shoulder complex, is not connected to the right shoulder. In addition, two of Plaintiff’s physicians, Dr. Barnes and Dr. Carroll, testified that the surgical repair Plaintiff underwent in 2007 weakened the complex where her bicep attached to the shoulder socket, placing her at a higher risk for injury to the bicep. Thus, the Court determined that Defendants had failed to rebut the presumption that the biceps injury was related to the original 2007 accident.
The Court further determined that Defendants should have immediately reinstated Plaintiff’s disability compensation following her unsuccessful trial return to work. As Defendants did not immediately reinstate benefits, the Court held Defendants were subject to a ten percent (10%) penalty on TTD benefits not paid to Plaintiff following the end of her trial return to work.
RISK HANDLING HINT: Bell provides further clarification as to how the Parsons presumption impacts defendants who have admitted the compensability a prior accident. If the injured worker suffers a new injury affecting a previously accepted body part, even it if is arguably an injury to a different part of the accepted body part, whereBell applies, the burden of proof will shift to defendants to show the new injury is unrelated to the original claim.
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