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Can You Believe It? Genital Tuberculosis Flare Up didn’t Connect to Work

24 Jul, 2023 Frank Ferreri

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Boston, MA ( -- How to handle preexisting conditions has raised factual and legal questions in workers' compensation from pretty much the beginning.

As one case, Green's Case, 165 N.E. 120 (Mass. 1929), which involved a worker's genital tuberculosis, from the 1920s showed, the question has long come down to what the evidence showed the injury was like before the workplace accident and what it was like after.

The Injury, the Case

While lifting a trough, a worker received an injury "to the back and front of his body," and hernia developed. At a hearing on the worker's claim, his genital tuberculosis was found not to be causally connected to the injury. On appeal, the Industrial Accident Board determined that the injury aggravated the pre-existing genital tuberculosis and totally incapacitated the worker.

The insurer appealed to Massachusetts' highest court, with the question being whether there was evidence to warrant the finding that the injury aggravated to the point of total incapacity for work a pre-existing condition of genital tuberculosis?

Under workers' compensation law, if the injury accelerated the pre-existing condition and the progress of the genital tuberculosis was hastened by the injury, the employee is entitled to compensation, although the injury did not cause the disease but merely accelerated it.

The court ruled in the insurer's favor, finding that the evidence did not show that the work injury aggravated the worker's genital tuberculosis.


How did the court reach its decision? It found the following pieces of evidence persuasive:

(1) An impartial physician testified respecting his examination of the worker, that a strain such as the worker received, causing a hernia, could not cause genital tuberculosis.

(2) The physician answered, "No" to the question, "Assuming a force of sufficient strength or degree to cause a hernia, would that awaken a quiescent tuberculosis of the genitals?"

(3) There was no evidence that prior to the injury the employee suffered from quiescent tuberculosis or had such a complaint. 

(4) Considering the nature of the disease, even if it could be inferred that the germs of genital tuberculosis were in the system at the time of the injury, there is no evidence to warrant a finding that the strain accelerated or hastened the development of these germs.

The court found that speculation wasn't enough to buoy the worker's case.

"The fact that the present condition of the claimant might reasonably result from the injury, or that it was conceivable that this condition might so result, is not sufficient to justify the conclusion that the condition was causally related to the injury," the court wrote. "A mere conjecture or surmise is not proof."

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    About The Author

    • Frank Ferreri

      Frank Ferreri, M.A., J.D. covers workers' compensation legal issues. He has published books, articles, and other material on multiple areas of employment, insurance, and disability law. Frank received his master's degree from the University of South Florida and juris doctor from the University of Florida Levin College of Law.

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