(CompNewsNetwork) - In conventional medicine, breast implants come in pairs: in most
circumstances, you install (or replace) both at the same time. There is a compelling
aesthetic symmetry in the process. In the idiosyncratic world of comp, however, symmetry is
trumped by the "work-related" standard.
Penny Rumple Richardson was injured in an on-the-job car accident. Her breast implants
were damaged. The North Carolina Industrial Commission determined that the damage was
work-related and approved replacement of both implants. The insurance company appealed. Ms.
Richardson's doctor, Greensboro plastic surgeon Dr. David Bowers, originally testified
that the right implant had ruptured in the accident and the left implant showed signs of
rippling, so he replaced both. But presumably when pressed by defense counsel, he conceded
that the left implant most likely had rippling because it was under-filled. In other words,
damage to one implant is clearly related to the accident, but damage to the other is
At the appeals court level, Judges Barbara Jackson and Sanford Steelman Jr. agreed that
breast implants are covered in workers' compensation claims, because they are a
"prosthetic device that functions as part of the body." However, they determined that
only one implant was damaged as a result of the accident. They sided with the carrier in
denying coverage for the "rippled" implant.
Judge James Wynn, Jr. dissented. He pointed out that Richardson needed both implants
replaced to ensure that they were "symmetrical and evenly matched." Judge Wynn sought to
expand comp coverage to include the rather obvious aesthetic considerations, but he failed
to convince his colleagues on the bench.
The Draconian remedy, of course, would be to remove the uncompensable implant.
Fortunately, that won't happen. The case has been sent back to the workers comp
commission for resolution. We hope Ms. Richardson has conventional health insurance and
that it will cover half of Dr. Bowers's fee. If that doesn't work, Richardson herself
will have to pay the price for maintaining essential symmetry.