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Injured worker's comp benefits discontinued after hip, back surgery

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disability

A worker who had hip replacement and back surgery in the year after he sustained a workplace injury failed to show that he is entitled to continue disability benefits.

In Shaw v. Workers Compensation Appeal Board, a three-judge panel of the Pennsylvania Commonwealth Court unanimously affirmed on Friday a Workers Compensation Appeals Board decision granting the termination petition of his employer.

Kevin Shaw worked as a heavy construction maintenance mechanic when, on July 8, 2015, he was injured while swinging a sledgehammer during a demolition job, and felt a ripping in his left hip and shooting pain in his lower back that radiated to his right leg. He reported the injury to his supervisor but did not seek medical treatment that day and continued to work until he underwent a left hip replacement surgery in November 2015. His injury — described as left hip and low back pain, sprain/strain was accepted as compensable.

In April 2016, he had low back surgery and also filed a petition seeking partial disability benefits from July 2015 to November 2015 and total disability benefits as of Nov. 13, 2015. He says he continues to experience pain and cannot return to his original job.

He acknowledged that before the work incident, he had received a hip injection and had a history of back problems that included surgery in 1990.

An MRI in September 2015 showed a significant amount of degenerative disease and osteoarthritis in Mr. Shaw’s left hip, which the doctor said took place “over many years” and was aggravated by the trauma. Another doctor, however said the MRI showed progressive osteoarthritis, not “post traumatic-type arthritis” and believed he sustained a left hip sprain and strain as a result of the work incident, and that his hip replacement surgery was due to preexisting conditions. Medical notes in September 2015 also noted that Mr. Shaw said he “re-aggravated” his hip playing roller hockey.

In October 2016, his employer filed a petition to terminate benefits on the basis that Mr. Shaw had fully recovered from the work-related injury.

A workers compensation judge held that that Mr. Shaw’s hip and low-back surgeries were unrelated to the back and hip sprain he sustained at work. The Workers Compensation Appeals Board affirmed the judge’s decision that Mr. Shaw’s hip and low-back surgeries were unrelated to the back and hip sprain he sustained at work. He appealed to the appellate court, which affirmed the board’s decision.

Although Mr. Shaw argued that the board erred and that he experienced wage loss, the appellate court noted that he continued to work until November 2015 with accommodations and therefore was not disabled. He also argued that the board erred in granting the termination petition because he continues to suffer from left hip and low back pain, but the appellate court held that the judge and board did not err in finding credible the physician testimony that Mr. Shaw’s disability was not related to the injury, but rather “the progression of longstanding degenerative conditions.”

 

 

 

 

 

 

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