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Workers comp surgery awards do not count toward disability limits: Okla. court

Workers comp surgery awards do not count toward disability limits: Okla. court

OKLAHOMA CITY—The Oklahoma Supreme Court has ruled that workers compensation awards for amputations and surgeries can't be included when calculating limits on permanent partial disability benefits.

An Oklahoma law limits PPD ratings to 100% for individuals, or 520 weeks of lifetime compensation for PPD awards.

A three-judge panel from Oklahoma's Workers' Compensation Court and a state appellate court had issued conflicting opinions on whether amputations and surgeries, as well as awards under the state's Multiple Injury Trust Fund, qualify for the 520-week limitation, or whether the time limit should apply only to accidental personal injuries and occupational diseases, according to court records.

The case, Evans & Associates Utility Services et al. vs. Ruben Espinosa et al., involved a manual laborer who received multiple workers comp awards for several injuries, some of which were determined to be permanent and needed surgery. The company argued that Mr. Espinosa had reached the 520-week limit for benefits, while Mr. Espinosa said his surgeries should not count toward either statutory limit.

On Tuesday, the Oklahoma high court said neither the rating limit nor the time limit applies to Mr. Espinosa's surgeries. It also ordered an evaluation of Mr. Espinosa's previous awards so surgery-related benefits could be excluded from his workers comp limits.

“There is no rational reason expressed in the statute” why amputations and surgeries would be excluded from the 100% rating limit, but not from the 520-week limit, the Oklahoma Supreme Court ruled. The state legislature “clearly” intended to exclude amputations and surgeries from PPD award limits in a 2001 amendment of its workers comp law, the court said in its 7-2 ruling.

“This (makes sense) because, (were) it not for the injured (worker's) previous on-the-job injuries, the worker would not have had any previous amputations or surgeries,” the court ruled in sending the case back for further action.