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A “morbidly obese” worker in Arkansas failed to prove that his umbilical hernia resulted from a work-related injury and not pre-existing conditions, the Arkansas Court of Appeals has ruled.
Roberto Jaramillo was working for El Dorado, Arkansas-based Systems Contracting Corp. in September 2008 when a forklift allegedly swung a pipe into him and caused him to fall on his neck and shoulder, court records show.
While Mr. Jaramillo was placed on light duty after reporting the incident to his supervisor, he said he was never offered medical treatment and that he couldn't seek immediate medical treatment because he lost his private health insurance when he was laid off for periods following the incident, according to records.
He first sought medical treatment nearly one year later in August 2009 when he visited an emergency room complaining of chest, abdomen, and pelvic pain, records show.
According to records, numerous diagnostic studies showed that Mr. Jaramillo suffered from several chronic conditions and a small umbilical hernia comprised of fatty tissue.
Mr. Jaramillo was instructed to lose weight when he returned to the medical center to be reevaluated, records show. And in 2010, a colonoscopy confirmed the presence of diverticulosis in his descending colon, and small hyperplastic rectal polyps.
During a hearing before the Arkansas Workers' Compensation Commission on June 21, 2013, Mr. Jaramillo said he “experienced an immediate sensation” following the work-related injury, “like water running in his body,” records show.
According to medical reports, his hernia was asymptomatic as of August 2009 and likely existed prior to the accident at work in September 2008.
On Sept. 18, 2013, an administrative law judge found that Mr. Jaramillo's umbilical hernia was “the compensable consequence of the work-related incident,” records show. However, the Arkansas Workers' Compensation Commission reversed the judge's decision in its Jan. 21, 2014, opinion, noting that Mr. Jaramillo “failed to prove by a preponderance of the evidence that his hernia resulted from the work-related incident.”
The commission said excessive abdominal pressure can cause an umbilical hernia and that obesity is a common cause of umbilical hernias in adults, according to records. Other than Mr. Jaramillo's testimony, there was “no clear proof of the exact mechanics of his fall or the amount of force exerted when his shoulder connected with the floor,” the commission said.
On Oct. 22, a three-judge panel of the Arkansas Court of Appeals affirmed the commission's opinion.
Mr. Jaramillo said he fell on his neck and shoulder, but did not note any force applied directly to his abdominal wall, according to the ruling. In addition, none of his treating physicians said the hernia was caused by the work-related accident.
Idaho employers will see a “slight” reduction in workers compensation rates as of Jan. 1, 2015, the state Department of Insurance said Monday.