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Nursing home not liable for injured worker's knee replacement

Posted On: Mar. 3, 2015 12:00 AM CST

Nursing home not liable for injured worker's knee replacement

An Alabama worker with preexisting arthritis is entitled to workers compensation benefits, but not knee replacement surgery, the Alabama Court of Appeals has ruled.

Lula Durgin worked as a nursing home activities director for Fairhope, Alabama-based Fairhope Health & Rehab L.L.C., taking nursing home residents on outings to participate in various activities, court records show.

On Feb. 10, 2012, Ms. Durgin twisted her right knee while climbing into the driver’s seat of the company van before an outing, according to records. Even though her knee hurt, she said she went on the outing and didn’t seek medical treatment for a few days.

An orthopedist later diagnosed Ms. Durgin with a torn medial meniscus and found that she had preexisting arthritis in her right knee, records show.

The orthopedist said it was difficult to determine how much of her meniscal tearing was preexisting and how much was caused by the 2012 injury, according to records. However, he said it was clear that the injury “aggravated, accelerated, or incited” Ms. Durgin’s knee condition.

Ms. Durgin’s orthopedist said she reached maximum medical improvement for the work-related injury in June 2012, six weeks after undergoing an operation to remove the meniscal tear, records show. But she continued to have pain in her right knee, and in October 2012 another physician diagnosed her with “severe degenerative joint disease” and recommended she have her right knee replaced, according to records.

The orthopedist that first treated Ms. Durgin said a knee replacement wouldn’t be related “in any way” to her work-related injury. Rather, he said it would be a result of her preexisting arthritis, records show.

According to records, Baldwin County Circuit Court in Alabama in August 2014 ordered Fairhope Health & Rehab to provide medical care and treatment to Ms. Durgin, “including, but not limited to, the prescribed right knee replacement.”

On Friday, the Alabama Court of Appeals issued a writ of mandamus, directing Baldwin County Circuit Court to amend its order requiring Fairhope Health & Rehab to pay for Ms. Durgin’s right knee replacement surgery.

Finding that Ms. Durgin did suffer a compensable injury, the Court of Appeals ruled that, “After an employee recovers from a temporary aggravation, an employer bears no liability under the (Workers’ Compensation) Act for any lingering or permanent injury or disability caused solely by a preexisting condition.”

The undisputed evidence indicates that Ms. Durgin was diagnosed with arthritis in her right knee four years before her February 2012 injury, according to the ruling.