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Court reverses benefits rejection for twice-injured worker

Idaho Supreme Court

The Idaho Supreme Court on Thursday ruled that the state’s Industrial Special Indemnity Fund, which covers workers compensation settlements for workers disabled in a second workplace injury, failed to prove that a disabled worker was deemed disabled before he reinjured his back and is thus liable to cover the second injury.

Arturo Aguilar, who primarily worked as a manual laborer in various industries and for various companies, injured his back in 2006 while lifting a jackhammer, resulting in surgery two years later. In 2011, after working several jobs, he reinjured his back and was later deemed disabled and unable to work in any capacity, according to documents in Arturo Aguilar v. State of Idaho, Industrial Special Indemnity Fund, filed in Boise.

In the cases of both injuries, his employer settled his claim. However, in the second injury that deemed him disabled, he also filed a claim with the Industrial Special Indemnity Fund, which was eventually rejected by the state Workers’ Compensation Commission, which found that Mr. Aguilar “was rendered ‘totally and permanently disabled by virtue of his low back condition alone. . . .’ and “that Aguilar's pre- and post-injury limitations had not changed, effectively deciding Aguilar was totally and permanently disabled prior to his second injury,” records state.

The state Supreme Court on appeal found that the commission erred in that it did not apply the correct legal standard in weighing whether Mr. Aguilar, who had worked in between injuries, was disabled prior to the second injury, thus absolving the fund from liability.

“Here, the record shows that Aguilar met his initial burden because it was undisputed that he was working regularly at two rigorous jobs before his second injury,” the ruling states. “As a result, any finding by the Commission that Aguilar was rendered totally and permanently disabled prior to the second injury was in error.”

The commission also failed to apply the correct standard as to causation of the second injury, which the court said resulted in its decision to remand the case back for further proceedings.

Officials with the state fund and attorneys involved could not immediately be reached for comment. 







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