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“Significant Causative Factor” Applied to Deny Permanent Total Disability Benefits to a Worker Without Prior Permanent Restrictions

It has long been the law that although a claimant is not required to establish that an industrial injury is the sole cause of an alleged inability to earn wages, the claimant must nonetheless demonstrate that the industrial injury is a “significant causative factor” in her alleged permanent total disability. Under this test, the Administrative Law Judge must determine the residual impairment caused by the industrial injury, and determine whether it was sufficient to result in permanent total disability without regard to the effects of subsequent intervening events.

In a recent case where the claimant was alleging an inability to earn wages caused by an industrial injury, an Administrative Law Judge found that the claimant’s disability from the industrial injury was not a significant causative factor to her disability even though the claimant did not have any prior work restrictions and was released to work full duty at the time of the injury.  In that case, I argued that the evidence demonstrated that the claimant no longer was capable of working in any position without significant modification even before the industrial injury, even though no physician had provided any work restrictions prior to the industrial injury. The Administrative Law Judge agreed, and denied the claimant’s request for Permanent Total Disability benefits because it was not a significant causative factor in her inability to earn wages.

The Administrative Law Judge was not compelled to find that the injury caused the claimant’s alleged inability to earn wages, despite the fact that the claimant was working “full duty” at the time of the injury with no prior work restrictions, because the employer witnesses credibly testified that the employer accommodated her poor physical condition while it attempted to transfer her to a job which was more compatible with her deteriorating physical condition. This decision clearly turned on the unique facts of the case (i.e. the injured worker was of significantly advanced age, and medical records and employment records documented a significant deterioration in the claimant’s overall physical condition in the twelve months prior to her industrial injury which prevented her from being competitive in the workforce). Regardless, this decision shows that creative application of the facts to the law can overcome the difficult problems associated with defending a difficult fact pattern in permanent total disability case.

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