North Carolina Appellate Court Upholds Denial of Benefits in Claim Involving Multi-Decade Pre-Existing Knee Injury

One of the most important determinations in a workers’ compensation claim is whether the alleged injury can be directly related to the claimant’s job duties and functions. If the employer can point to a pre-existing injury as the primary cause of your pain and injury, then you may not be awarded workers’ compensation benefits. As dedicated North Carolina work injury lawyers, we have provided seasoned legal guidance to injured parties throughout the region and are prepared to help you ensure that you receive the full amount of compensation that you deserve.

Recently, the North Carolina Court of Appeal considered a dispute in a claim involving a pre-existing injury. The claimant worked at a hospital where she was injured on April 20. Roughly one month later on May 26, she stood up after finishing her lunch, heard a loud popping noise in her knee, and experienced immediate unbearable pain.

The plaintiff filed a claim seeking compensation for the original injury. She also had a history of conditions in both knees, starting roughly 40 years ago. The employer accepted the claim on a medical-only basis and denied further treatment on the basis that the claimant’s current condition was not causally related to the accident. It also denied the injury that occurred one month after the accident. A Deputy Commissioner denied the woman’s claim for benefits, which was later affirmed by the Full Commission.

The plaintiff appealed on several grounds, including an allegation that the judge mistakenly imposed a burden of proof on her, and determined that there was no exacerbation of her existing injury and that the May 26 injury was an intervening accident.

Regarding her first assignment of error, the appellate court disagreed and found that the woman was not entitled to a presumption that would have shifted the burden of proof to the employer. This presumption is only available where the claimant’s injury has been proven to be compensable. The employer’s acceptance of the claim on a medical-only basis did not serve as an admission of liability and therefore could not serve as a basis for shifting the burden of proof to the employer. The court properly assigned the burden of proof to the plaintiff to show that her need for medical treatment was the result of the April 20 accident.

Next, the appellate court addressed the plaintiff’s allegation that the court erred in concluding that she was no longer experiencing an aggravation of her pre-existing injury. Reviewing the record, the appellate court concluded that there was sufficient evidence to support the judge’s finding that the claimant had returned or was returning to her pre-injury state or baseline condition after the accident. Multiple doctors testified about the injury and whether it contributed to the woman’s need for a total right knee replacement. They concluded that her need for the surgery was inevitable regardless of the injuries that were sustained on April 20 or May 26. For these reasons, the appellate court upheld the lower court’s decision.

If you were hurt at work, call us immediately to start learning about the North Carolina workers’ compensation system and whether you may be entitled to benefits and medical expenses reimbursements. We have assisted countless individuals throughout the region with a wide variety of injury types. We are ready to put our experience to use for you and offer a free consultation so that we can discuss your situation. Call us now at 844-817-8058 or contact us online.

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