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Did The Claimant Sustain An Injury In The Course & Scope Of Employment With Resulting Disability?

Practice Area: Workers compensation

Outcome: Plaintiff prevailed before the DWC

Description: S.G. was injured after clocking out, while walking to the car that arrived to pick her up from work. While stepping off of the curb in front of her employer's building, and while still on her employer's premises, she fell and sustained a serious injury to her ankle and shoulder. X-Rays showed her ankle to be fractured. The workers' compensation insurance company denied liability, claiming that she did not injure herself at work. The carrier determined that it was unwitnessed and therefore did not happen as S.G. described. S.G. had a lot of other serious health issues, and had not worked in many years. She had been on social security disability, and this work accident occurred on her first day at work. It appeared to the carrier to be a fraudulent attempt to obtain benefits. The best evidence in this case was the initial x-ray that was performed on the date of injury. It showed a fractured ankle. It would be unlikely that a person would be at work all day doing strenuous physical labor with a broken ankle. S.G. was placed in a cast and had to use crutches following the accident. The evidence indicates it is more likely that the claimant did get injured that day in that accident as opposed to having a pre-existing ankle injury, therefore the judge ruled in favor of S.G. Regarding disability, the judge found that she has been uable to work due to her injury for the past 18 months. Diagnostic testing was not able to be obtained until recently, and an MRI showed a torn ligament in the ankle. The judge determined that this was one of the reasons why S.G. has not been able to return to work. Even though she has other medical conditions that limit her work ability, the work injury is a reason too, and so S.G. is entitled to workers' compensation benefits called temporary income benefits. The carrier may still file an appeal, so the case has not become final.

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