In Massachusetts, Non Work Related Slip And Fall

MCCARTHY, J. The employee, Daniel Morgan, appeals from a decision in which an administrative judge denied his claim for § 30 medical benefits for treatment alleged to be causally related to his accepted 1990 industrial accident. Mr. Morgan suffered a non-work-related slip and fall further injuring his back a month before he had surgery in September 1997. The judge denied § 30 medical benefits based on the occurrence of the non-work-related accident. Because we agree with Mr. Morgan that the judge misapplied the law governing independent intervening causes, and that the medical evidence indisputably indicates a causal connection between the 1990 industrial accident and the 1997 surgery, we reverse the decision and award the medical benefits claimed.

Mr. Morgan fell on a loading dock at work on September 24, 1990, and sustained injuries to his lower back. (Dec. 1.) The insurer accepted liability for the injury, paying § 34 incapacity benefits and medical benefits that included a hemi-laminectomy in 1991 for the removal of an extruded disc at L5-S1. (Dec. 2-3.) After a recovery of about one year, Mr. Morgan returned to normal activity, excluding strenuous bending and lifting. (Dec. 3.) On February 5, 1992, the parties entered into a lump sum settlement of the case, which left open Mr. Morgan’s entitlement to §30 medical benefits as a matter of law. (Dec. 2.)

Mr. Morgan is correct in his contention that Dr. Hewson never changed his opinion that the 1990 injury was a substantial contributing cause of the condition necessitating surgery in 1997. (Dec. 4; Statutory Ex. 1.) The fact that the triggering event was the 1997 non-industrial slip and fall is not decisive. As with most every aggravation injury, there is no way of knowing how the employee’s medical condition might have developed, were it not for the aggravation. In positively establishing causal relationship, the doctor need not negate every conceivable hypothetical scenario. See Rodrigues’ Case, 296 Mass. 192, 195 (1936)("The employee had the burden of proving such a causal relation but he was not required to exclude all other possible sources of his injury."). Finally, the fact that the surgery in the present case was a distinct new treatment for the employee’s worsened medical condition in no way prevents the compensation insurer from being held liable. Town of Hudson v. Wynott, 128 N.H. 478, 522 A.2d 974, 977-978 (1986)(lifting bucket of bait triggered surgery for back already compromised by lump-summed work injury; court held that medical evidence established treatment was "a direct and natural result" of work injury, and therefore supported award of medical benefits).

Because the medical evidence unequivocally supports the award of § 30 medical benefits for the 1997 surgery by causally connecting it to the 1990 work injury, we reverse the decision and award the claimed benefits.

So Ordered.

Administrative Law Judge: William A. McCarthy