Compensability – The Claimant Failed To Prove Compensable Claim Because the Injury Had Not Resulted In Lost Time

Claimant was a 62 year old airport shuttle driver for employer who fell onto her knee while unloading a passenger’s luggage. Claimant began receiving conservative treatment for a knee sprain and returned to modified duty work. Due to ongoing symptoms, claimant was eventually referred to an orthopedic surgeon for surgical evaluation. The surgeon determined, based on the diagnostic testing, that claimant required a total knee replacement but concluded the need for the knee replacement was not work related. Respondents also obtained an IME who agreed that claimant’s need for surgery was not work-related. He also determined that claimant, at most, sustained a minor strain as a result of the work incident and did not need any further treatment. Respondents denied liability for the claim based upon the IME. Claimant thereafter began treating with her primary care provider. Several months later after being taken off of work, claimant applied for hearing on compensability and temporary total disability benefits.

The ALJ credited the opinion of respondents’ expert and found that any minor strain or sprain claimant may have sustained in the initial incident did not require work restrictions and would have resolved completely a few weeks after the incident. The ALJ further determined that any lost time claimant suffered after beginning treatment with her primary care physician was the result of her underlying degenerative problems and not due to the work incident. Relying on Harmen-Bergstedt, Inc. v. Loofbourrow, 320 P.3d 327 (Colo. 2014), the ALJ found that claimant had failed to prove compensable claim because the injury had not resulted in any lost time. As a result the claim for benefits was denied and dismissed.

Sharon Wagner-Garcia v. Hertz Corp, W.C. 5-020-897-02 (September 10, 2018)

Would you like to know more? Contact Michelle L. Prince at or 877-259-5693.

From the November 2018 Pollart Miller Newsletter