Medical Benefits—A temporal relationship does not equal causation

Claimant was an 86 year old maintenance technician who sustained a head injury when he slipped and fell on snow stepping out of a golf cart. Claimant was evaluated by an occupational clinic and at the ER on the date of incident.  He was admitted to the hospital on the date of the incident and it was noted that he had no changes in his vision or hearing.  Approximately one week after the initial incident claimant had a subsequent fall while at home and was re-admitted to the hospital for an additional three weeks.  During this second admission, it was again noted that claimant denied any vision or hearing changes.  Approximately four months later, five months after the initial incident, both claimant and his wife began complaining of a change in claimant’s hearing.  He was referred to an ENT specialist who diagnosed a bilateral high frequency hearing loss that he related to the head injury.  He recommended additional work up for hearing aids.  Respondents obtained a second opinion IME with an ENT specialist.  Respondent’s IME opined that claimant’s hearing tests revealed normal age-related hearing changes.  He further explained that an acute hearing loss from head trauma would imply damage to the temporal bone or the inner structures and result in a different type of hearing loss that would have been immediately noticeable after the accident. Claimant’s medical records did not confirm an acute or traumatic hearing loss.  The Administrative Law Judge (“ALJ”) credited the testimony and opinions of Respondents’ IME over the opinions of the treating provider and the statements of claimant and his wife that he had no problems with his hearing prior to the accident.  The ALJ noted that age related hearing losses progress slowly and it was likely that the head injury disrupted the adaptive mechanisms claimant had been using to manage the hearing loss.  The ALJ denied the request for the hearing aids.

Edward Thomas v. Wagner Equipment, W.C. 5-099-234

Want to know more?  Contact Michelle Prince at mprince@pollartmiller.com or 877-259-5693.

August 2020 Newsletter

2020-09-02T17:02:42+00:00