Workers’ Compensation – Causation – Back Pain – Slip & Fall

Steelman v. Select Medical Corp. (Lawyers Weekly No. 11-16-0439, 17 pp.) (Robert N. Hunter Jr., J.) Appealed from the Industrial Commission. N.C. App. Unpub. Click here for the full text of the opinion.

Holding: Even though plaintiff’s doctor partially based his causation opinion on the fact that plaintiff did not have back pain before her fall but did have back pain after she fell, he also based his opinion on plaintiff’s symptoms, his experiences with other patients, and his medical expertise. The doctor’s opinion that plaintiff’s fall at work aggravated her pre-existing back condition was not based solely on the doctrine of post hoc ergo proper hoc.

We affirm the Industrial Commission’s award of benefits.

Immediately after plaintiff fell, she felt “excruciating” pain in her right leg, right hip, and back. This pain was listed on her initial Form 18.

The records from her visit to the emergency room immediately following the fall reflect her back pain, showing she had tenderness in her lower lumbar area. She was found to have “acute back pain: lumbar strain.”

Although plaintiff did not continue to complain specifically about back pain, she did continue to have problems with her right lower extremity. Dr. Whitman confirmed that the calf pain and thigh pain she reported to him could be associated with lower back pain. Dr. Whitman stated, “I think that in retrospect and looking at all the additional information that I have now, that it’s certainly within reason to think that some of the symptoms in her leg could’ve come from her back.”

Dr. Spivey also believed plaintiff’s pain could be “caused by a radiculopathy, a problem from her lumbar spine.” He believed her radicular pain may have been masked by plaintiff’s complex regional pain syndrome and that it was likely that the two conditions co-existed.

At her Dec. 17, 2007, visit, Dr. Spivey indicated plaintiff’s stenosis “has been pre-existent, but may have been exacerbated by the injury sustained at work since the patient maintains that she was asymptomatic until that time.”

Dr. Brown expressed his opinion to a reasonable degree of medical certainty that plaintiff’s fall aggravated her preexisting degenerative disc disease. When a pre-existing, nondisabling, non-job-related condition is aggravated or accelerated by an accidental injury arising out of and in the course of employment the employer must compensate the employee for the entire resulting disability even though it would not have disabled a normal person to that extent.

Dr. Brown’s opinion on causation was based not only upon plaintiff’s history of not having back pain prior to the fall, but also his 35 years of experience with patients having similar symptoms.

The medical records, plaintiff’s testimony, and the depositions of Drs. Whitman, Spivey, and Brown are adequate to support the commission’s finding that the Nov. 22, 2006 fall caused the aggravation of plaintiff’s degenerative disc disease in her low back with radicular pain into her legs. The commission’s findings of fact are sufficient to support its conclusions that plaintiff sustained a compensable aggravation of her pre-existing low-back condition.  

Affirmed.