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An employee may deserve workers' compensation, but not forever

We have spent a great deal of time talking about workers’ compensation fraud on this blog. And indeed, it is unfortunately true that there are some people in Ohio who try to defraud their employer and the state Bureau of Workers’ Compensation by faking a workplace injury, or claiming that a non-work condition occurred on the job.

Other times, the person applying for workers’ compensation did sustain a legitimate work injury or illness, and is entitled to a certain amount of benefits. But they might seek more than they deserve, for example by asking for permanent workers’ comp when their injury is temporary.

Whether or not someone is entitled to lifetime workers’ compensation can be a technical matter. For instance, Business Insurance recently reported on a ruling by the Texas Supreme Court, finding that a former cook was not entitled to permanent benefits, because her disability was not directly related to her 2004 accident.

The woman fell while working at a restaurant and hurt her back and left knee. She was approved for workers’ comp, which was paid by the restaurant’s insurer. After a month, she tried to return to work on light duty, but was unable to do even those functions.

She underwent surgery for both injuries, but numbness and pain in her legs persisted. By 2009, the woman was claiming to have total and permanent loss of the use of her feet because of pain. She petitioned for permanent workers’ compensation, which was rejected, then granted on appeal.

The Supreme Court reversed the appellate decision, on the theory that the pain in her feet was not directly related to her 2004 accident. The Court’s ruling also said that “pain alone is not an injury” under Texas’ workers’ comp law.

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