Workers’ Compensation Claims Can be Recognized Even Without a Specific Description of Injury

It would seem that if an employee cannot specifically recall when, or how, an injury occurred at work, he or she will not have a compensable workers’ compensation claim. However, that is not always the case. The mere fact that the injured worker cannot specifically identify the exact time of his or her injury or the exact circumstances that gave rise to the injury does not necessarily defeat an attempt to obtain workers’ compensation benefits. So long as the injured worker alleges that a certain activity or series of tasks caused the injury, the claim may be recognized, even when the claimant alleges that his or her pain did not arise until several hours or days after the alleged incident. As in most workers’ compensation claims, so long as there is a doctor that is willing to render an opinion that connects the alleged event or activity to the diagnosed injury or condition, then the claim can be allowed.

That was the situation in the case of Critser v. Zimmer Surgical, Inc., 5th App. Dist. Ohio, 2015-Ohio-4754. In that case, Mr. Critser alleged that he had been injured on July 30, 2013 but could not recall the specific instance of his knee injury. Instead, he recalled lifting boxes and stacking them on pallets all day long. He also stated that he had to pivot and twist on his knee all day while doing his job. Later in the day, he began to suffer pain in his knee. His claim was originally denied by the Industrial Commission and he filed an appeal in a court of common pleas. His employer, Zimmer Surgical, filed a motion for summary judgment claiming that if Mr. Critser could not identify a specific incident, there was no basis to conclude that he had been injured in the course of his employment. The employer also challenged the medical opinion provided by Mr. Critser’s treating physician. The employer alleged that because the physician had no personal knowledge of a specific event that caused Mr. Critser’s knee injury, his opinion must be disregarded.

The trial court initially granted the motion for summary judgment in favor of the employer. Mr. Critser then appealed that decision to the Court of Appeals for Tuscarawas County. The Fifth Appellate District then reversed the decision of the trial court. The Court indicated in its opinion that even though Mr. Critser could not pinpoint a specific time when his injury occurred, his doctor’s opinion provided sufficient evidence to support the allowance of his left knee injury. In particular, his treating physician indicated that Mr. Critser suffered a left knee injury when he was loading a skid at work on July 30, 2013. The doctor’s review of the medical records and the description provided by Mr. Critser of his activities were found to be a sufficient basis for the doctor’s opinion. Therefore, the court specifically found that it was not necessary for Mr. Critser to be able to identify a specific incident or for the doctor to indicate that he was basing his finding of an injury on a specific accident or incident. It was merely enough for Mr. Critser to indicate that he was loading skids and felt pain later that day.

Please keep in mind that the court was only ruling on the employer’s motion for summary judgment. The case would still have to proceed to trial and the employer could still rely upon its own expert to criticize the treating physician’s opinion and to highlight the fact that there was no immediate reaction or pain with the left knee while loading the skids. However, this case does emphasize the fact that a medical doctor’s opinion can go a long way in establishing causation in a workers’ compensation claim even if the claimant himself cannot specifically identify a particular event or incident causing injury.