Kym Hurst was a physical therapy assistant for Cirrus Allied in Lafayette, Louisiana. Ms. Hurst had a history of back problems, which she had previously sought treatment for. On January 6, 2010, Ms. Hurst injured her back while helping one of her patients.
Ms. Hurst sought workers’ compensation benefits from her employer and its insurer, Ullico Insurance Company. She was eventually awarded a lump sum of over $46,000 and weekly indemnity benefits. By February 2013, Ullico had stopped paying benefits and had ultimately been declared insolvent. Kentucky Insurance Guaranty Association (“KIGA”) took over for Ullico after the insolvency.
In 2014, three things changed KIGA’s treatment of the workers’ compensation claim. First, Ms. Hurst was in an automobile accident and sustained more back injuries. She settled a claim against the other driver for these injuries but did not inform Cirrus or KIGA of the accident or settlement. Moreover, the treatment she received for her car accident cured her back pain. Second, Ms. Hurst began treatment at Advanced Neurosciences Institute, where she was eventually diagnosed with multiple sclerosis (MS) on July 1, 2014. Lastly, Ms. Hurst had an incident of severe pain in her lower back, which required an overnight stay at her local hospital.
In response to the change in Ms. Hurst’s circumstances, Cirrus and KIGA filed a lawsuit to terminate Ms. Hurst’s workers’ compensation benefits. They claimed that her disability was no longer the result of her 2010 work accident and that her benefits should be forfeited.
The primary evidence they pointed to was her treatment after the car accident. The records showed she stopped seeking treatment because her back pain was cured. Ms. Hurst argued that she was still entitled to her workers’ compensation benefits because her diagnosis of MS was related to the 2010 work injury.
The Workers’ Compensation Judge agreed with Cirrus and KIGA. Ms. Hurst’s workers’ compensation benefits were terminated correctly, and the WCJ also determined that her MS was not caused by or related to her 2010 work accident. Ms. Hurst then appealed the judgment, seeking reinstatement of her workers’ compensation benefits and a declaration that her MS was related to her 2010 accident at work. On appeal, the only issue revisited was whether Ms. Hurst’s MS was caused or aggravated by her 2010 work injury.
To create a valid workers’ compensation claim for a later illness or injury, the injured party must prove that a work accident caused, aggravated, accelerated, or combined with some condition to produce the disability the employee is being compensated for. See La. R.S. 23: 1031A. The burden is on the injured party to prove an excellent case that the later diagnosis was related to the earlier injury. If the court sees both sides of the argument as equally possible explanations, the injured party fails to prove their case. See Grant v. Assumption Parish School Board, 813 So. 2d 622 (La. Ct. App. 2002).
An appellate court will look at this lawsuit under the manifest error standard. See Bridges v. Gaten ‘s Adventures Unlimited, L.L.C., 167 So. 3d 992 (La. Ct. App. 2015). This means the appellate court can consider the entire record and determine if the work accident and later illness are related. See Hayes Fund for First United Methodist Church of Welsh, LLC v. Kerr-McGee Rocky Mountain, LLC, 193 So. 3d 1110 (La. 2015).
On appeal before the Louisiana First Circuit Court of Appeal, the WCJ’s verdict was upheld. When the First Circuit looked at the record, it did not find the evidence Ms. Hurst presented as convincing. Ms. Hurst argued that her MS was potentially aggravated by the work injury and, additionally, the stress of her workers’ compensation claim denials made her MS worse.
Expert testimony by Ms. Hurst’s doctor did not provide clear evidence of either claim. Her expert witness testified that the causes of MS are unknown, and her claim that stress caused or aggravated her MS was only plausible. When denying the MS-related claim, the First Circuit distinguished between an injury caused or aggravated by the work injury and an injury related to a work accident claim.
Injuries while working may create complications later down the road. In this case, the injured employee failed to establish a strong enough connection between her work injury and a later neurological disease. Because her conduct before contracting MS invalidated her workers’ compensation reward, her last chance at compensation failed because the causes of MS were too tenuously related to a previous back injury that the First Circuit could not accept that explanation. Workers’ Compensation claims can be challenging and should be handled by an excellent lawyer.
Additional Sources: Kym Hurst versus Cirrus Allied & Kentucky Insurance Guaranty Association
Written by Berniard Law Firm
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