Oklahoma Work Comp Hip, Knee & Other Lower Joint Injury Settlements
Introduction to Oklahoma Workers' Compensation Hip, Knee & Other Lower Joint Injury Cases
Serious injuries that affect an injured Oklahoma worker’s hip, knee, ankle or other lower extremity joints can be quite disabling since, on either or both a temporary or permanent basis, such injuries can limit such worker to a sedentary job. Since most jobs are classified as light in physical demand, or even heavier, most worker’s limited to sedentary work will be unable to return to the job he or she was performing at the time of the injury. If limited to sedentary work on a permanent basis most worker’s will be forever prevented from returning to his or her usual and customary occupation, which generally will bring forth issues of vocational rehabilitation and training, as well as a permanent disability settlement to help offset the painful effect of a worker’s inability to earn the same level of wages as he or she did before his or her hip, knee and/or other lower extremity joint injury.
Medical Case Management in Oklahoma Workers' Comp Hip, Knee, Ankle, and Lower Extremity Injuries
The Oklahoma Workers’ Compensation Court has defined Medical Case Management as the systematic coordination, by a nurse or medical case manager, of an injured worker’s medical, hospital, rehabilitation and other care and treatment to ensure that such treatment follows all applicable treatment guidelines, utilization controls and practice parameters and is otherwise delivered in an expedient and cost-effective manner; and finally that the injured employee is adhering to the prescribed treatment plan and otherwise engaging in activity that will promote his or her healing. To be otherwise qualified to be a case manager an individual must be either a registered nurse licensed by the Oklahoma Board of Nursing or an individual with one or more of the following certifications: (1) Certified Disability Management Specialist; (2) Certified Case Manager; (3) Certified Rehabilitation Registered Nurse; (4) Case Manager–Certified; (5) Certified Occupational Health Nurse; and/or (6) Certified Occupational Health Nurse Specialist.
Obtaining Medical Treatment Under an Oklahoma Workers' Compensation Certified Workplace Medical Plan, or "CWMP"
In Oklahoma an employer and/or its workers’ compensation insurance company can choose, under certain limited circumstances, to provide its injured employees medical treatment for on-the-job injuries through a Certified Workplace Medical Plan, which basically is a group or organization of medical treatment providers, certified by the Oklahoma State Commissioner of Health, that is approved to contract with an employer (or its insurance carrier) to administer medical treatment on a fee-for-service basis pursuant to the express terms of the Oklahoma Workers’ Compensation Law.
Hip, Knee, Ankle and Foot Injuries Covered Under Oklahoma's Compensation Law
Hip, Knee and Foot Injury Must Arise Out Of And In The Course & Scope Of The Injured Worker’s Job Assignment
Not all Hip, Knee, Ankle and Foot Injuries that occur during work hours or on-premises are covered under Oklahoma Workmens’ Compensation Law. Generally, for an injury to be covered, the resulting harm or damage to the worker’s lower extremity must have been occasioned or caused by an accident, repetitive motion, overuse, cumulative trauma, and/or an industrial disease that arises out of and in the course and scope of that hurt employee’s job task and/or assignment.
NOTE: Oklahoma Courts have determined that the term ACCIDENT means just that and only applies to any event or occurrence involving factors not personal to the employee that: (1) were unforeseen, unplanned, unexpected and most importantly, unintended; (2) occurred at a specific time and otherwise identifiable place; (3) was unaccompanied and independent of any sickness, mental illness or other independent or intervening injury or condition affecting the worker.
NOTE: The Oklahoma Workers Compensation Courts have determined that the phrase COURSE AND SCOPE OF EMPLOYMENT means an engagement and/or course of activity of any kind, type or character for which a worker was hired to do and relates to and derives from the business, occupation or profession of the worker’s employer. This course of activity, to be work related for workers’ compensation purposes, must be performed by a worker in furtherance of the business affairs of his or her employer. The term necessarily includes activity performed by the worker on premises of the employer but also includes off-property work in furtherance of the employer’s business or trade (and travel by the worker necessary to complete that worker’s assigned job task or duty).
Hip, Knee, Leg, Ankle and Foot Case Must Be Proven By Medical Testimony Supported By Objective Medical Findings
In order to be a compensable injury under Oklahoma Law, a worker’s hip, knee or other lower extremity injury must be proven by medical testimony from a medical doctor which testimony being based upon objective medical findings. Furthermore, an injured worker, and/or his or her Oklahoma City or Tulsa Workers’ Compensation Attorney must prove, by a preponderance of the evidence, that he or she sustained an otherwise compensable injury under Oklahoma Law.
Hip, Knee, Ankle, Foot and Other Lower Extremity Injuries Not Covered by Oklahoma Workers’ Compensation Law
The following lower extremity cases are not covered under Oklahoma Law
- Any sprain, degenerative condition, disease, harm, defect or structural damage to a worker’s knee, foot, ankle or hip joint resulting from the employee’s aging process, rheumatoid and/or osteoarthritis or other degenerative process-to include degenerative joint disease;
- Any other then existing or pre-existing condition unless the worker’s treating doctor testifies that his or her patient has suffered “an identifiable and significant aggravation which aggravation occurred through that employee’s work detail”;
Hip, Knee, Ankle or Foot Injury Occurring While Worker Traveling To and From His or Her Workplace
Any hip, knee, ankle or foot injury which occurs while a worker is simply traveling to and from his or her work assignment or station is not covered under Oklahoma Workers’ Compensation Law–obviously these cases usually arise out of a car wreck which occurs while the worker is on his way to or back home from his or her workplace. This is the traditional ‘coming and going’ rule. However–as more fully indicated above, an accident which occurs while a worker is traveling for work, particularly when his or her employer pays for or the worker otherwise is reimbursed for his or her mileage or other travel expenses, is covered under compensation law in Oklahoma.
Travel by Worker That Benefits Both The Worker and His or Her Employer Not Covered-The “Dual-Purpose Doctrine”
Any knee, foot or other lower extremity injury that occurs during travel by a worker that is in furtherance of his or her work and the employer’s business and/or trade, but which is also in furtherance of that worker’s own personal or private business is not a covered accident under Oklahoma’s Workers’ Compensation Law. This is commonly known as the ‘Dual Purpose’ doctrine.
Any Independent and Subsequent Intervening Accident or Injury Will Prevent Worker From Receiving Further Benefits For Lower Extremity Joint Injury
Assuming an otherwise compensable injury or occupational disease-a subsequent occurring, intervening injury or accident will break the necessary nexus between the original injury and that worker’s ongoing right to medical and indemnity benefits for a knee, hip, foot or ankle joint injury.
Worker Entitled to Cash Benefits and Increased Compensation For A Consequential Injury Under Oklahoma Law
Oklahoma Workers Compensation Courts have determined that a consequential injury is that injury or disease to an otherwise separate part of an injured worker’s body that is directly related and proximately caused by that worker’s original, compensable at law, industrial injury (or caused during medical treatment received for the original injury). In Oklahoma a workers’ compensation court cannot make a finding of a consequential injury unless and until it is determined that medical treatment was required to treat that body part.
Receiving Continuing Medical Maintenance For Lower Extremity Joint Injuries Under Oklahoma Law
The Oklahoma Workers’ Compensation Court has determined that, following a worker’s attaining maximum medical improvement for his or her hip, knee, ankle or foot injury, he or she may be awarded ongoing treatment for that injury if such care is necessary and reasonable to maintain maximum improvement and keep his or her extremity injury condition stable. Oklahoma Courts have determined that the following treatment modalities are not considered, and cannot be made part of, an injured worker’s continuing medical maintenance plan or program:
- Radiographic or other diagnostic testing and studies
- Surgery or other operative procedures
- Injections and Blocks
- Counseling and other psychological treatment
- Physical and/or Occupational Therapy
- Pain management and other pain management devices
Employer Liability For Cumulative Trauma Hip, Knee, Foot and Other Lower Extremity Injuries
A cumulative trauma injury is any damage to a worker’s hip, knee, foot or other extremity joint that is caused or created by the combined, sustained and repeated effect of repetitive physical activity extending over some period of time. Obviously, to be a compensable workers’ compensation case in Oklahoma the repetitive damage must be caused by activity performed within the course and scope of the employee’s work. The Oklahoma Courts have determined that ‘cumulative trauma’ does not include fatigue, soreness or general aches and pains that may have been associated with, caused, aggravated, by an injured worker’s job assignment.