I try not to write too overly lawyerly on here, but some things are legal issues that have no plain English explanation. So bear with me on this one.
When you are hurt on the job in Illinois, you have to prove that your injury arose out of, and in the course of, your employment. In simple terms, you must show you were hurt while doing your job duties in a way that benefits your employer.
Showing you had an accident isn’t enough to win benefits. You also must show that your injuries and need for treatment are “causally connected” to the accident. I first learned about “casually connected” when I took a workers comp class in law school way back in 1996. Essentially it means that you must show that your injuries are a result of the accident. You don’t have to prove it’s the only cause or primary cause, but must show it’s at least a contributing factor.
The #1 way that insurance companies fight cases that seem like they should be accepted is by saying you have a pre-existing condition. This is their way of stating that your injuries aren’t “causally connected” to the accident, but instead you had a temporary problem and everything is related to the older injury. It’s not always a successful defense, but certainly is one they will try any time that they can. This includes trying to pin problems on medical treatment you needed 10-20 years ago.
There are other ways that causal connection comes in to play in Illinois work comp cases. If you need a surgery, for example, you have to show that your accident made that surgery necessary. This issue came up in a recent Illinois Workers’ Compensation Commission case. A machinist testified that he reached down to pull a lever and felt a pop in his left shoulder. Eventually he was diagnosed with a torn rotator cuff.
The Judges found that he did in fact have a work related accident. There was no dispute that what he said happened actually happened. The Judges, however, also believed the IME doctor who testified that the job duties, without significant force, couldn’t have caused a torn rotator cuff.
So in as plain English as I can describe it, causal connection requires you to have a credible doctor state that your need for treatment and/or being off work is related to getting hurt while working.
The other big argument when it comes to causal connection has to do with what is known as an intervening injury. Let’s say you hurt your back while lifting a patient. You report it to your boss, get medical treatment and start physical therapy. One day you are driving home and get rear-ended. Your physical therapy was almost complete, but now your back pain is worse.
So the legal argument becomes which accident is the reason you need medical treatment. It’s not always obvious. One case could result in an Arbitrator saying that the car accident changed the injury enough that it ended the work comp case. Another case could say that your back was so broken down that the car accident was just a temporary aggravation.
These are the types of issues where a lawyer really earns their fee. As an injured worker it’s not always easy to anticipate this type of problem coming up. When a lawyer gets a case, if they are doing their job, causal connection is part of their legal analysis in determining if you have a case.
I hope I didn’t confuse or bore you. If you have any questions about causation or anything else, you can always call or email us for free any time.