The Commonwealth Court issued several interesting “unreported memorandum opinions” in the past several weeks. The Court revised its Internal Operating Rule 414 several years ago, allowing unreported or unpublished opinions to be cited and relied upon by counsel, for persuasive value, but not as binding precedent in future cases. Thus, it is sometimes important to pay attention to unreported cases, which the Court has chosen not to circulate more broadly, to advance arguments and defenses in pending cases.
In McKee v. WCAB (Geisinger Medical Center), the employee, a nursing assistant, sustained an admitted right knee meniscus tear, while moving a patient from a wheelchair to a stretcher. She underwent an arthroscopic surgery two months later, followed by a total knee replacement, another three months after that. The employer refused to accept the total knee replacement, and the employee sought to amend the injury description to include “aggravation of pre-existing osteoarthritis.” Her medical records revealed a lengthy history of knee complaints, which included as part of the work injury, at least two prior surgeries.
The employer offered medical evidence, found credible by the WC Judge, that the work incident, despite causing a discrete meniscal tear, did not cause or materially worsen the underlying arthritic condition. In legal terminology, the work incident was not a “substantial contributing factor” in her needing a knee replacement. Specifically, Claimant’s medical expert could not provide a credible explanation of any “biomechanical, biochemical, tissue or cellular changes in the knee” that would demonstrate an aggravation of the knee osteoarthritis, which necessitated the joint replacement surgery.
In a second unreported case, Kozlowski v. WCAB (Lehigh Valley Imaging), the Court found that a medical secretary who works in a seated position while scheduling and checking in patients, answering phone calls, filing and faxing, did not sustain a work injury, when she spontaneously experienced a sudden onset of low back pain while scheduling patients at work. The employee had injured her low back several years prior (but could not recall how that injury occurred). The medical evidence she submitted to support her claim, reflected only the history that “her chair is very uncomfortable and is the cause of her pain.” Her physician also noted that her radiating low back pain was “related to repetitive activity” and “prolonged sitting” at work.
The employer’s expert diagnosed a non-work related, non-specific low back pain with leg pain and numbness, and pre-existing symptomatic mild lumbar disc degeneration. He felt that there was no precipitating event, trauma or repetitive activity to suggest that Claimant suffered a work-related lumbar spinal injury. The Court found no error in the Judge’s acceptance of the employer’s evidence because Claimant failed to meet her burden of proof by presenting unequivocal medical testimony establishing a causal connection between her injury and the alleged work-related cause. Such evidence was necessary, because there was no obvious connection and no “act requiring force or strain” that had caused her pain.
The above fact patterns are fairly typical in today’s aging workforce and the holdings in these cases, may be helpful in defending against various non-work-related conditions or circumstances.
