Washington courts provided new guidance and protection for employers handling industrial injury and occupational disease claims. Previously, under the compensable consequences doctrine, employers risked being stuck with covering unrelated complications or aggravation with no causal connection to an industrial injury.
In Brinson-Wagner v. Kennewick School District, No. 39388-7III (Wash. Ct. App. Nov. 16, 2023), the Washington Court of Appeals ruled that the school district did not have to pay for an employee's industrial injury that was stabilized, (even where subsequent unrelated injuries had developed), and found that the employee was barred from recovering for an injury found to be outside the scope of her original industrial injury.
Facts of the Case
Janice Brinson-Wagner worked as a para-educator for the Kennewick School District (the "District"). One day while working at the school, a student who was using an occupational bar fell backwards onto Wagner's left leg and ankle. Wagner filed a worker's compensation claim with the Department of Labor and Industries (the "Department"). The injury was accepted as an industrial injury and Wagner underwent ankle surgery in 2014, the cost of which was covered by the District.
Several years later, Wagner had issues with her left knee that she claimed were caused by the prior injury to her ankle. The Board of Industrial Insurance Appeals (the "Board") determined that the knee condition was caused by the natural progression of degenerative arthritis. However, pursuant to WAC 296-20-055, the Board directed that Wagner's left knee replacement be authorized by the Department as an aid to recovery of the industrial injury. On appeal the Board's decision was affirmed by the court and Wagner received her knee replacement in 2018.
In 2020, the Department issued an order to close Wagner's claim with a permanent impairment award related to her left ankle. Wagner appealed the decision before an industrial appeals judge, providing testimony that her surgeon stated, "her ankle was as good as it was going to get" and "any loss of movement was just the way it was going to be."
The Department retained a doctor to conduct an independent medical examination of Wagner, who opined that Wagner's ankle had little to no chance of further improvement from its current state, and that Wagner's knee did not impact the condition of her stable ankle.
The orthopedic surgeon who performed Wagner's knee replacement stated that a third knee surgery would be needed but agreed that the ankle was stable.
The Industrial Appeals Judge reversed the Department's decision and ordered further treatment of Wagner's knee. However, the Board subsequently reversed this decision and affirmed the closing of Wagner's claim. Wagner appealed and argued that the proximate cause of her ongoing knee pain was the industrial injury to her ankle, and that the compensable consequences doctrine entitled her to further treatment for the knee. The superior court found for the District concluding that res judicata precluded Wagner's claim and that the compensable consequences doctrine was inapplicable, affirming the Board's closure of the claim.
In 2018, the Board agreed to temporarily treat Wagner's knee injury pursuant to regulations guidelines and the District covered a total knee replacement as an aid to her recovery from the industrial injury to her knee. Generally, temporary treatment of a condition that is determined unrelated is only allowed if the department or insurer provides prior approval. Under the regulations, Wagner would need to show that the knee issues "continued to directly retard recovery of the accepted condition." WAC 296-20-055.
The compensable consequences doctrine covers complications that arise or result from the treatment of the initial injury or the industrial injury itself. See Clark County v. Maphet, 10 Wn. App.2d 420, 438, 451 P.3d713 (2019). Here Wagner's knee problems were not a result of her ankle injury and the treatment of her knee in 2019, was only authorized to assist in the healing of her ankle injury. As such, the court held that the compensable consequences doctrine does not apply.
Conclusion
The court’s decision in this case is favorable to employers as it limits the application of the compensable consequences doctrine. An employer that authorizes treatment as an aid to recovery, is protected from the argument that in doing so it concedes that the preexisting condition was causally related to the industrial injury.
