Some Unusual Legal Rules Which Affect Workers’ Compensation Claims
A few workers’ compensation claims are relatively straightforward. For example, a victim with no pre-existing conditions whatsoever, who is carrying work-related materials, falls down the stairs. But such cases are few and far between. To reduce or deny compensation, or at least to deny payment, many insurance companies rely on obscure legal loopholes.
Fortunately, a Baton Rouge workers’ compensation lawyer also has some legal loopholes available. These rules help victims obtain maximum compensation for their work-related injuries. This compensation usually includes lost wage replacement and medical bill payment.
Eggshell Skull
There is something fundamentally wrong with taking advantage of another person’s weakness to improve one’s own position. Bullying and harassment are two good examples. This analysis also applies in injury claims, including workers’ compensation claims.
The eggshell skull rule usually applies if the victim had a pre-existing condition, such as a chronic illness or prior injury, which contributed to the risk of the current injury, or the current injury’s severity. Essentially, the eggshell skull rule prohibits insurance companies from using these conditions to challenge the claim or reduce benefits. If the victim had poor eyesight which increased the risk of a fall or a bad knee which made the injury worse, the insurance company bears the risk.
The eggshell skull rule only goes so far. A victim must prove that the pre-existing condition contributed to the current injury, and not the other way around. Attorneys often partner with specialized physicians who provide the necessary proof in these situations.
Discovery Rule
Normally, the eggshell skull rule applies in trauma injury claims, like falls and motor vehicle crashes. The discovery rule often applies in occupational disease claims. Generally, victims have a duty to immediately report trauma injury claims. But victim’s need not report occupational disease claims, like work-related breathing problems, until the victim:
- Knows the full extent of his/her injury, and
- Connects that injury with the workplace.
Hearing loss is a good example. Most victims do not immediately see doctors the first time they must turn on the captions to follow dialogue on television. Even if that happens, they usually don’t connect their hearing problems with their work environments. These realizations usually come later.
This scenario could involve the eggshell skull rule as well. Most people hear loud noises all the time, and not just at work.
Work-Related Connection
In the before times, this element of a workers’ compensation claim was relatively easy to establish. People worked at work. They did not work at home. Furthermore, the law clearly stated that workers’ compensation didn’t cover commuting-related injuries, like car crashes. The work-related connection was not strong enough.
Things are different now. Pretty much all white-collar workers do at least some work from home. If nothing else, they answer work-related emails, grade papers, or attend occasional Zoom meetings from home.
Workers’ compensation might apply to work-from-home injuries. Generally, if the employer approved the work area and provided WFH equipment, like an additional computer monitor, workers’ compensation usually applies. If only one of these conditions is present, a work-related connection is more difficult to establish.
Reach Out to a Savvy Louisiana Attorney
Many job injury claims involve some rather complex legal rules. For a free consultation with an experienced workers’ compensation lawyer in New Orleans, contact Lunsford, Baskin & Priebe, PLLC. After-hours visits are available.
Resource:
law.cornell.edu/wex/eggshell_skull_rule
