Yet Dr. Cove's history clearly documents chronic low back pain that was ongoing since 1985. However, nothing in the record suggests that any particular event prompted the onset of back pain in September 1993. Even the physician who administered the epidural in October of that year noted as an indication that claimant had low back pain since 1985 and that his pain was really no different than it had been for the previous eight years. Dr. Cove clearly testified that had claimant not fallen at work in 1994, he certainly would not have needed the 1993 epidural injection. The medical evidence, therefore, establishes the requisite causal link between the early work-related injury and the need for the 1993 epidural as well as the lack of an intervening cause.
Defendant is responsible for the medical costs associated with that epidural.
Less clear is whether the 1994 motor vehicle accident caused injuries sufficient to be called an aggravation that would end the employer's liability. That claimant suffered back and neck pain as a result of the Accident is clear. Claimant's attempt at designating all upper back and neck pain to the Accident and all low back pain to the work-related accident is unconvincing and unsupported by the medical records. Defendant's suggestion that a motor vehicle accident and recovery necessarily must lead to a finding of aggravation is similarly unconvincing. The central issue is not whether claimant experienced pain after the Accident or even whether he recovered in a civil settlement related to that accident, but whether he suffered injuries which contribute to his current condition and need for treatment.