Opinion ID: 2043003
Heading Depth: 1
Heading Rank: 8

Heading: the nature of roan eagle's injury

Text: In Williams v. Dobberstein, 182 Neb. 862, 865, 157 N.W.2d 776, 778-79 (1968), this court stated that [p]ain alone is not compensable under our statute, and disability is the basic factor which gives rise to a claim for compensation. Accordingly, a claimant must give notice and file a petition `within the statutory period after he had knowledge that compensable disability resulted from the original accident.' Williams, supra at 865, 157 N.W.2d at 778 (quoting Welke v. City of Ainsworth, 179 Neb. 496, 138 N.W.2d 808 (1965)). Accord Borowski v. Armco Steel Corp., 188 Neb. 654, 198 N.W.2d 460 (1972). Our review of Nebraska decisions indicates that Roan Eagle's case appears to be the first instance for this court's consideration of the question whether medical treatment for an initial and compensable injury may result in a subsequent compensable injury under the Nebraska Workers' Compensation Act. No one doubts that Roan Eagle sustained a serious work-related injury on June 26, 1986, and required the orthopedic care and treatment rendered by Dr. Wilkinson. Although Roan Eagle experienced leg pain during his postoperative visits to Dr. Wilkinson in 1986, nothing in Dr. Wilkinson's observations, including radiographic examinations, indicated that Roan Eagle's fractured femur, supported by the metallic implants, was not knitting in the best medical expectations. Consequently, Dr. Wilkinson expressed the orthopedic belief, imparted to Roan Eagle, that the femur was mending, although Roan Eagle's recuperation might last as long as 2 years. That medical optimism was reaffirmed in 1987 when Dr. Wilkinson decided to leave the implants in Roan Eagle's femur, but cautioned Roan Eagle against heavy lifting. Throughout this time, according to Dr. Wilkinson, a radiographic examination of Roan Eagle's hip would not have disclosed any movement or rotation by the lag screw in the femoral head. However, when pain compelled Roan Eagle to return to Dr. Wilkinson, the physician was concerned about the persistent pain in the area of Roan Eagle's hip and, on examination of radiographic films of the fracture site on June 26, 1989, discovered that the previous expectations of a good medical result from the metallic implants had vanished. There was motion about the lag screw, which accounted for the lag screw's protrusion into Roan Eagle's hip joint. Even then, with his limited radiographic equipment, Dr. Wilkinson was unable to ascertain the exact extent of the painful protrusion; hence, Dr. Wilkinson suggested computerized tomography for Roan Eagle to obtain a complete and precise picture of the nowevident injury. At that point and for the first time, Dr. Wilkinson estimated Roan Eagle's disability as 13% impairment of the whole person, with the proviso that his impairment rating might be revised in light of future surgery involving the metallic implants. Professor Larson has noted that it is uniformly held that aggravation of the primary injury by medical or surgical treatment is compensable. 1 A. Larson, The Law of Workmen's Compensation ß 13.21(a) at 3-574 to 3-575 (1990). Larson further comments: Fault on the part of the physician ... even if it might amount to actionable tortiousness, does not break the chain of causation. 1 A. Larson, supra, ß 13.21(b) at 3-584. See, also, 82 Am. Jur.2d ß 337 (1976). Courts in several jurisdictions have expressed that, as a general rule, an employee may recover compensation for a new injury, or aggravation of an injury, which results from medical or surgical treatment of the employee's compensable injury if an intervening independent cause does not break the chain of causation between the employee's original injury and the new or aggravated injury; for example, see, Roberts v. Krupka, 246 Kan. 433, 790 P.2d 422 (1990); Martin v. Ford Motor Co, 401 Mich. 607, 258 N.W.2d 465 (1977); Turner v. Guiliano, 350 Mass. 675, 216 N.E.2d 562 (1966); Yount v. United Fire & Casualty Co., 256 Iowa 813, 129 N.W.2d 75 (1964); Matter of Kestenbaum v. Dunrite Painting Co., 10 N.Y.2d 838, 178 N.E.2d 430, 221 N.Y.S.2d 728 (1961); Ortkiese v. Clarson & Ewell Engineering, 126 So.2d 556 (Fla.1961); Shortridge v. Bede, 51 Wash.2d 391, 319 P.2d 277 (1957); Heaton v. Kerlan, 27 Cal.2d 716, 166 P.2d 857 (1946); Matter of Compensation of Sparks, 60 Or.App. 397, 653 P.2d 1002 (1982); American Smelting & Refining Co. v. Industrial Com'n, 25 Ariz.App. 532, 544 P.2d 1133 (1976). Consequently, we now hold that, as a general rule, an employee may recover compensation for a new injury, or aggravation of an injury, which results from medical or surgical treatment of the employee's compensable injury if an intervening independent cause does not break the chain of causation between the employee's original injury and the new or aggravated injury. Since Roan Eagle's disability, established on July 25, 1989, was directly traceable to the femoral injury on June 26, 1986, there is an unbroken chain of causation between the original injury and the eventual disability from Roan Eagle's hip injury. The medical evidence supports a conclusion that Roan Eagle's disability, discovered in July 1989, resulted from medical or surgical treatment of Roan Eagle's compensable injury. Thus, the State failed to prove that Roan Eagle's petition was untimely filed after the established existence of Roan Eagle's disability. Consequently, the findings by the Nebraska Workers' Compensation Court are not clearly erroneous and are sustained under the record.