Injured Worker’s Description of Injury Amended to Include Aggravation of Arthritis Requiring a Total Knee Replacement.

Fred Xavier (name changed for this summary) while working for Defendant in June 2014, sustained an injury to his right knee. Inservco, the workers’ compensation insurance carrier for the employer, issued a Notice of Compensation Payable and the injured worker received wages in lieu of workers’ compensation. Mr. Xavier’s injury was accepted as a “right knee medial meniscus tear”.

We filed a Review Petition seeking to have the description of injury amended to include an aggravation of underlying arthritis requiring a right total knee replacement. Defendant filed a Termination Petition alleging that Mr. Xavier was fully recovered from his injuries based upon an IME performed by Dr. Cooper.

Mr. Xavier testified that he was continuing to work for the employer even though he continued to have pain and swelling in his right knee and that he has undergone two surgeries and several injections. Mr. Xavier was advised by his doctor, Dr. Kutz, that he should have a total knee replacement and that he does not believe that he is fully recovered from his work injury. The Judge found Mr. Xavier to be credible.

Dr. Kutz testified that he performed the surgeries to repair Mr. Xavier’s meniscus tear and that during the first surgery, he found evidence of arthritic changes in his knee. After surgeries and injections, Dr. Kutz continued to treat Mr. Xavier and felt that he was suffering from continued aggravation of his arthritis and recommended he undergo the total knee replacement. Dr. Kutz testified that Mr. Xavier is suffering from advanced osteoarthritis of his knee which was aggravated by his work injury and that the surgery is related to same. He also testified that Mr. Xavier was not fully recovered from his work injury. The Judge found Dr. Kutz to be credible.

The IME physician, Dr. Cooper had testified that Mr. Xavier did not have any problems with his knee before the injury occurred and that he had to undergo surgery to repair his meniscus and after attending physical therapy he underwent a second surgery to his knee. Dr. Cooper had reviewed MRI’s of Mr. Xavier’s knee which showed he had arthritis dating back to 2009. Dr. Cooper had testified that Mr. Xavier’s need for a total knee replacement was not related to the work injury and that the work injury did not aggravate his underlying arthritis. The Judge found Dr. Cooper to be incredible.

The Judge granted Mr. Xavier’s Review Petition and the description of injury was amended to include an aggravation of underlying arthritis requiring a total knee replacement. The Judge denied Defendant’s Termination Petition. Mr. Xavier’s medical bills relating to this arthritis and total knee replacement are now the responsibility of Defendant.