View this article online: https://www.claimsjournal.com/news/west/2007/04/16/78702.htm
The Arizona Court of Appeals has ruled that subjective pain does not fall under Arizona’s definition of an injury for which an employee is entitled to workers’ compensation benefits.
According to court documents, in Polanco vs. Industrial Commission and Pima County, Mont Polanco, an employee of Pima County, injured his back during the scope of his employment while lifting a rock out of a manhole in 2001. His subsequent workers’ compensation claim was accepted for benefits, and he had diskectomy surgery. Polanco’s claim was closed in Feb. 2003, but he continued to receive treatment for his back injury, “including caudal epidural injections” that “markedly improved [his] pain and allowed him to work full-time.”
He suffered an industrial motor vehicle accident in Aug. 2004, at which time the injections became less effective. In late 2005, Polanco’s physician recommended he have a spinal cord stimulator implant to control his pain. Consequently, Polanco filed in Nov. 2005 a petition to reopen his initial claim, which the insurer denied.
“The ALJ denied benefits, finding the employee had not shown his inability to return to work was related to his injury and, in the alternative, determining his injury was not compensable because residual pain did not “constitute a ratable permanent impairment under the … [American Medical Assocation] Guides,” according to court documents.
In writing for the appeals court, Judge William Brammer Jr. said a claim could not be reopened based on a worker’s “increased subjective pain if the pain is not accompanied by a change in objective physical findings.” To qualify for benefits, the court of appeals said the employee must prove from both a legal and medical perspective that the injury is work-related.
“Section 23-1061(H) governs the reopening of workers’ compensation claims and requires an employee to prove the existence of ‘a new, additional or previously undiscovered temporary or permanent condition’ to reopen a claim. And the employee must show a causal relationship between the new condition and a prior industrial injury,” courts documents note.
Thus, the court acknowledged that “because subjective pain is not an injury within the meaning of article XVIII, § 8 of the Arizona Constitution, § 23-1061(H) does not unconstitutionally eliminate it as a type compensable injury. And the objective physical findings requirement of § 23-1061(H) does not address either legal or medical causation. That requirement instead makes clear that subjective pain alone cannot support a petition to reopen a claim. Rather, subjective pain must be directly related to the degree of impairment resulting from an objective physical change.”
Source: Arizona Court of Appeals