Highlights of Noteworthy Decisions

Decision 193 14
2014-05-20
C. MacAdam - J. Blogg - A. Grande
  • Transfer of costs (no fault motor vehicle insurance)
  • Apportionment (LOE) (multiple claims)

The worker suffered a left knee injury at work on March 22, 2011, while stepping off a ladder. On March 23, 2011, the employer sent the worker by taxi to a medical appointment for completion of a functional abilities form. The taxi was involved in a motor vehicle accident, and the worker suffered back and neck injuries. A new claim was established for the motor vehicle accident. The Board determined that a third party was negligent and fully responsible for the motor vehicle accident. All costs of the motor vehicle accident were removed from the employer's experience rating record.

The worker continued to work until he was laid off on August 25, 2011, due to lack of suitable employment. He underwent compensable knee surgery for a torn meniscus on November 3, 2011. He returned to work on March 12, 2012. The Board assigned the worker's LOE benefits from August 25, 2011 to March 12, 2012, to the knee claim. The employer appealed.
The two claims in this case were divisible. The accident on March 22, 2011, caused a knee injury. The accident on March 23, 2011, caused a neck and back injury. Accordingly, the LOE benefit arising from the claims may be apportioned according to the degree that each is responsible for the worker's wage loss.
Evidence indicated that the worker was able to work with torn meniscus. It was the back and neck injury that really prevented the worker from working while waiting for the knee surgery. The Panel concluded that the LOE benefits from the time of the lay-off on August 25, 2011, until the knee surgery on November 3, 2011, should be assigned to the back and neck claim. LOE benefits from the date of the knee surgery on November 3, 2011, until recovery from the surgery on January 2, 2012, should be assigned to the knee claim. LOE benefits from after recovery from the knee surgery on January 2, 2012, until the worker's return to work on March 12, 2012, should be assigned to the back and neck claim.
The appeal was allowed in part.