Injured knee while recovering from shoulder surgery...

by A
(Annapolis, MD)

I had shoulder surgery to repair a rotator. While still in the sling and on medication, I fell while at home. As a result of falling I twisted my knee, trying to prevent myself from falling on the side where the injury occurred. I have been told by Risk Management they will not cover this injury as being a result of the first injury.

My argument was if I had not injured my shoulder and needed surgery in the first place, due to a job related injury, then I would not have possibly lost my balance and protected my fall. Is there any case law related to this type of secondary injury? I need something I could possibly use to assist with establishing the second injury as an unfortunate result of the first injury? Thanks for any info you can give.

Visitor Question:
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ANSWER for "Injured knee while recovering from shoulder surgery...":

A (Annapolis, MD):

Your home injury resulting from an on-the-job injury may yet be covered. Don’t just accept the decision of the claims adjuster handling your claim. The decision to cover or not cover your home injury is a subjective one, and subject to interpretation at the discretion of the adjuster.

In your case, it’s pretty obvious the adjuster has refused to even consider the possibility the home injury may be related to the on-the-job injury. If the adjuster maintains her position, ask to speak with the supervising adjuster. The supervising adjuster has the authority to overrule the adjuster handling your claim.

If the supervising adjuster refuses to overrule your initial adjuster, contact the state of Maryland Workers' Compensation Commission. You have a right to a hearing and adjudication of your claim. You can also tell the adjuster(s) if they don’t change their decision you will seek a hearing under the Commission. That may help to change their minds.

Finally, if all else fails, contact a workers' compensation attorney. Your claim seems valid and a workers' comp attorney will likely want to represent you.

The above is general information. Laws change frequently, and across jurisdictions. You should get a personalized case evaluation from an attorney licensed in your state. Find a local attorney to give you a free case review here, or call (888) 647-2490.

Best of luck,

Judge Calisi

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