Workers Compensation: Symptomatic Aggravation of an Underlying Pre-Existing Condition is No Longer Compensable

October 9, 2003
Priority Read - Employment Law Update Fall 2003

A landmark decision eagerly anticipated by Michigan employers arrived on July 30, with a Michigan Supreme Court ruling that changes the rules concerning aggravation of pre-existing medical conditions.

Before this decision, an employee who had a pre-existing condition that was made symptomatically worse as a consequence of work activities was entitled to workers disability compensation benefits.  But in Rakestraw v General Dynamics Land Systems, the Supreme Court held that, without a clear distinction between the symptoms and the pre-existing condition, symptomatic aggravation of a pre-existing condition is no longer compensable.

Case law had held that under § 301(1) of the Workers Disability Compensation Act, aggravation of symptoms of a pre-existing condition was compensable even if no work-related injury had occurred.  The Supreme Court reversed that finding as being inconsistent with the clear language of the statute, which requires proof of causation in order to establish benefits – that is, proof that an employee suffered a personal injury "arising out of and in the course of employment."

The Supreme Court explained that the Michigan statute requires the claimant to provide proof of a work-related injury, beyond aggravation of symptoms of the pre-existing condition.  The plaintiff has the burden of establishing the relationship between the injury and the workplace event by a preponderance of the evidence.  The Court held that symptoms that are consistent with the progression of a pre-existing condition are not compensable.  The burden rests upon the claimant to differentiate between the pre-existing condition, which is not compensable, and the work-related injury, which is.

In Rakestraw, the Workers’ Disability Compensation Magistrate had awarded benefits on the basis of the aggravation of symptoms of a non-work-related medical condition.  The plaintiff had a previous neck condition which had been surgically repaired.  He recovered from the injury, became asymptomatic, and returned to employment, but experienced symptoms on the job that led to a disability.  The magistrate found that the plaintiff did not show any objective signs of either post-surgical changes or worsening of spondylosis of the cervical spine.  She found that his work activities had not significantly contributed to, aggravated, or accelerated any such changes.  Still, she held that the plaintiff’s employment aggravated the symptoms of the pre-existing neck condition to the point that he could no longer work, and therefore she awarded benefits.

That decision was confirmed by the Michigan Workers’ Compensation Appellate Commission, which cited cases from the Michigan Court of Appeals as precedent for their decision.  The Michigan Court of Appeals denied leave to appeal.

The Supreme Court, however, reversed this decision and overruled previous cases from the court of appeals that held that symptomatic aggravation of a pre-existing condition alone could be compensable for as long as those increased symptoms resulted in disability.  Under the court of appeals ruling, once the claimant returned to his pre-existing condition, the liability ceased.

The Court explained that where symptoms complained of are equally attributable to the progression of the pre-existing condition and a work-related injury, plaintiff will fail to meet his burden of proof by a preponderance of the evidence.  In order to establish "a personal injury arising out of and in the course of employment" under § 301(1) of the Act, the plaintiff must show that the injury arose out of and in the course of employment, and is distinct from the pre-existing condition.

In dissenting opinions, Justices Weaver and Kelly complained that the Supreme Court’s majority opinion should be governed by the liberal construction rule that has generally been applied in workers compensation cases.  That rule holds that the Act is a remedial statute that should be construed liberally to grant benefits rather than deny them.  The dissenting Justices would apply this liberal interpretation of the statute to hold that aggravation of symptoms may constitute a work-related injury that is compensable under the Act.  Justice Kelly stated in a scathing dissent that the majority decision is "a crippling blow to the liberal construction rule" and that the decision "shakes the foundations of established worker’s compensation jurisprudence."  She went on to say that "the majority’s decision represents a serious departure from established law and a disavowal of established public policy," and that it constitutes changes that are "seriously ill-conceived."

As a practical matter, Rakestraw stands for the proposition that a claimant will not be compensated merely for showing that symptoms of an underlying pre-existing condition are worse.  Rather, he must establish that the symptoms are distinct and different from the symptoms of his pre-existing condition and prove that any increased pathology is not the consequence of  the natural progression of the pre-existing condition but of work activity that has significantly contributed to, aggravated, or accelerated it.  In other words, the claimant must establish an injury.  Symptoms alone of a pre-existing condition which have been aggravated or accelerated by work activity are no longer compensable in Michigan.

By themselves, symptoms that are equally attributable to the progression of a pre-existing condition and a work-related injury are no longer compensable in Michigan.  In short, the plaintiff must prove an injury.

For more information on this topic, please contact your Miller Johnson employment lawyer, or the author, Bert J. Fortuna.

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