Claimant is bound by the description of the injury in the agreements for compensation.

The Board grants the employer’s motion to dismiss the claimant’s petition for additional compensation, finding that the medical treatment was beyond the portion of the cervical spine injured in the work accident.

Deborah Kreuwieser v. Sandra Kite, (IAB Hearing No. 1466189 - Decided Feb. 3, 2020)

This case shows the advantage to the employer in defining as precisely and narrowly as possible the nature of a compensable work injury.

On April 17, 2016, the claimant was leading a horse out of a stall at Delaware Park during the course of her employment when the horse reared after becoming frightened by a chair in its path. The claimant sought medical treatment with Dr. Bose. Treatment included multiple diagnostic tests identifying problems at various levels of the cervical spine, including a fracture at the C2 level and other findings at the C3-C7 levels. Dr. Bose’s records for treatment of the claimant in early November 2017 indicated that they discussed possible surgery to include various options involving the C3 through C7 levels.

The parties entered into an agreement for compensation on November 29, 2017, which specifically stated: “The only injuries sustained were a right shoulder biceps tendon rupture with a SLAP tear; left thumb fracture; left leg contusion; and cervical fracture of Employee’s C2 vertebra.” That agreement was approved by the Board on January 19, 2018. On April 11, 2018, the parties entered into a supplemental agreement to pay for additional medical expenses, but this agreement also recited the precise description of the injury given in the first agreement.

In July 2019, the claimant filed a petition to determine additional compensation, which sought payment for medical expenses related to cervical spine surgery she had undergone with Dr. Bose on March 5, 2019, involving the C5-C6 and C6-C7 levels. The employer filed a motion to dismiss that petition. The claimant argued that she was clearly entitled under the Act to have the Board review the previous agreements on the basis that her medical condition had changed. She further argued that the recent surgery with Dr. Bose was necessary, reasonable and causally related to her work injury.

The Board rejected that argument and granted the employer’s motion to dismiss. The key fact, as pointed out by the Board, was this was not a situation where the claimant’s condition had changed or a new injury had developed through a progression caused by the initial work injury. To the contrary, the need for surgery had existed and been discussed before the execution of the agreements by the parties. Those agreements make it clear that the accepted work injury to the cervical spine was limited to the C2 level. The claimant had the opportunity to include other cervical levels as being compensable when the agreements were executed, but she had not done so. Accordingly, the claimant was bound by the description of the injury on the agreements, and the petition to determine additional compensation was dismissed.

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