In Matter of B&W Electrical Contractors (WCB # 9980 1481, Jan. 29, 1998), the New York Workers’ Compensation Board (WCB) recently amended a 1998 claim to include aggravated hypertension as the carrier was unable to provide a credible opinion asserting why the claim was unrelated and was only able to provide additional possible explanations for the claimant’s hypertension.
1998: The Claim Begins
In 1998 the claim was established for injuries to claimant's head, neck, back, knees, and pelvis. In 2014, the claim was amended to include chronic pain syndrome, depression, and post-traumatic stress disorder.
2021: Claimant Raises Hypertension Issues
In 2010, the claimant’s treating physician noted that his blood pressure was elevated and in 2012, he stated that claimant had non-causally related hypertension which was “well controlled.” In a January 2021 report, the claimant's treating nurse practitioner, NP Laing, diagnosed hypertensive disorder which was “[n]ot well controlled due to his extreme anxiety and dealing with workers comp.” In April 2021, the WCLJ found prima facie medical evidence for “aggravation of hypertension” based on NP Laing's January report. The claim was amended to include consequential anxiety in July 2021.
The carrier utilized a consultant, Dr. Wein, who conducted a records review and issued a report in August 2021, concluding that the claimant's hypertension was unrelated to this claim. Depositions of the doctors were then directed on the issue of causal relationship.
NP Laing testified that the anxiety that the claimant “has been dealing with has caused a fluctuation with his blood pressure” and that his hypertension was the result of his workers' compensation accident.
Dr. Wein testified that he was unable to find causal relationship between the claimant's hypertension and his work injury as the medical records periodically indicated that claimant suffered from hypertension. Dr. Wein testified that claimant “most likely does have hypertension” but “there are many causes of high blood pressure, including heart disease itself, anxiety, stress, lifestyle.”
In November 2021, the WCLJ amended the claim to include consequential hypertension. Special Funds requested administrative review.
On review, the Workers’ Compensation Board (WCB) found that Dr. Wein failed to explain why the claimant's causally related anxiety did not contribute to his hypertension. Therefore, the WCB found Dr. Wein’s opinion to be less credible than that of NP Laing, and in doing so they noted that NP Laing examined the claimant and Dr. Wein did not. The WCB found that the claimant has experienced hypertension for many years, at least since 2010, and that it is clear that claimant's causally related anxiety at the very least exacerbated and worsened that condition.
Takeaway
In workers’ compensation, denying causal relationship requires an explanation. Merely pointing out other possible causes does not rebut causality. Further, carriers should always obtain an in-person examination, when possible, rather than a records review, as the WCB took that into account in evaluating the credibility of the doctors.