New Washington case provides limitations to Maphet
For self-insured employers in Washington, one of the most significant decisions in recent years was the Washington Court of Appeals’ 2019 opinion in Clark County v. Maphet. 10 Wn.App.2d 420 (2019). This decision was significant because it no longer allowed employers to authorize treatment for conditions that held no causal connection to the accepted industrial injury or occupational disease without accepting them under the claim. Previously, employers had been able to authorize such treatment without risking acceptance of an unrelated condition. However, Maphet established that if treatment performed for an industrial injury caused complications or aggravates the industrial injury, the claim would cover those complications or aggravations.
The Court of Appeals’ departure from the established practice has resulted in gray area for employers attempting to handle claims without broadening their exposure by accepting new conditions. Since 2019, the court has slowly addressed cases invoking Maphet and its application of the compensable consequences doctrine. These cases have slowly provided guidance to employers, and in some cases, the court has even narrowed the broad application of Maphet. The court’s recent decision in Brinson-Wagner v. Kennewick School District announces a new limitation on Maphet. 2023 WL 7904109.
In Brinson-Wagner, claimant was working as an educator for the school district when one of the students under her supervision fell onto her left leg and injured her ankle. Ms. Brinson-Wagner originally filed a worker’s compensation claim with the Department of Labor & Industries for her left ankle, which was accepted as an industrial injury. Several years later, Ms. Brinson-Wagner claimed that the industrial injury from 2008 had also injured her left knee and asked the School District to pay for a knee replacement surgery.
Despite well-established evidence showing that her knee condition preexisted her 2008 industrial injury, claimant argued that her knee condition was proximately caused by the 2008 injury. As such, she requested that the replacement surgery to address it should be included under her claim due to the application of the compensable consequences doctrine established in Maphet.
The court found that, unlike the facts of Maphet, Ms. Brinson-Wagner’s industrial injury was not the proximate cause of her knee condition for which she was now seeking treatment. Rather, treatment of her preexisting knee condition was merely authorized as an aid to recovery for her accepted condition. The court determined that the compensable consequences doctrine should not be applied in these situations. It rejected claimant’s argument that by authorizing treatment as an aid to recovery, the employer had essentially conceded that the preexisting condition was causally related to the industrial injury.
Additionally, the court determined that there are limits to the employer’s liability for treatment, even when a pre-existing condition has been ordered to be treated as an aid to recovery. If the original injury has reached maximum medical improvement, the claim can be closed, even when the preexisting condition requires further treatment.
The court’s decision in this case is significant because it limits the scope of the compensable consequences doctrine as applied in Maphet. Where Maphet opened the doors to additional exposure for employers, this decision puts some notable limitations on the doctrine. These limitations afford employer’s protection in situations where the authorized procedures are performed merely as an aid to recovery. It also protects the employer where the underlying injury has reached maximum medical improvement, and the authorized treatment is for pre-existing conditions, treated as an aid to recovery. If you have any questions regarding Maphet or Brinson-Wagner, please contact me at 503-776-5426 or .
Posted by: Nathan McFadden.
