Bahman Haftsavar v. All American Carpet and Rugs, Inc. and Twin City Fire Insurance Company
59 Va. App. 593
Va. Ct. App.2012Background
- Claimant sustained a compensable right inguinal hernia on Jan. 5, 2007 arising out of employment.
- Pre-operative clearance on June 8, 2007 showed abnormal EKG, prompting further cardiac evaluation.
- Cardiologist Dr. Sherber found markedly abnormal stress test on July 1, 2007 and recommended catheterization; bypass surgery followed July 5, 2007.
- Hernia surgery occurred March 17, 2008 after claimant recovered from heart surgery; employer paid temporary disability through April 13, 2008.
- Claimant sought payment for heart surgery costs via change-in-condition petition filed Dec. 3, 2009; deputy commissioner and later the full commission issued conflicting rulings on causation.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether employer must cover treatment for a medical condition unrelated to the compensable injury. | Haftsavar—heart condition unrelated to hernia injury; treatment should be compensable. | Employer not responsible as no causal connection and not a compensable consequence. | No; employer not responsible for the heart surgery. |
| Whether Papco Oil v. Farr governs this case. | Papco supports compensability where treatment relates to compensable injury. | Papco distinguished; here no causal link and treatment not an adjunct to hernia care. | Papco does not control; denial of coverage upheld. |
| What is the proper test for compensability of pre-surgery medical treatment under the Act? | Compensable consequences or two-causes doctrine should apply to require coverage. | Adopts new causal-test that treatment unrelated to compensable injury is not covered. | Court adopts a test focusing on causal connection; unrelated heart treatment precludes coverage. |
Key Cases Cited
- Papco Oil v. Farr, 26 Va. App. 66 (Va. App. 1997) (treatment of an unrelated condition may be compensable only when linked to the work injury)
- Goad v. Lynchburg Foundry Co., 15 Va. App. 710 (Va. App. 1993) (causal relationship and necessity govern employer medical coverage)
- Morris v. Badger Powhatan/Figgie, Int'l., Inc., 3 Va. App. 276 (Va. App. 1986) (compensable consequences doctrine applies to natural consequences of injury)
- S. Iron Works v. Wallace, 16 Va. App. 131 (Va. App. 1993) (accelerated/ aggravated pre-existing conditions may be compensable)
- McGregor v. Crystal Food Corp., 1 Va. App. 507 (Va. App. 1986) (burden on employee to prove medical necessity of disputed treatment)