The case of Chandok vs. Subsequent Injuries Benefits Trust Fund (SIBTF) is an excellent example of the complexities surrounding workers’ compensation claims, particularly with regard to preexisting disabilities. The case involved a cashier/waitress for Shan Restaurant in Santa Clara, California who claimed more than 100 percent overall disability from preexisting and subsequent industrial injuries. In this article, we’ll delve deeper into the nuances of the case and explore the challenges of rating disabilities associated with preexisting conditions.
Background information on the case of Chandok v. Subsequent Injuries Benefits Trust Fund
The applicant in the case, Chandok, had been working as a cashier/waitress for AAK, LLC doing business as Shan Restaurant in Santa Clara, California. She had suffered from various pre-existing conditions, including disabilities involving her cervical, thoracic, and lumbar spine, reproductive parts, gastrointestinal system, and respiratory system due to a lifetime of exposure to second-hand smoke. In 2002, she underwent a tubal ligation, an elective surgical procedure to prevent pregnancy.
In 2013, Chandok suffered a fall at work which resulted in injuries to her cervical and lumbar spine. She filed a worker’s compensation claim, and the parties resolved the claim by compromise and release in February 2017. She was awarded $100,000 in compensation.
The applicant has requested benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF)
After the worker’s compensation claim settlement, Chandok requested benefits from the Subsequent Injuries Benefits Trust Fund (SIBTF). She argued that her various preexisting disabilities had been exacerbated by the fall, resulting in an overall disability rating of more than 100 percent.
The applicant’s claim of pre-existing disabilities
Chandok claimed that her preexisting conditions resulted from a variety of factors, including genetics, lifestyle choices, and workplace exposures. She cited medical evidence that her cervical and lumbar spine impairments were due to a combination of degenerative disc disease, herniated discs, and spinal stenosis. Her gastrointestinal problems were due in part to a history of gastritis and esophagitis, as well as to work-related stress. Her respiratory difficulties were attributed to a lifetime of exposure to second-hand smoke. Finally, she claimed that her tubal ligation had caused emotional and social ramifications that had affected her work.
The judge’s findings on the applicant’s disability rating
A judge was appointed to hear the case and determine Chandok’s overall disability rating. The judge found that she had more than 100-percent overall disability, consisting of 47-percent pre-existing disability involving her spine, reproductive organs, and gastrointestinal system, and 58-percent permanent disability for the subsequent industrial injury. The judge based this rating on comprehensive medical evidence presented by both Chandok and the SIBTF.
There is a dispute from the SIBTF regarding the rating for the applicant’s reproductive impairment.
Despite admitting to 77 percent overall disability at most, the SIBTF disputed the judge’s rating for Chandok’s reproductive impairment. The SIBTF argued that the tubal ligation was elective and asymptomatic, and therefore any disability related to the procedure was not compensable. The SIBTF suggested that the emotional and social ramifications of the procedure did not constitute a disability related to work.
Following the judge’s decision, the SIBTF asked for a reconsideration of the rating for reproductive impairment. The SIBTF argued that the rating was not based on substantial medical evidence and did not reflect the true nature of the impairment.
The Chandok case demonstrates the challenges of rating disabilities associated with pre-existing conditions in workers’ compensation claims. While pre-existing conditions are not necessarily a barrier to compensation, they can complicate the process and require careful consideration of the interplay between pre-existing conditions and subsequent injuries. It remains to be seen how the reconsideration will be resolved and what implications the case will have for similar claims in the future.