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The Hindrance to Recovery Theory

The Hindrance To Recovery Theory

When the Carrier is on the hook for your unrelated injury.

Typically, the Workers’ Compensation carrier does not have to provide any medical treatment or other benefit for preexisting injuries. But what if my doctor cannot treat my work injury due to a preexisting injury and/or condition? The Hindrance to Recovery Theory may dictate that the carrier is on the hook for treating your unrelated injury if it is impeding the doctor from treating your compensable work injury.

The Hindrance to Recovery Theory entitles an injured worker to medical benefits for preexisting conditions if the treatment will aid or improve recovery. This entitlement may apply to conditions that you had before the accident, and to conditions that arise after the accident.

One example of where you see the Hindrance to Recovery Theory in action is in a situation where an injured worker could not pass pre­op clearance for a compensable injury and surgery due to an unrelated heart condition. If your authorized physician recommends surgery, and you cannot pass the pre­op clearance due to high blood pressure or some other heart condition, the Hindrance to Recovery Theory kicks in. The Carrier could be responsible for treating the heart condition to a point where you can undergo the surgery for the compensable injury. In addition to heart conditions, the First District Court of Appeal has opined that in certain instances, the employer may be responsible for providing the injured worker with a weight loss program.

In the aforementioned case the claimant suffered a compensable work injury to his back. The doctor opined that his weight of 278 pounds complicated his recovery and that a weight loss program would relieve some of his pain. The court agreed with doctor and ruled that the carrier must provide the program.

In 2003 the Florida Legislature attempted to end the Hindrance to Recovery Theory for good by amending the Workers’ Compensation act to provide that no compensation or medical care attributable to preexisting conditions is compensable or payable.

However, the First DCA in Gallagher Bassett Services ­Orlando v. Mathis, 990 So. 2d 1214 (Fla. 1st DCA 2008) indicated that the theory still applies and did not mention 440.15(5)(b).

These situations can become extremely complex and you can bet that a fight is coming from the Carrier over treatment. We would love to discuss your case and explain all your options to make sure that the Carrier is providing the correct benefits that you are entitled to under the law. This is why it is important to hire a workers’ compensation attorney who handles these types of situations and knows what your entitled to. If you or someone you know is in this situation, please give us a call at (877) 817­4127.


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