- Causation (thin skull doctrine)
- Pregnancy (miscarriage)
The issue under appeal was initial entitlement to benefits for a premature termination of pregnancy. The worker claimed that on September 12, 2019 she ran to answer a phone call and as she tried to sit on a chair, the chair moved away. The seat of the chair hit her back. She held onto a table and almost fell to the ground. The worker was pregnant at the time. The worker reported back pain immediately which was followed by cramping.
The appeal was allowed.OPM Document No. 15-04-05, "Premature Termination of Pregnancy," states that claims for compensation and health care benefits shall be accepted in cases where it is medically determined that a premature termination of pregnancy "arose out of and in the course of employment," as a result of trauma, including to the abdominal or genital region. With regard to trauma to the abdominal/genital region, the medical evidence must confirm that: a) a chance event involving the abdominal or genital region occurred; b) the onset of the miscarriage occurred within 48 hours; and, c) it is medically considered that the abortion or miscarriage is due to the accident reported.The Panel accepted that the worker had a number of risks for miscarriage, but the question was whether the chance event made a significant contribution to the worker having a miscarriage. Decision No. 2068/18 was considered helpful. In that case, due to the worker's pre-existing condition, the worker's estimated lifetime risk of hemorrhage was 85% - virtually inevitable. However, it was the opinion of the Medical Assessor that the hemorrhage would not have occurred at the exact time it did were it not for the occupational factors which lead to an elevation in blood pressure. Therefore, the worker's activities of June 25, 2014 hastened the onset of the hemorrhage and made a significant contribution to the occurrence of the hemorrhage on that date.In the present appeal, the worker had an accident at work, experienced cramps and bleeding, and shortly after her pregnancy terminated. The Panel found that the accident of September 12, 2019 hastened the miscarriage of a viable pregnancy. In determining the compensability of the consequences of a work injury, the Tribunal applied the "thin skull doctrine." Under the WSIA, workers are entitled to workers' compensation benefits for injuries resulting from their work activities – even if some pre-existing condition predisposed them to developing that injury.