- Consequences of injury (iatrogenic illness) (treatment) (chiropractic manipulation)
- Second accident (during rehabilitation)
- Consequences of injury (secondary condition)
- Fracture (vertebra) (lumbar)
The worker was granted initial entitlement for a lower back strain/sprain. In this appeal, the worker claimed entitlement for a non-transverse displaced fracture of the left transverse process at the L4 level, caused by chiropractic treatment on November 28, 2018.
The Panel allowed the appeal.OPM Document No. 15-02-05 on the subject of "Accidents Resulting from Treatment", states that entitlement is in order if a second accident results from treatment of a work-related condition. The worker had attended her chiropractor's office complaining of back problems. The chiropractor proceeded to perform chiropractic treatment on the worker's lower back without any diagnostic imaging. In completing the spinal manipulation therapy, the chiropractor pressed on the worker's lower back with significant pressure. Later, while at home, the worker felt something suddenly "pop" in her back and she felt a rush of significant pain.The Board CM asked a physician to provide an opinion regarding compatibility of the diagnosis of a low back sprain with the mechanism of injury being reported for the October 1, 2018 claim. Dr. Khan noted that it is unusual to fracture this aspect of the bone without significant trauma, and that the spinal manipulation therapy could cause exactly this type of fracture when significant force is applied at the precise locale of the worker's body. The Panel interpreted this evidence to mean that the most likely cause of the worker's fracture was the spinal manipulation therapy that the worker received on November 28, 2018 when she attended a chiropractic appointment for treatment of her low back as a result of her October 2018 compensable accident. The worker's fractured vertebrae resulted as a secondary condition as a direct result of the chiropractor's failed attempts to adjust and "crack" the worker's back while treating her for the accepted compensable injury of the low back.