Understanding the Compensability of Hernia Injuries

Written by: James G. Smith, Esq.

Georgia law provides special rules for determining whether a hernia injury is compensable. I have had a several hernia cases recently, and in each case, the “heavy lifting” of defending the claim undoubtedly takes place in the initial moments or discussions when the alleged hernia is reported to the employer and/or insurer. It is critical to ask the proper questions at the outset to determine whether the injury is compensable under Georgia law.

For starters, the law requires states that for a hernia injury to be compensable, an injured worker must demonstrate that the hernia resulted from an accident sustained in the course and scope of his or her employment. Additionally, there are four other requirements which must also be demonstrated by the injured worker: (1) The hernia must have appeared suddenly; (2) the hernia must have been accompanied by pain; (3) the hernia must have immediately followed an accident; and (4) the hernia must not have existed prior to the accident for which compensation is claimed.

Importantly, several cases have clarified that “sudden appearance” does not necessarily mean “instantaneously.” Furthermore, the term “immediately” has been defined as a “relative and reasonably close coincidence between the accidental injury and the hernia where no other agency intervened to cause the accidental injury.”

Obviously, the terms “suddenly” and “immediately” create some gray area. As such, as noted above, it is imperative to ask very detailed questions when taking a statement from a worker who is reporting a hernia injury. For example, it would be beneficial to ask the injured worker to provide a specific timeline of events as to when the hernia was noticed, when it became painful (if at all), how long after the “accident” (in terms of minutes or hours or days) that the hernia appeared, and whether the worker can even attribute a specific incident as the cause of the hernia. The more detail, the better. Obviously, it is also important to know if the worker had ever been diagnosed with a hernia prior to the alleged date of accident. All of these questions and answers will be beneficial in determining whether the hernia is compensable or if it should be denied.