When an employee is injured in the course of his employment, the natural and resulting consequences from such injury are compensable as also arising in the course of employment. The compensable consequences of the injury can encompass a negative progression or complication of the injury or a completely new injury resulting from the initial one. However, for the initial injury to be considered the root of the resulting condition, there can be no independent intervening cause occasioned by the employee’s own intentional conduct.
Compensability for the consequential effects of an injury may be jeopardized if the worker refuses to submit to reasonable treatment for the injury. The intentional avoidance of reasonable treatment will break the necessary causal link between the initial injury and the consequential condition that follows. For an extreme example, consider the worker who suffers a deep cut on his hand but refuses to wear a bandage, take antibiotics, and get the necessary stitches that are required for the wound to heal. If the wound develops an infection that leads to gangrene resulting in the amputation of the worker’s hand, such consequential condition would likely not be compensable because the causal link between the cut on the hand and the infection/amputation has been broken by the worker’s unreasonable refusal of treatment.
The worker who intentionally engages in an activity that would very likely cause further damage or prevent healing of the injury may also be denied compensation for the consequential condition. Consider the worker who fractures his wrist on the job, but then goes rock climbing a few days later. Rock climbing, which requires heavy use of the climber’s arms to support and pull his weight, would be almost certain to exacerbate the injury and would more likely than not cause a considerable amount of more damage to the worker’s arm.
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