The Law

Workers’ Comp Coverage Must Be Paid for Bathroom Injury

Court must decide whether worker's pain flare-up is related to a four-year-old work injury or a pre-existing condition.
By: | August 30, 2018 • 2 min read

Kellie Farricker, an employee of the Bravo Brio Restaurant Group, sustained work-related injuries to the head, neck and back in March 2009. She was cleared for maximum medical improvement by 2012.

One day in April 2016, Farricker felt a sharp, sudden onset of pain in her lower back while on the toilet. She went to the ER, presenting with continued pain and numbness in her legs. After an exam and MRI, the doctor concluded that Farricker had a herniated lumbar disc, which would require immediate surgery.

Farricker applied for temporary total disability (TTD), stating the herniated disc was a result of her previous injuries from 2009. Bravo Brio denied the claim because the herniated disc came seven years after her original injuries.

The restaurant submitted its own physician assessment, which concluded that Farricker’s discs were degenerating before the bathroom injury. He said surgery and treatment did not fall under the allowed conditions of the initial claim.


A district hearing court authorized both the surgery and TTD, stating the injury was an exacerbation of her pre-existing condition. Bravo Brio appealed, but a staff hearing officer sided again with Farricker.

The restaurant filed for a writ of mandamus relief, asking the commission to issue a new order denying medical treatment. It argued Farricker’s was an intervening injury, meaning it developed after and apart from the original workers’ comp injuries. But the commission did not agree.

Stephanie Bisca, Ohio’s court of appeals magistrate, oversaw the final ruling. She wrote in her opinion that “the commission did not abuse its discretion in finding that [Farricker] here did not sustain an intervening injury when she wiped herself after utilizing the bathroom facilities. This is an ordinary, everyday event which, as a general rule, does not cause any injury.”

She denied Bravo Brio’s request for writ of mandamus.

Scorecard: Kellie Farricker’s herniated disc is an extension of her original workers’ comp claim. Her employer, Bravo Brio, will need to cover temporary total disability costs.

Takeaway: In workers’ comp, reinjury can extend claims well beyond initial injury. Best practice is to invest in employee wellness and other like programs or else face a growing compensation bill.

Autumn Heisler is the digital producer and a staff writer at Risk & Insurance®. She can be reached at [email protected]

More from Risk & Insurance

More from Risk & Insurance

4 Companies That Rocked It by Treating Injured Workers as Equals; Not Adversaries

The 2018 Teddy Award winners built their programs around people, not claims, and offer proof that a worker-centric approach is a smarter way to operate.
By: | October 30, 2018 • 3 min read

Across the workers’ compensation industry, the concept of a worker advocacy model has been around for a while, but has only seen notable adoption in recent years.

Even among those not adopting a formal advocacy approach, mindsets are shifting. Formerly claims-centric programs are becoming worker-centric and it’s a win all around: better outcomes; greater productivity; safer, healthier employees and a stronger bottom line.


That’s what you’ll see in this month’s issue of Risk & Insurance® when you read the profiles of the four recipients of the 2018 Theodore Roosevelt Workers’ Compensation and Disability Management Award, sponsored by PMA Companies. These four programs put workers front and center in everything they do.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top,” said Steve Legg, director of risk management for Starbucks.

Starbucks put claims reporting in the hands of its partners, an exemplary act of trust. The coffee company also put itself in workers’ shoes to identify and remove points of friction.

That led to a call center run by Starbucks’ TPA and a dedicated telephonic case management team so that partners can speak to a live person without the frustration of ‘phone tag’ and unanswered questions.

“We were focused on building up a program with an eye on our partner experience. Cost was at the bottom of the list. Doing a better job by our partners was at the top.” — Steve Legg, director of risk management, Starbucks

Starbucks also implemented direct deposit for lost-time pay, eliminating stressful wait times for injured partners, and allowing them to focus on healing.

For Starbucks, as for all of the 2018 Teddy Award winners, the approach is netting measurable results. With higher partner satisfaction, it has seen a 50 percent decrease in litigation.

Teddy winner Main Line Health (MLH) adopted worker advocacy in a way that goes far beyond claims.

Employees who identify and report safety hazards can take credit for their actions by sending out a formal “Employee Safety Message” to nearly 11,000 mailboxes across the organization.

“The recognition is pretty cool,” said Steve Besack, system director, claims management and workers’ compensation for the health system.

MLH also takes a non-adversarial approach to workers with repeat injuries, seeing them as a resource for identifying areas of improvement.

“When you look at ‘repeat offenders’ in an unconventional way, they’re a great asset to the program, not a liability,” said Mike Miller, manager, workers’ compensation and employee safety for MLH.

Teddy winner Monmouth County, N.J. utilizes high-tech motion capture technology to reduce the chance of placing new hires in jobs that are likely to hurt them.

Monmouth County also adopted numerous wellness initiatives that help workers manage their weight and improve their wellbeing overall.

“You should see the looks on their faces when their cholesterol is down, they’ve lost weight and their blood sugar is better. We’ve had people lose 30 and 40 pounds,” said William McGuane, the county’s manager of benefits and workers’ compensation.


Do these sound like minor program elements? The math says otherwise: Claims severity has plunged from $5.5 million in 2009 to $1.3 million in 2017.

At the University of Pennsylvania, putting workers first means getting out from behind the desk and finding out what each one of them is tasked with, day in, day out — and looking for ways to make each of those tasks safer.

Regular observations across the sprawling campus have resulted in a phenomenal number of process and equipment changes that seem simple on their own, but in combination have created a substantially safer, healthier campus and improved employee morale.

UPenn’s workers’ comp costs, in the seven-digit figures in 2009, have been virtually cut in half.

Risk & Insurance® is proud to honor the work of these four organizations. We hope their stories inspire other organizations to be true partners with the employees they depend on. &

Michelle Kerr is associate editor of Risk & Insurance. She can be reached at [email protected]