The Requirement In Virginia For Showing Of A “Structural or Mechanical Change.”

In Virginia, an injured worker to prevail must establish an injury by accident arising out of and in the course of the employment.   Not all accidents that occur in the workplace are compensable.

It is important that the Virginia adjuster recognize that an injured worker must establish an injury by accident resulting in a structural or mechanical change to the body.  The Full Commission’s very recent decision in Curtis Martin, Jr. v. Mastec, Inc., JCN VA00001918587 (August 13, 2024) offers a good discussion of this requirement.

In Curtis Martin, the Full Commission, in a split 2-1 decision, affirmed the finding of the Deputy Commissioner that claimant did not show an injury by accident resulting in a structural or mechanical change to the body.

In Curtis Martin, the claimant testified that on November  27, 2001 he placed one end of a ladder on the hook at the front of the van, but as he attempted to hang the ladder on the rear hook, it “kicked me back… like it was stuck on something,” knocking him down resulting in immediate onset of low back pain.  Claimant presented to the emergency room three days after the accident and described low back pain to “a lot of heavy lifting” on November 27, 2001.  A CT was done at the hospital revealing degenerative disc bulging at levels L3-L4 and L4-L5.  At the hearing, the claimant initially denied suffering any back complaints prior to the ladder lifting incident.  Medical records presented at the hearing established a prior history of treatment involving the lower back.

The Full Commission, in affirming the decision of the Deputy Commissioner noted that the claimant must “prove an accident that caused an injury” and that “he failed in both regards.”  The Full Commission held, “[a]t best, he suffered an exacerbation of symptoms without a mechanical or structural change.  An increase in pain is not compensable without further evidence of an injury.” (Citation omitted).  Commissioner Marshall dissented noting disagreement with the Majority’s finding of no mechanical and structural change.

The requirement for establishing a structural or mechanical change must always be evaluated before agreeing to accept compensability of a claim.   The Curtis Martin decision makes it clear that an exacerbation of symptoms without a mechanical or structural change is not compensable.

This author recommends that in cases where (1) diagnostics showing degenerative changes only; and (2) there is a prior history of medical care to the body part at issue that consideration be given to denial for no structural or mechanical change to constitute an injury by accident.   In these cases it is advisable to approach the treating physician to address whether there has been a structural or mechanical change.

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