Dental Damage Claim

A salesperson for a large department store in West Virginia fell at work in 2011.  Dorl Holdren applied for and received workers’ comp coverage for right eye/head lacerations, sprains of both wrists, left knee sprain and left shoulder pain.  Holdren received stitches to the right side of her face.  She was off work for the rest of the week.

Two days after the fall, Holdren went to the dentist.  The treatment notes say she had soreness in her jaw while chewing, but didn’t mention of dental injuries related to her recent fall.  Then, in 2014, Holdren filed a claim to amend her workers’ comp to include teeth. Her dentist said bridgework, root canal, along with other dental work were, in fact, related to her fall at work in 2011.

However, a claims administrator denied adding the dental work to the claim.  The West Virginia Workers’ Compensation Office of Judges and Workers’ Compensation Board of Review upheld the ruling.  The Office of Judges said it is more like than not that Holdren did not injure her teeth in her workplace fall.  It pointed to the fact that her dentist records two days after the fall didn’t contain any mention of the dental conditions allegedly related to her fall.

Recently, the state’s Supreme Court of Appeal looked at the case, but agreed with the previous decision.  The court claimed Holdren didn’t report injuries to her teeth due to the fall to the emergency room or any doctor.  There was no mention of broken bridgework until three years and eight months after the fall.

Holdren didn’t get to add coverage for dental work to her workers’ comp claim.