What is an “Intervening Accident?”


What is an “Intervening Accident?”

Often a Petitioner is injured on the job while working. Everything is going smoothly as the insurance company is paying for the medical treatment for the injury; then the worker is involved in another accident or incident and the insurance company stops paying for the medical treatment. The insurance company alleges that the new accident or incident is an intervening accident and, as such, they are no longer responsible for any additional medical treatment.

Some accidents or incidents are considered intervening, severing the causal connection between the original accident and the medical treatment being received and sometimes it is not. If, in fact, the medical treatment received prior to the intervening accident is the same after the intervening accident, then usually the Illinois Industrial Commission will not deem the intervening accident to be sufficient to sever the responsibility of the insurance company to pay for that treatment. If, however, the medical treatment changes after the intervening event, then the Illinois Industrial Commission quite often will find that there was an intervening accident severing their responsibility of the insurance company to pay for any additional medical treatment. Case law is usually quite clear on this matter. It states that if the Illinois Industrial Commission finds that the intervening accident was sufficient to break the chain of causation between the work accident and the condition of ill-being that is being treated then no additional medical treatment will be awarded.

The Illinois Supreme Court, on this issue, has stated: “independent and intervening cause has been held to be one which breaks the chain of causation between a work-related injury…. Where the work injury itself caused a subsequent injury; however, change in causation is not broken.” An example of the above would be where a worker injures his knee and while receiving medical treatment, he re-injures it. The re-injury is caused by the knee giving out is not considered an intervening event happens but as a result of the original injury. However, the same individual with the same knee injury, is involved in a separate accident un-related to medical treatment or the weakening of his knee and that knee is seriously injured, this would be an intervening event severing the responsibility of the insurance company to pay for medical treatment.

It should be noted that insurance companies will argue that at any time that there is another intervening event, even minor to a specific body part, that it is an intervening accident and will stop paying for medical treatment. A lot of times that occurs with back injuries. The best way to handle this is if you do have a work-related injury and you subsequently suffer an intervening event to the same body part, make sure that you tell your doctor about the injury and how the pain and discomfort that you notice is different than what you were suffering to prior to the intervening event. Once you receive medical treatment for the intervening event, you should then tell the doctor and therapist that you returned to the baseline as it was prior to the intervening event. At that point, the doctor or therapist should put in your medical records that you have returned to the baseline and the continued treatment is related to the original accident.

This is a very complicated issue and requires you to keep in touch with your attorney and doctor at any time you have an intervening accident.