Pathological Change - Michigan Supreme Court Refines Its Prior Holding in Rakestraw The Michigan Supreme Court (MSC) recently issued an order in the case of Fahr v General Motors Corp. (Case No. 133500, June 22, 2007), holding that the Workers' Compensation Appellate Commission (WCAC) had misinterpreted the MSC's decision in Rakestraw v General Dynamics Land Systems, Inc., 469 Mich 220 (2003). In Rakestraw, the MSC had held that, in order for a worker to recover workers' compensation benefits for a pre-existing condition, the worker must show that the work caused an injury that is ""medically distinguishable"" from the progression of the underlying pre-existing condition. In its decision in Fahr, the WCAC asserted that Rakestraw does not require a ""pathological change"" in a pre-existing condition in order for a plaintiff to establish that a work-related personal injury has occurred. The MSC held that the WCAC had misinterpreted Rakestraw. The MSC held that a ""medically distinguishable"" injury cannot be proved ""by merely showing a worsening of symptoms."" The MSC offered some guidelines on proving a pathological change in the underlying pre-existing condition. The court stated that, ""[a]lthough a medical expert need not use the phrase 'change in pathology,' there must be record evidence from which a legitimate inference may be drawn that the plaintiff's underlying condition has pathologically changed as a result of a work event or work activity in order to meet the legal test for a personal injury under MCL 418.301(1) and Rakestraw. SIGNIFICANCE This decision seems to reverse a line of WCAC cases which had been viewed as diluting the original intent of Rakestraw by only requiring a worker to show a change in symptoms, not pathology, in order to prove a new work injury. In Rakestraw, the MSC had used the phrase ""medically distinguishable"". This order clarifies that the court meant a ""pathological change"", not just a symptomatic change, in condition for a pre-existing condition to be compensable. 6/27/07