Maryland Court Holds that Degenerative Meniscal Tears are Considered an Occupational Disease

Michael Quinlan worked as a Paramedic/Firefighter for Baltimore County for 24 years. Quinlan typically worked four days a week, consisting of two 10-hour shifts and two 14-hour night shifts. During his shifts, Baltimore County required Quinlan to participate in activities such as climbing in and out of emergency vehicles, carrying up to 50 pounds of gear, crouching to address and provide services to patients, administering compression or other aid, lifting patients onto stretchers, moving stretchers, and taking patients up and down the stairs.

In 2015, Quinlan filed a claim with the Workers’ Compensation Commission against his employer, Baltimore County. Quinlan asserted that he developed an “occupational disease”—meniscal tears in his right knee—as a result of the work he was required to do as a paramedic/firefighter. At the hearing, the Commission concluded that Quinlan had not sustained an “occupational disease” as defined by Md. Code Ann., Lab. & Empl. § 9-502(d). Quinlan sought a review of the Commission’s decision by the circuit court, and the case proceeded to trial.

           At trial, Quinlan testified that he started experiencing pain and “clicking” in his right knee in 2014, causing him to seek out a doctor. He further testified that he was right dominant, meaning that he depended on his right leg more while performing his required tasks as a paramedic/firefighter. Quinlan also presented a video deposition of Dr. Barbara Cochran. After her review of Quinlan’s medical records, Dr. Cochran opined that Quinlan had tears in both his medial and lateral menisci, extending to the articular surface of the tibia. Cochran described Quinlan’s meniscal tears as “part of the continuum of osteoarthritis.” In her video deposition, Dr. Cochran also stated that repetitive use was a primary risk factor for Quinlan’s knee issues. She further cited to a study that concluded that “paramedic/firefighters have a ‘relative risk’ of developing knee osteoarthritis of 2.93 compared to the general population, meaning that for every 100 cases in the general population, there are 293 cases of degenerative knee tears in paramedic/firefighters.” Based on this study, Dr. Cochran opined that Quinlan’s “essential job functions” were the cause of his knee osteoarthritis.

           At the end of the trial, the jury returned a verdict in favor of Quinlan. The jury found that Quinlan had sustained an occupational disease of right knee degenerative tears of the medial and lateral menisci arising out of, and in the course of, his employment. The County appealed to the Court of Special Appeals arguing that: (1) As a matter of law, tears of the medial and lateral meniscus do not qualify as an “occupational disease” for a paramedic/firefighter; and (2) Quinlan had not shown that the degenerative meniscal tears were due to the nature of his employment.

           An occupational disease is “one which arises from causes incident to the profession or labor of the party’s occupation or calling.” Victory Sparkler & Specialty Co. v. Francks, 147 Md. 368, 379 (1925). Md. Code Ann., Lab. & Empl. § 9-502(d) lays out the requirements for claiming an occupational disease. To hold an employer/insurer liable to provide compensation for an occupational disease, the claimant must show: (1) that the occupational disease is due to the nature of an employment in which hazards of the occupational disease exist; and (2) on the weight of the evidence, it reasonably may be concluded that the occupational disease was incurred as a result of the employment. Md. Code Ann., Lab. & Empl. § 9-502(d).

           The Court found that there was a legal basis for concluding that the nature of paramedic/firefighter work, in general, involves a higher degree of risk for developing degenerative knee conditions. Quinlan presented evidence that demonstrated that paramedic/firefighters have a “significant” risk of developing osteoarthritis, relative to the general population. Quinlan also presented expert testimony from Dr. Cochran, who stated that hazards inherent in Quinlan’s “essential job functions” as a paramedic consisting of considerable repetitive kneeling, bending, and stress on the knee caused his knee osteoarthritis. Thus, Quinlan did show that the hazards that led to the development of degenerative knee conditions were within the ambit of a paramedic’s natural role.

The County’s expert, Dr. Hinton, argued that while he did not disagree with Quinlan’s characterizations of his job functions, these job functions were not distinct or unique from any other labor-intensive employment. The Court found that “uniqueness” is not a required element of Md. Code Ann., Lab. & Empl. § 9-502(d). The Court further stated that, as a matter of law, based on the evidence presented by Quinlan, the jury could have reasonably concluded that Quinlan’s employment caused his degenerative meniscal tears. Therefore, as a matter of law, degenerative meniscal tears should not be excluded from the universe of occupational diseases. Finally. there was sufficient evidence for the jury to reasonably conclude that Quinlan’s degenerative knee tears were “due to the nature of an employment in which hazards of the occupational disease exist.” Md. Code Ann., Lab. & Empl. § 9-502(d).  

-Jahnee Waller, Law Clerk