Shifting injury claims to workers’ compensation

| Mar 23, 2016 | Workplace Injuries |

People from all walks of life can be affected by physical issues such as muscle strain. The diagnosis of soft-tissue injuries can also be challenging for health care providers in Louisiana. In some cases, these injuries might follow heavy physical activity such as sports. In other cases, they could occur in sedentary settings because of a slip-and-fall situation or the use of poor body position while handling supplies. In some cases, it could be difficult to determine whether work or leisure activity has contributed to a physical problem. In such vague cases, a health care provider might decide to process the treatment within the workers’ compensation system if the patient is covered.

One of the challenges in such vague situations is the potential for a physician to make a determination based on financial interests. Workers’ compensation typically pays providers up to 20 percent more than would be received through health care insurance. When the injury is inappropriately considered to be one that was sustained on the job, the higher medical costs tend to be absorbed by the employer. There is also potential for workers to attribute vague conditions to their work activities because workers’ compensation cases don’t require individuals to meet deductibles or to make co-pays.

Other types of vague medical conditions could include pain related to herniated discs or damaged joints, which might not immediately manifest symptoms on the job. An individual involved in a manual labor profession might find it easier to attribute knee problems or a spinal issue to work activities. In a case involving major questions about the cause of an ailment, a workers’ compensation claim might be denied.

In difficult workers’ compensation cases, legal help could be important for pursuing appropriate treatment and other benefits. It may be helpful to keep a journal of aggravating circumstances to create a record that demonstrates how work activity correlates to the symptoms.