Injured at Work in South Carolina? What you need to know. (Part 2)

Posted on June 23, 2011 by Trey Mills

This is the second of a series of blogs written to tell workers in South Carolina what they need to do if they suffer a work-related injury.  

2.    Tell the treating doctor that you got hurt at work!

In my previous blog, I stressed the importance of reporting your work injury immediately to your employer.  Today, I stress the importance of telling your doctor that you got hurt at work and how you got hurt at work.

In many denied workers’ compensation claims, there is, for lack of a better word, a swearing match going on between the injured worker and the employer.  The worker claims to have been injured on the job.  The employer denies that the worker got injured on the job or claims that the injured worker did not properly report his injury to the employer.  The workers’ compensation commissioner is charged with the responsibility of finding the truth and, therefore, must decide which one to believe.  

In my experience, the commissioner often relies on the medical records to break the tie.  He discounts the injured worker’s testimony as well as the employer’s denial because they are both taking self-serving positions.  Then, he especially looks at the initial medical record of treatment of the injured worker to find the truth because he assumes that the initial treating doctor does not “have a dog in the fight.”  If the initial medical record documents that the employee was being treated due to an injury that the employee contends occurred at work, and especially if the record describes how the injury occurred, the commissioner will view that record as giving credibility to the injured worker’s claim.  On the other hand, if the injured worker does not mention anything about the work injury to the initial treating doctor, the commissioner will likely view that record as giving credibility to the employer’s defense that the employee did not get hurt at work.

Therefore, if you were injured at work, it is imperative that you document that you are at the doctor’s office seeking treatment for an injury that occurred at work on all of the forms that the doctor’s staff may ask you to complete prior to your examination and then you must describe the injury to the doctor when he examines you so that he will include it in your medical record.  

As a general rule, the more details that you can give to the doctor, the more believable your claim will be to a commissioner.  For example:

  • know the exact date of your injury before you go into the doctor’s office.  Do not guess at your date of injury because it will come back to haunt you if your claim is contested and the date of injury that you give the doctor is wrong.  I have seen situations where the injured worker haphazardly reports to the doctor that he got hurt at work on Wednesday about two weeks ago and then prior to the workers’ compensation hearing we learn from  reviewing his time cards that the worker did not even work on that Wednesday.  At that point after closer examination, we realized that the injury actually occurred on Wednesday, but it was three weeks ago rather than two weeks ago as reported to the doctor.  That is an error that can be explained and corrected, but it could have been avoided all together if the worker had been prepared when he initially went to the doctor.

  • be specific in your description of the injury to the doctor.  Which is more believable?

    • “I hurt my back at work last Wednesday just doing my job;” or
    • “Last Wednesday afternoon at work, I injured my back lifting a 75 pound box  off of the floor.  I was going to put the box on my work table.  As I twisted while lifting up the box, I felt a sharp pain in my lower back and pain even went down my left leg.  I had to put the box back down on the floor and was never able to lift it up to the table.”

In conclusion, it is imperative that you give your doctor specific details about your work-related injury during your first medical appointment after the injury.  If you do so, the employer and insurance carrier will likely admit that you got hurt at work and will provide you with workers’ compensation coverage without unnecessary delay.

My next blog will be about the fact that you can suffer a work injury without being required to suffer trauma.


 

(Ernie Trammell is the author of this blog post and subsequent posts on Workers' Compensation in South Carolina. Mr. Trammell has been a Workers' Compensation attorney in South Carolina for 29 years, primarily in the Upstate encompassing the counties of Anderson, Abbeville, Greenville, Greenwood, Laurens, Oconee, Pickens, and Spartanburg.) 

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South Carolina Medical Professionals Cheat Sheet to Legal Depositions

Posted on August 17, 2010 by Trey Mills

I am a lawyer not a doctor. Doctors are medical professionals trying to help people get better by diagnosing, treating, and preventing. When we step outside our profession and into another professional arena we know very little about, it can be confusing. No matter how much reality television we watch, it may not carry over to the realities we live in.

In the short time I have been an attorney, it never ceases to make me laugh when I go to a doctor's deposition. We, as lawyers, have to ask certain questions in certain ways to meet legal thresholds and adhere to the prevailing rules of evidence, which makes those questions sound verbose, obnoxious, and confusing.

  1. "Doctor  ______, is it your opinion to a reasonable degree of medical certainty that it is more probable than not, that my client's disc herniation were caused/aggravated/ and/or made worse from the motor vehicle collision/slip and fall/dog bite?"
  2. "Doctor ______, based on your education, observations, and medical treatment of my client, was it medically necessary to send them for physical therapy/diagnostic testing/pain management as a result of the motor vehicle collision/slip and fall/dog bite?"
  3. "Doctor ______, do you have an opinion to a reasonable degree of medical certainty as to the permanent impairments my client would be assigned under the AMA guidelines?"

It's important for medical professionals to understand that Plaintiffs have the burden of proving their case by the preponderance of the evidence. The most common example is the tipping of the scales of justice ever so slightly to provide an imbalance that would warrant the "preponderance" part, "more likely than not". (David Swanner of South Carolina Trial Law Blog gives several good examples).

Therefore, medical professionals don't have to know 100% one way or the other. They just have to give an opinion (based on a reasonable degree of medical certainty) whether an injury or aggravation of a pre-existing injury is "more likely than not"/ "more than a 50% chance"/ "ever so slightly tips the scales" was caused or directly affected by the trauma.

Plus, know what you charge for your office visits. You are a professional and are running a business. In the 100 or more medical depositions that I have taken, not one medical professional has been able to tell me what they charge per office visit. That could be one explanation in the health insurance and medical professional struggle now. How can you talk about lost profits and exorbitant prices when you have no clue about money, fees, or service costs directly related to services rendered?

This is the typical response cut and pasted directly from an recent examination of my client's treating physician's deposition:

I can't make an assessment about causation.  When I see a patient or take care of patients, I'm not really thinking about, you know, is this going to go to a legal situation. I'm mostly concerned about the patients and their well-being so I just go what they tell me, by the history.  So the answer to your question is:  I don't know.  I can't say with 100 percent certainty that the motor vehicle accident caused the herniated disk.

I asked the questions previously discussed. Do you have an opinion? Not can you tell me for certain. Plus, if you were truly concerned for the patient, you would also be concerned about the financial stress and misery of undergoing medical treatment and being personally responsible for the medical services you have rendered to them unless you agree that someone else affected their pre-existing injury or caused new injuries.

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