Be honest is most important when speaking with workers’ compensation doctor or even when you are getting a second opinion or independent medical examination.
Lying about the existence of a pre-existing condition can later affect you negatively as the employer uses it as a basis not to pay your workers’ compensation benefits. A pre-existing condition in the context of an injury case is a form of injury for which a worker has previously received medical treatment or for which a diagnosis of an injury has been made in his or her current work injury case. In most cases, your physicians will make the initial determination about whether you have a pre-existing condition. This determination is based on a number of factors including prior medical records, physical exam, etc.
You want to make sure your symptoms don’t go unnoticed by your doctor. But at the same measure, workers’ comp doctors are usually well-trained to spot exaggerated claims and false displays of suffering. During the exam the doctor will run you through a series of tests and exams to diagnose the cause of your pain, suffering, and discomfort. Some of these tests are intended to gauge your response to pain or even lack of response. You may think that exaggerating your symptoms will only increase the chances of a sizable workers’ comp payout. Let me assure you: Nothing could be further from the truth.
Your doctor will ask how you were hurt. You may be asked multiple times to describe your accident. Stick to the basic facts. If there are things you don’t know or don’t remember, leave them out or say you don’t recall. Don’t guess about facts, and do not exaggerate what happened. If at some point there are discrepancies in your story, this could be a big problem. There could be witnesses or even security camera video of your accident. You don’t want to give the insurer a chance to raise questions about what happened.
As soon as you suffer an on-the-job injury or think you have an occupational illness, you should notify your employer and request medical care. This is the first step in filing a workers’ compensation claim. A delay in seeking treatment can raise questions about the seriousness of your injury or how it occurred. Basic workers’ compensation pays medical bills and a portion of weekly wages for occupational injuries or illnesses that cause a worker to be out of work for seven consecutive days or more. After an accident or medical diagnosis, a worker has 90 days in most cases to request medical care from their employer through the workers’ comp system. However, by waiting to request a doctor, you may raise a question about the seriousness of your injury or whether it was related to a workplace accident. Waiting to seek treatment for a workplace injury is a mistake.
The objective of workers’ compensation is to assist the injured worker financially until they recover and are able to return to work. Most injured workers look forward to returning to work for the income and to get their old lives back. But returning to work too soon can lead to being reinjured. The insurance company that has ended benefits and closed your claim may fight resuming payments. The insurer may argue that you had recovered – you went back to work – and this is a new case that warrants full investigation before any benefits are paid. Your treating physician must sign off on you having reached maximum medical recovery and being ready to return to work. Don’t push them, regardless of how bored you are with rehab or being at home. If you think your assigned doctor wants you to return to work too soon, you can seek a second opinion. If a second doctor disagrees, you can retain legal help and challenge your release to return to work.
Describe all relevant previous injuries and don’t leave out details about your accident. Honesty is the best policy when it comes to workers’ comp cases.