Savings Hints: March 2008.

Defending claims of  Aggravation to a Pre-Existing Condition

The first defense is in the form of a comprehensive recorded statement from the injured worker immediately after the accident.  In this statement we not only record the fact that the injured hurt his shoulder, but we record the fact that he did NOT hurt his neck, has no pain in his neck and specifically where in the shoulder the pain is situated.  We also ask if they have ever had any shoulder injuries or pain in the past or any neck injuries or neck pain, and if the answer is positive, we need to find out who treated them for those conditions and if they ever had X-rays or MRI’s in the past.  We need to find out where those X-ray films and MRI films may be.  Then, with the first hint that the doctor is wanting to look to the cervical area for the source of the pain, we need to gather the prior diagnostic X-rays and MRI films and reports and take a position of denial of cervical diagnostics because there was no injury to the neck as indicated by the patient in the original statement.  We further have to submit the exact details of the accident to a “force analyst” so we can prove, beyond any doubt, that no injury could have occurred to the cervical area.  If the doctor proceeds with the cervical MRI and has findings, we then have to submit all of the new and old X-rays and MRI films to our defense physician along with the force analysis to scientifically document that no cervical injury or aggravation exists!

Next month’s savings hint:

How to Use a Force Analyst in Defending an Injury Claim.