In order to receive Worker’s Compensation benefits when an injured worker is not totally disabled, they must show proof of several things:
they must have a doctors note from an authorized treating physician, stating that they cannot go back to their pre-injury job. These are usually in the form of “work status notes,” light duty, work authorizations, or Selective duty instructions.
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Under Virginia law, they must show sufficient evidence of reasonable and regular marketing efforts consistent with their current physical abilities.
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they must be compliant with medical treatment and their medication regimen.
Failure to do any one of those 3 things will cause an injured workers claim for continuing wage loss compensation to be unsuccessful. Today’s post will focus on light duty, work restrictions, instructions and documentation.
How is light duty work status determined?
If it was up to the insurance company, or their nurse, case managers, it would not exist or be minimal. The workers comp insurance companies and their lawyers frequently come up with letters or forms for the doctors to sign, releasing the unknowing, injured worker (behind their worker’s back), to work, at a job that may not exist, or which will likely exceed their current, physical capabilities. An example of these “one size fits all” forms is shown here.
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It is not unusual for Doug,Landau and the Worker’s Compensation team at ABRAMS LANDAU, Ltd., to see evidence of an insurance nurse case manager pressuring the treating doctor to release a patient EARLIER than planned, to go back to work. The insurance company agents will try to convince the doctor, Physicians Assistant, or even surgeon, that the injured worker does not need 18 weeks of physical therapy, but only 10 or 12, and not at three times a week, but only two. This obviously saves insurance company money. The workers comp carriers have many ways of leveraging their greater economic power, such as suggesting delays in payment of not only a worker’s medical bills, but other patients from whom the orthopedic or neurological practice is receiving payment for care from this insurance company! The best Herndon, Franklin Farms and Oak Hill Virginia workers comp lawyers know what is in the insurance companies’ playbooks, and can anticipate their actions.
This is why it is so important that the injured employee come prepared to discuss their recuperation and treatment plan with their treating doctor, as well as their family physician. Because lawyer Landau sees job descriptions foisted upon treating healthcare providers, the injured worker should have a clear idea of the significant physical requirements of their pre-injury job, and share them with the doctor, physicians assistant, nurse practitioner and physical therapist. Frequently, the insurer’s nurse, case manager, or adjuster, will understate the difficult aspects of the job in order to get an early work release.
To counter this strategy, the injured worker needs to educate the doctor as to how many pounds are frequently lifted, what the heaviest objects are, and any specific requirement to climb into trucks, ascend, ladders, walk on uneven or disturbed ground at a construction site, twisting, bending, stooping, crawling, working with vibrating machinery, or other significant tasks. A job that requires: overhead reaching or grasping that may be out of reach for the worker with carpal tunnel syndrome, torn rotator cuff surgery, a herniated disc in their neck, or low back pain from a compression fracture in their spine, will be a problem.
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Though our newest workers comp team member, Sofia Bartalone has shown deep understanding when it comes to preventing insurance company mischief in the area of “light duty work” releases
The Workers Comp team at ABRAMS LANDAU frequently will work with our clients to put together specific questions to the doctor, so as to educate the medical experts as to what the particular job requires. This is because most doctors have not been ditch diggers, construction workers, or forklift operators. Very few doctors have held manual labor positions. So, in order to get specific written responses, so that the client does not undo the good work that has been done for them by their surgeons, physical therapists, orthopedic specialists, and other physicians, it is critical that the health care provider know what the patient actually did at their job.
In addition, the ABRAMS LANDAU Workers Comp. team will also endeavor to get a secondary opinion from either the primary care physician, family doctor, or other medical professional, who has had real interactions with the injured worker. This “1-2 punch” has proven to be especially effective when the insurance company has sent the workers comp claimant to a doctor of their choosing, who, after a seven minute exam, releases them to “full duty work” with “no restrictions. “
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The Worker’s Compensation judges in the Commonwealth, called “Deputy Commissioners,” have been instructed to give more weight to the authorized treating doctors opinions than the “one and done“ hired litigation witnesses for the insurance companies. However, it has to be approached the right way, because there are cases where the insurance medical exam has defeated the treating doctor where the report did not address specific issues. This is why the letters that the ABRAMS LANDAU team put together for each individual client are custom-made. They have proven to be effective over many years. The insurance companies will often use a check off box form, like the one shown here, to get what they want. However, these forms do not always address the types of tasks our clients are asked to do at their workplace.
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Doug Landau tries to get treating doctors and family physicians to “see the light” when it comes to the patient’s ACTUAL pre-injury job duties, so that they are not released to do work they cannot safely perform.
For example, if a particular client has a computer installation job, it may not have heavy lifting or other tasks that would aggravate a low back injury. However, if they are pulling cable through a ceiling, they are obviously going to be exerting a lot of force, twisting, pulling, as well as bending and stooping to get the wires through the ducts and conduits found in most office buildings. It is important to educate the doctor as to these particular job duties, so that a “fully work release“ is not issued out of ignorance. Landau has taken the time to actually meet with a number of treating orthopedic, neurological, PM&R specialists and other doctors throughout the country to try to educate them as to why this issue is so sensitive. Landau has talked to doctors about why they need to spend an extra few minutes to discuss with their patient what it is that they actually do, and not simply rely on what they think that the patient does at work. Even so-called “sedentary jobs,” for example, at a law firm, may require the lifting of heavy boxes of files, reaching overhead, bending, stooping, squatting and other tasks that are contrary to what the doctor would like to see as the patient transitions back, slowly and carefully, to their pre-injury employment.
Landau will often ask Dr. what their patient can. “safely” do so is not to endanger other workers. Where there is a significant leg or foot injury, or hand trauma, driving a manual shift truck or construction type vehicle may be an activity that endangers the patient, as well as others if the affected leg goes into spasm, has reduced range of motion, or lack sensation. Safety boots for a patient with a ankle fracture, so they don’t re-injure or twist the joint on the uneven surfaces, such as those found in construction areas, or in the dark on the Airport Operations Area (if they are working for airlines or airport), are all considerations to be kept in mind.
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The above considerations and unique requirements of each client’s job are reasons why the initial interviews with the Worker’s Compensation team at ABRAMS LANDAU are so thorough and take such a long time. We want to learn as much as we can about the client, their job, their expected duties, and how these things may impact upon the particular injury they sustained. We want our clients to get the best possible outcomes through competent medical care, appropriate medication regimen, durable medical equipment, home improvements and post accident Physical Therapy.
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If you, or someone you know, or care about, has been involved in a workplace incident that has resulted in permanent injury or restrictions, and there are questions about the laws that apply, please email us at front desk@landaulawshop.com or call 703-796-9555 right away. They’re important legal deadlines that applied these cases, especially with return to work, as under Virginia law, there is only a 90 day “look back” for “Change in Condition” Applications. This results in many injured workers innocently, losing out on valuable benefits because they were getting “played “ or their claim was denied or delayed by the Worker’s Compensation insurance companies. Don’t let that happen to you, call today.
If it was up to the insurance company, or their nurse, case managers, it would not exist or be minimal. The workers comp insurance companies and their lawyers frequently come up with letters or forms for the doctors to sign, releasing the unknowing, injured worker (behind their worker’s back), to work, at a job that may not exist, or which will likely exceed their current, physical capabilities. An example of these “one size fits all” forms is shown here.
