Today’s blog post comes from lawyer Thomas Domer, who is an advocate for injured workers through Domer Law Firm in Milwaukee, and he also teaches the workers’ compensation course at Marquette University. He writes about a talk he gave in New Orleans regarding three important tips for people making a workers’ compensation claim. These tips generally apply in Nebraska and Iowa, but workers’ compensation laws vary by state. So please speak with an experienced workers’ compensation lawyer if you have questions about specifics regarding your experiences. Have a safe, productive day.
I just returned from New Orleans where I made a presentation to about 150 workers’ compensation lawyers (both for workers and for employers) on “Case and Client Evaluation In Workers’ Compensation”.
Since many in the audience represented insurance companies and employers, I paid particular attention to their response to my presentation. As one would expect, their best chance to win a case on behalf of the employer and insurance carrier occurs when several items come into play:
When there is no actual report of the injury. [Worker’s Tip: No matter how small the work injury, make sure it is reported in some fashion – cell phone, voice recording, or Accident Report and the worker keeps a copy (BEST).]
Failure to report that a work injury occurred to the first treating practitioner (whether Emergency Room, employer-directed medical facility, hospital, or primary care physician). The single most difficult hurdle in a workers’ compensation claim involving a traumatic injury occurs when no report of the injury is found in the initial medical record.
In “Occupational Exposure” cases, no discussion with the doctor about work duties or prior incidents. (In Wisconsin, a worker can recover for workers’ compensation in one of two ways:
A traumatic injury where a single incident has caused the disability (lifting a box, falling, etc.)
Occupational Exposure, where the wear and tear of a worker’s job causes the disability over time. In this latter category, workers routinely do not indicate with any kind of specificity the type of work they perform when they see the doctor.
These three tips can help us as workers’ compensation lawyers win claims, more so than any “Clarence Darrow” court room techniques or strategies.
Today’s post comes from guest author Thomas Domer from The Domer Law Firm in Milwaukee. Although Nebraska doesn’t require a “single incident or episode” like Wisconsin, the terms “trauma” and “traumatic injuries” most definitely mean different things to different people. Context matters, and most injured workers don’t have a lot of experience with medical terminology and what it means. The legal profession has its share of jargon, but that’s part of the job of an attorney and their staff – to help clients navigate through both the jargon and process of their claims. But I agree with Mr. Domer that it would be much more helpful to injured workers if doctors spent a quick moment explaining what their jargon – especially using words like trauma – really means in the context of a work injury report.
I’ve been investigating Wisconsin and national fraud statistics in worker’s compensation to prepare for a national presentation I am making in Cape Cod in July. One fascinating and recurring basis for denial of worker’s comp claims (and potential claims against employees for fraud) stems from an insurance carrier’s review of the initial medical report.
Often the physician or emergency room nurse, physicians assistant or First Responder will ask an injured worker “Did you have any trauma?” If the answer to the question is “no”, the medical records will routinely indicate “no trauma”. This information is translated by the insurance carrier as a denial that an injury occurred. The level of medical sophistication for an injured worker is routinely limited. Most of my clients (and based on inquiries with other workers’ attorneys, their clients as well) believe a trauma is something akin to getting hit by a bus. They do not equate the notion of trauma with lifting a heavy object such as a table or a box. The criteria for traumatic injuries in most states, including Wisconsin, is that a single incident or episode caused the injury or aggravated a pre-existing condition beyond a normal progression. In many cases a lack of “traumatic injury” at the initial medical presentation is not an accurate indication of whether a traumatic injury actually occurred.