What Is the Usual Work Comp Settlement for Lower Back Injury
Knowing what not to say to your workers' compensation doctor is important to help make sure that your claims' process is smooth and successful. A doctor for workers' compensation evaluates injured workers to determine the extent, cause, and prognosis for on-the-job injuries.
After a serious work injury, it’s important to act right away and ensure you have the proper documentation to secure your rightful benefits. Unfortunately, that’s not always so easy. You’ll need to know what to do and what to avoid while on workers' comp, and what not to say to your workers' comp doctor.
Fortunately, if you’re concerned about your workers' compensation doctor visit, a lawyer from Pothitakis Law Firm, PC can help. We understand how difficult it can be to get your compensation, and we’ll help you fight back for the full funds you deserve after your work accident.
Under Iowa law, the employer and insurance carrier may choose an injured employee's medical care – which includes choosing which doctor an injured worker sees for their work-related injury. This can result in some difficulties for injured workers because the insurance company both selects and pays for these doctors, and ultimately the doctor may want to obtain additional business from that insurance company in the future. For that reason, injured employees need to follow some ground rules as it relates to providing information to the doctor.
The most important guideline workers' compensation attorneys highlight is to be truthful and honest with the doctor about the injury and the employee’s condition. Along with that is to make sure to tell the doctor for workers' compensation every complaint or problem that exists because of the injury. On some occasions, it may be appropriate to provide a list of an injured employee’s complaints to the doctor. By documenting every problem that exists because of the work-related injury, it can help ensure that those conditions will be dealt with as part of the work-related injury. For example, if an injured worker has low back pain that radiates down her right leg, it is imperative that that injured worker discuss both the low back pain and the right leg pain. If the focus is solely on the low back and the right leg is not discussed, that can create problems if the right leg develops issues several months or years later.
In addition to being open and comprehensive in your discussions with the workers’ compensation doctor, it is also important to note that anything that is told to the doctor will ultimately get conveyed to the insurance company. For that reason, the focus of the discussion as it relates to the injury should be the work-related conditions as opposed to any other issues or problems. Comments to the doctor that the worker does not want to go back to work or plans to quit or hopes to receive a large settlement, are things that should not be discussed with the workers’ compensation doctor. Those types of discussions can take away from the focus of the medical care; which is mainly to try to provide relief to the injured worker as much as possible.
One of the most damaging things you can do for your work comp claim is to say that your injuries are worse than they are. When you go into the office for your independent medical exam, your doctor will need to ensure you’re getting the appropriate treatment.
However, if you exaggerate the symptoms you’re experiencing, you might find yourself dealing with denial. A doctor will likely recognize when you’re exaggerating a symptom or claiming to experience a symptom you don’t have.
If a doctor believes that you’re exaggerating claims of an injury, they may then state that you don’t need workers' compensation benefits following your injury. Instead, you’ll need to be honest with your doctor, which means you shouldn’t downplay the severity of your symptoms, either. Being honest about your condition can help you get the benefit approval you require.
If you have a preexisting injury, you might be concerned about getting compensated for your new injury. For example, you might have already had back problems, but after your work accident, your injury worsened, leaving you unable to work. Because many people worry about a preexisting injury affecting their claim, they may be tempted to lie and say they didn’t have a previous injury.
Unfortunately, this can hurt your claim, too. Your doctor can easily find out about your previous accident, especially if they have access to your medical records. If they know you lied about your past injury, they may instead assume that this is the same condition, not a condition worsened by your work accident. Because of this, it’s important to be honest about your medical history.
Under Iowa law, if a doctor provides restrictions for a work-related injury, the employer has to decide whether they return you to work. If they decide they want to return you to work under those restrictions, they have to provide you an offer in writing. If you refuse to accept the work offered, your entitlement to weekly workers’ compensation benefits may be suspended. The offer of work has to be suitable and reasonable, given your restrictions as well as your abilities and qualifications. There can be disputes whether an offer of work is reasonable. A more recent law change requires the employer to submit any offer of suitable work in writing. It also requires the employee to set forth in writing any refusal to accept the offer of work and why they are refusing the same. (Iowa Code Section 85.33).
What has been occurring more often regarding Iowa employers and Iowa workers’ compensation insurance carriers is to make up light duty positions to require the employee to come to work to simply sit. They do this because they don't like the idea of an employee being home and receiving weekly workers’ compensation benefits. Although ridiculous, in most instances they can require an employee to come to work as long as they do not violate any stated restrictions from their treating physician.
Defendants, employers, and insurance carriers on many occasions seek to send an injured person who is pursuing an Iowa workers’ compensation claim to an independent medical exam. How independent is that exam? This is up for debate. Commonly, the insurance company sends the injured employee to a doctor who is conservative and likely to give an opinion that is supportive of the employer's claim. The doctor may deny the claim altogether or provide little medical care for the claim. The defendants have the right to this exam and can force an injured employee to go to an independent medical exam. When we have clients asked to attend these exams, we typically let them go to the appointment and want them to be as nice as possible to the doctor, even if that doctor may not ultimately give a good opinion. Nothing helps a doctor more to lean more against an injured employee if they don’t like that employee or feel like the employee is exaggerating or is belligerent about their claim or injury.
It is important for the injured employee to tell the doctor all things that are wrong and that are hurting them, being as honest and open as possible so that they take down all the necessary information. On some occasions, these independent medical exam doctors are watching the injured employee walk into the facility to see if they are limping or appear to be in pain. They are trying to catch the employee doing something they shouldn’t be doing or appearing to act differently before the appointment starts.
Another and a different type of independent medical exam is when we, Claimant’s lawyer, send the Claimant for an independent medical exam. In those situations, we’re waiting for that doctor to give an opinion about the condition being work-related and also maybe to try to get a higher impairment rating or more severe restrictions. There are a few different doctors that the workers' compensation attorneys at Pothitakis Law Firm use for these independent medical exams, and these are doctors that Niko has worked with for many years. Again, it is important to be very open and honest about your condition and how you are doing and things that are bothering you. We have to pay these doctors, but typically can obtain reimbursement from the insurance company for the appointment at a later date.
When you’re facing a possible workers' comp denial, you’ll need to act appropriately to protect your claim. That means knowing what to say and what not to say to your workers' comp doctor when you’re preparing for your examination.
Fortunately, a lawyer from Pothitakis Law Firm, PC can answer your questions about your workers' compensation and your medical exam. Starting with a free consultation, you can get the answers you need from an attorney before beginning the work comp claims process.
If you’re worried about your medical exam and have some questions or concerns, reach out to your lawyer today. Our attorneys can be reached by calling 866-753-4692 or by filling out the online form below.