How Do I Know When the Work Comp Storm is Heading My Way?


This is non-scientific and merely anecdotal but there are early indicators that a comp claim has major dollar potential.  When I see some combination of these factors, I immediately rally my medical review swat team as I know I have a potential complex situation at hand:

1)  My first contact is from a plaintiff attorney,
2)  The treating provider is one of the “one percenter” (i.e. one of the few clinics that seems to prescribe 99% of the narcotics)
3)  The Claimant has a long history of degenerative problems, prior surgeries and previous injuries,
4)  Co-morbidity issues such as obesity, diabetes, smoking, high blood pressure, etc. reduce recovery prospects
5)  Job dissatisfaction factors.  For example, in KY employees who work on thoroughbred horse farms seem to like their jobs and want to get back to work ASAP.  By contrast, short term/entry level employees in the fast food, housekeeping or health service industry may not be so enamored with their work environment.
6)  Ever changing diagnoses, CRPS (RSD) and chronic pain symptoms
7)  And finally, the common thread in almost all complex or catastrophic claims—Long term/ever increasing pain prescriptions.
8) The initial treatment record indicates the patient was o opioids & benzodiazepine at the time of the injury.


Posted in Workers’ Compensation