“That’s Not Our Responsibility” Isn’t Always the Right Answer


Sometimes it’s easy for work comp adjusters to draw a line in the sand and say, “That’s not work-related and I’m not paying for it.”  They may be talking about the claimant’s diabetes, high blood pressure, addictions, depression, obesity, etc.  Often, the adjusters are half-right.

Clearly, there are many co-morbid conditions that did not develop as a result of a covered injury.  But that condition may be stalling or blocking the claimant’s recovery.  Often this will be the situation in large, complicated cases that never seem to resolve.

So if the claimant continues to be disabled and the condition(s) result in a higher award or settlement, the adjuster is, in fact, paying for it.  It’s just that the money is going to the wrong place.

Don’t be afraid to deal with and treat comorbid conditions.  Often this is the ONLY path to settle the claim.  OMCA, through its ClaimsCLEAR® program, specializes in assembling the right medical team to deal with whatever aspect of the case is blocking recovery and settlement. If managing the claimant’s diabetes or addressing the addiction to opiods will close the case, let’s do it.  It’s only going to get worse if ignored.

Call us.  We can do better.

William V. Faris, JD
Chief Executive Officer

Posted in Medical Cost Containment, Workers’ Compensation