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DISCLAIMER: Please note that every case is different and these verdicts and settlements, while accurate, do not represent what we may obtain for you in your case.

If You Go Back to Work on Light Duty, Do You Think the Adjuster Will Let the Doctor Take You Out Again?

The Case: "Jerry" worked in the lumber department of a large home improvement store. He injured his back loading bags of concrete onto a cart of a customer. He immediately reported the injury to his superiors. The employer immediately sent him to their company doctor to give a urine sample before they would investigate the claim any further. Once it was proven that he had no drugs in his system, the insurance company permitted him to go through a course of treatment. After several weeks of physical therapy, Jerry's doctor suggested that he return to work in a light duty position. Jerry was bored stiff from sitting at home and welcomed the opportunity to return to work and see his friends there.

Although the employer had assured the doctor that Jerry would only have to lift 10 pounds, they sent Jerry back to his regular position in the lumber department. On his second day back, a customer asked Jerry to help load some boards onto a cart. Jerry looked quickly for someone else but could find no one. At that point, he decided to help the increasingly impatient customer. As soon as he did so, he knew he'd made a mistake. His back hurt more than ever.

Jerry immediately went to his boss and asked to see the doctor. The employer said they would get back to him. The next morning Jerry couldn't even get out of bed. He called in, but his boss was non-committal. After two weeks out of work with no income and no word of a doctor's visit, Jerry came to see us.

Here's what we did: We immediately called the adjuster and demanded a return visit to the doctor. She agreed that this was necessary, and said she'd schedule it. We confirmed this conversation with a follow-up letter sent by fax. We also wrote to the doctor asking that he write Jerry out of work on a Form 28U. After several days, the adjuster claimed she had been trying to schedule the appointment but that the doctor was unavailable. For his part, the doctor indicated that because this was a workers' compensation claim, he would only see Jerry if the adjuster wanted him to. The doctor didn't feel comfortable writing Jerry out of work without actually seeing him.

We filed a motion with the Industrial Commission to force the insurance company to authorize the doctor's visit. We attached a copy of our letter to the adjuster, our letter to the doctor and an affidavit of a staff member regarding the doctor's comments regarding not being able to complete the form. The Industrial Commission ordered the insurance company to send Jerry to the doctor. The insurance company appealed this order. We then went back to the Industrial Commission for an order requiring the adjuster to comply pending an appeal. The adjuster attempted to get out of this by seeking a stay of the initial order. We filed an opposition to this, complete with all the relevant correspondence. Fortunately the motion for a stay was denied, and Jerry went to the doctor, who wrote him out of work.

Unfortunately, however, under laws which heavily favor the employers and their insurance companies, the doctor could only write Jerry out of work effective the day of the office visit. This was nearly eight weeks after Jerry originally asked to see the doctor.


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FAQs

Workers' Compensation

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Case Studies

Workers' Compensation

What Can Go Wrong with a Return to Light Duty Work.

How a Functional Capacities Evaluation Can Wreck a Claim.

An Example of a Workers' Comp Adjuster Manipulating the Recorded Statement.

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