A Claimant Files a Back Injury Claim – Is It Compensable?

In a recent Claims Success Story, Synergy used medical canvassing to uncover a claimant’s past medical history and ultimately settle the case in our favor.  An employee filed a workers’ compensation claim, alleging he injured his back when lifting an apparatus at work the previous week.  While investigating the claim, our Adjuster used medical canvassing to retrieve prior medical records showing the claimant was receiving medical treatment for his back weeks before the alleged work incident.  Additionally, a written witness statement revealed the claimant complained about back pain when he was new on the job, stating the pain was not work-related, but stemmed from a car accident a few years ago in which back surgery was required.  The medical canvas, combined with the witness statement, helped Synergy prove that the compensability of the claim was questionable.

In this situation, Fitness for Duty assessments would have been extremely beneficial for both the employer and the employee.  These assessments are used to determine an employee’s risk of injury while carrying out typical job duties.  Had these fit-for-duty assessments been completed, the results may have revealed that this individual would have an increased risk of injury due to his previous back surgery, and would not be a safe candidate for hiring in this particular position.

Synergy Coverage Solutions is dedicated to helping employers control workers’ compensation costs and investigating every claim thoroughly for compensability.  To learn more about hiring practices and Fitness for Duty testing, click here or contact us by email here.

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