Winter Workers Comp Surveillance Tips
Now that winter has arrived with a bang, it is always a ripe
time for surveillance on those questionable claims. The hustle and
bustle of the Holiday season is over, and people settle in to their
normal winter routines, waiting out the cold weather for the arrival of
spring.
For those problematic claims out there, this time of year is
always a busy one for surveillance companies. Adjusters cannot wait to
try and get some film of their injured claimant potentially violating
their medical restrictions by shoveling out their driveways or partaking
in a winter recreational sport.
Here are some tips to keep in mind for a successful hunt of
trying to get that elusive film that can direct a claim from compensable
to suspended:
Strike Not Only After the Big Storm, but During It
If you are like me and do not own a snowblower, the best way
to make shoveling your driveway easier is to do it a few times while the
storm is going on. This makes it a bit easier to heave all the snow
off of your driveway. True, the snow you are pushing may not weigh
500lb, but that is the point. Anyone with a lingering back injury is
going to have a hard time pushing a shovel, and I think any doctor will
lighten the medical restrictions if they see their patient spending a
lot of time outdoors with a shovel.
When caught, most claimants will try
to say they were only pushing the snow, and not lifting the shovel.
However, any activity is showing that they are active, and it can be a
way to get that person back to light duty work if they are currently on a
no-work status.
Use Snow Blowing to Your Advantage
Use Snow Blowing to Your Advantage
If your claimant does indeed have a snowblower, this can mean
that they are not actually lifting anything. But they are on their
feet, for long periods of time, pushing and pulling the blower around
and being active in general. This may not mean that they are 100%, but
they are certainly capable of doing light duty or sedentary work.
Even
if they claim that the snow blower is self-propelled, the claimant is
still walking behind it, bending down, and doing this for a period of
time. I would find it hard to believe that any doctor would keep this
person from doing sedentary work if confronted with the video evidence.
Use your tape to get them back to work, and doing something beneficial
for your workplace.
Watch For Potential Aggravation of Injury
Watch For Potential Aggravation of Injury
Snow and ice are slick, and people slip and slide while
shoveling and snow blowing. They are also bent over while using the
snowblower which could lead to an aggravation of your current back
injury claim. I am not injured, but I am sore after shoveling. If I
were to already have had a lingering back injury, this is only going to
make it worse.
The same could be said if you are watching the video and
your claimant slips and tweaks their back, or even worse they fall
hard, probably making their current injury worse. The best way to
handle this is to wait to show the doctor the tape until after their
next appointment. In the medical notes, the claimant may show worsening
signs of injury, and they probably will not tell the doctor that their
symptoms worsened due to falling on their rear end while shoveling.
At
this time you have good evidence to show that their injury wasmade worse
by slipping and/or falling down. Make sure you have the doctor be
objective. By showing the doctor the film, you have concrete evidence
when paired with the worsened medical report that their injury is now
exacerbated by their outside activity. This should allow you to be able
to be aggressive in trying to end your comp claim and move it to a
personal medical condition.
Know if they Have any Outdoor Hobbies
Know if they Have any Outdoor Hobbies
Since you know these people for a period of months or years,
you may already know that they love to ice fish, or to snowmobile.
Snowmobiling is very arduous, since riding on the machine can lead to
jarring of the back, resulting in a worsening of the injury. Even if
they do not claim to be medically worsened, if you can show them active
on a snowmobile, then it would seem that they are healthy enough to
return to work. The best evidence you could get is if the snowmobile
gets stuck and they have to get off and lift the back of the machine to
get it working again. These machines weigh hundreds of pounds, and if
you can do that, you should be good enough to be returning to work.
Ice fishing is not as arduous, in fact it is pretty lazy, but
it can still show a person hauling their gear out to their fishing
shack and sitting for long periods of time. You want to show the doctor
that this person is more active than they are leading on. Once you can
show that, you have some great evidence to show that this person is
healthy and ready for a return to work in some capacity.
If You Strike Out, Keep Trying
If You Strike Out, Keep Trying
Getting some great surveillance film is luck of the draw.
Sometimes there will be times that you send your vendor out and they
return with nothing. That is OK, you won’t strike gold every time. But
be persistent. Watch the weather reports, be aware of local fishing and
skiing competitions, and send your vendor out again. If indeed you
cannot gather any evidence then that is not necessarily a bad thing.
This means your claimant is avoiding any activity that will make their
pain worse or aggravate their injury. My friend calls surveillance “the
art of verification.”
Summary
Summary
There are a lot of people out there that love the snow and
the winter weather. I know people that have fishing shacks that are
like a mini house, complete with TV and propane heaters. Some people
snowmobile for miles in the bitter cold, and they actually enjoy doing
it. This doesn’t mean that everyone out there is up to something bad,
but it is a possibility. So take my pal’s advice, and verify that your
claimant is doing exactly what they are supposed to be doing–which is
laying low, resting, and giving their injury time to heal before
returning to work.
Article Source: http://www.workerscompensation.com/compnewsnetwork/workers-comp-blogwire/15799-winter-workers-comp-surveillance-tips.html
The Renwick Group can meet all your WCB surveillance needs - please contact us at www.therenwickgroup.ca
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