[music 00:00:00 – 00:00:15] Hello, I’m Jodi Brenner Ginsberg of Ginsberg
Law Offices. Today I want to talk to you a little bit about what goes on
behind the scenes. That is, when does the insurance company pressure the
treating doctor in worker’s compensation cases, and why? We all know,
with health care laws in front of us day in and day out and what the adversarial
nature is of worker’s compensation, that the insurance companies
are 99% of the time trying to get away with the cheapest possible way to
resolve your case and get out of it. Obviously, one of the biggest factors in the
cost of a worker’s comp case is the medical costs. Let’s suggest a situation
where an individual hurts their back, and previously had had no back
problems except maybe when they were five years old and had maybe fallen off
their bicycle. And I want to tell you that this is actually, I’ve actually
read this in a report. I had a client of mine who was a 55-year-old gentlemen
doing heavy work for his employer. He fell and he significantly injured
his back. Prior to that he had had no prior back problems. Now, when
you go to a doctor, they’re going to ask you a general history generally about
your lifetime, and he was very honest, and he said to the doctor in his history
report, you know when I was five years old, I fell off my bike and
I remember I had a bruise on my back for a few days, or whatever the case
might be, and that was it. And for the rest of my life I have not had any
prior back problems. This gentlemen, as I said, was doing rigorous work
for his employer, fell and hurt his back significantly, and the MRI had
shown he had a herniated disc and needed to have back surgery. When the insurance company gets hold of your
medical records, and they are allowed to do that in a worker’s comp case
without any HIPPA releases, because they’re paying for the care, the insurance
adjuster focuses significantly on the fact that when they person,
50 years ago, remember I told you he was 55, fell off his back, he
had hurt his back and had a bit of a bruise. Never had any problems after
that. The insurance company then got on the telephone
with the doctor, because prior to that, the doctor had been writing
that this man needed back surgery due to his work related injury, and
subsequently, the doctor somewhat changed his report, noting that the
gentleman had had a bruise on his back 50 years ago, and therefore, he decided
that at least in part, his medical problems to date was due to that childhood
injury. We were taken aback by this report. Why would
a doctor do that? Typically, a doctor is out there to help you as the patient.
Well when we sat down to depose this doctor, we got him to admit that
he believed that it was due to the work related injury, but that the insurance
company had been so focused on this 50 year old injury, when this man
was a child, that he had to listen to them, because ultimately they want
to get, meaning doctors want to get, the next set of referrals from this
insurance company. While he didn’t admit that, that was the real reason
why his report became a little bit more gray and was not so clear. So, please understand, in many cases this
does not happen. But there are some cases where your doctor, unfortunately,
is being pushed to the nth degree by the insurance company and not always
is your best interest in front of them. So when you’re coming up against
your doctors and seeing that they’re not listening to you or not understand
that you have been rocking along and doing just fine until you
got hurt at work, do not hesitate to call us. We’re happy to stick
up for you, we’re happy to advocate for you, we’re happy to go to bat
for you and make sure that these doctors understand what you’re medical history
is. We look forward to seeing you and speaking
with you if you need our help. 770-351-0801.