The Medcor team of (from left) Dave Matthias, risk manager for the Zoological Society of San Diego, Curtis Smith, executive vice president of Medcor, and Phillip Seeger, Medcor founder and CEO, readies for two 10-hour days of river travel to their destination in the Peruvian rainforest where they will medically support a team of research scientists.

 

It is one thing when an employee slips and sprains an ankle – but what would your company do if that employee was in the deepest part of the Amazon basin – you know, with, like, SNAKES!?

 

 

The answer is your company probably has no idea what to do – that is why smart businesses are hiring third party medical teams to manage remote location projects.

 

 

One such smart company is the Zoological Society of San Diego. It hired Medcor, an on-site medical firm, to establish a wilderness medical program to manage a research station at Cocha Cashu in the Peruvian Amazon jungle. Zoo officials asked Medcor to help assess medical needs and response options for a team of scientist and support staff at the station as it is very remote, requiring four days travel from the U.S., the last two being by small boats 10 hours a day.

 

 

According to Medcor executive vice president, Curtis Smith, the Cocha Cashu research station has been operating for about 20 years and the zoo just recently contracted with the Peruvian government to help manage it. For this Amazon project, research groups may vary from two to 30 people, staying from days to months. Hazards include a wide variety of snakes and insects, wild animals, and a risk of malaria, yellow fever, and other diseases, on top of many types of parasites and fungus — all this, along with temperature extremes and the usual work-site hazards of strains and sprains, slips and falls, and so on. Access to the park is restricted to only authorized researchers and a few indigenous people who live there without contact with the outside world.

 

 

The research station fits into the zoo’s broader mission of protecting and researching animals and plants, Smith says. The zoological society has a long history of conducting research in a wide variety of animal and plant topics, including preservation of endangered species, environmental sustainability, and wildlife education. The zoological society has conducted research throughout the world, including projects such as working with utility companies to minimize wind farms impact on migrating birds. The station at Cocha Cashu in Peru is so remote and untouched that is provides rare research opportunities, including baselines and comparisons for studies elsewhere.

 

 

Now that the zoo is assuming responsibilities for managing the station, they want to understand the risks to the participants — zoo employees or visitors — and provide for the safety of everyone there. These goals include bringing medical services to the program.

 

 

The service is based on extending Medcor’s existing telemedicine/triage services into the Manu National Park, which covers nearly 20,000 square kilometers of jungle. Medcor's triage service is already used in more than 80,000 worksites in the US, meaning Medcor is responsible for the health of workers at 80,000 locations. Additionally, Medcor provides on-site medical care at more than 170 factories, distribution centers, studios, farms, and mobile or temporary sites.

 

 

Founded in 1984 by CEO, Philip Seeger and COO Ben Petersen, the company operates with the belief that all employers want to control costs, improve outcomes, provide rapid response when it is really necessary and avoid claims when they are not necessary – and this means planning ahead even when the worksite is far from the typical office.

 

 

Privately held with 400 full-time and 400 part-time employees, Medcor does $54 million in business per year. The company boasts seasonality and flex work to meet changing client needs – for example, the retail distribution industry during the holiday season.

 

 

Through the use of telemedicine, Medcor reaches note just remote locations, but also employees working in worksites to small to support an on-site clinic, working on third shift when there are fewer clinics available, and even mobile workers. Telemedicine delivered through well-tested simple phone connections (or more complex satellite hookups) can be more practical and cost effective in many situations than providing on-site medical staff. In all cases, understanding the injury or illness and making a good decision about on-site treatment or the possibility of off-site treatment and evacuation is critical to ensuring good clinical outcomes and to avoiding unnecessary costs and claims.

 

 

To begin Medcor’s involvement with this project, Smith left for Peru with the zoo’s risk manager, David Matthias, to conduct a first-hand assessment of all the travel and evacuation logistics. They surveyed the site and tested two different satellite systems. Medcor also works with local personnel who have provided travel and support to the station in the past.

 

 

Smith says, “I’d call it more of a ‘business expedition’ than a ‘business trip.' We are bringing with us everything we need to live in the Amazon jungle for four to six days, including our tents, food, water purification systems — and our laptops!”

 

 

Matthias, a former Marine and law enforcement officer, says, as risk manager, he assesses all kinds of risks including health, safety, financial, legal, and helps create policies and protocols to address and mitigate the risks. He also helps place liability coverage/insurance for these projects and notes that safety and prevention are key components — as is working with specialized partners, such as Medcor, to address medical support.

 

 

Matthias made the trip to Cocha Cashu to understand firsthand the logistics of getting researchers, staff, students and supplies into the station. The station operates with very low environmental impact, with staff living in tents and relying on solar power. He also met local rangers from the Peruvian national park where the station is located and interviewed researchers who worked in the area before.

 

 

Medcor provides at least six support options for the station:

1.    Medical training for local staff and rangers.

2.    Stocking the station with essential medical supplies and equipment.

3.    Preventative measures, such as physical exams, fitness criteria and vaccinations prior to travel.

4.    Providing medical support for the station, based on extending Medcor’s existing telemedicine and triage services into the site via satellite phone, video and data links. (This is critical because the dense jungle canopy, distance, bad weather and lack of aircraft sources make helicopter evacuations nearly impossible.)

5.    Documentation and reporting with Medcor’s proprietary electronic medical record system, which is encrypted and HIPAA compliant.

6.    Sending qualified medical staff to work on-site supporting researchers at the station.

 

This is the first of several glimpses Medcor and the Zoological Society of San Diego we be sharing with our readers.

 

 

Posted in Medical Cost Containment & Managed Care, Medical Issues, Risk Management, Travel and Overseas Employees |

Pain, real or perceived, is a key barrier and among the most difficult of workers compensation claims to resolve. Pain can originate from the injury or from surgical intervention/treatment. Pain management is used to treat conservatively an injury or can be a part of the post-surgery rehabilitation process.

 

 

The numerous treatment techniques, methods, and approaches are divided into three broad areas.

 

1.     Non-drug, noninvasive pain management.

2.     Noninvasive drug management.

3.     Invasive pain management. (WCxKit)

 

Common non-drug, noninvasive pain management techniques include:

1.     Physical therapy to assist the employee in restoring normal movement of an injured body part.

2.     Cutaneous stimulation – the use of hot packs and cold packs to heat or cool the skin and underlying tissue.

3.     Treatment modalities of hydrotherapy, ultrasound, neurofeedback and electrical stimulation.

4.     Exercise including stretching, flexion, walking, weight lifting (appropriate to the nature of the injury), and aerobic routines. These exercises may be active, passive, or resistive depending on the nature of the injury and associated pain.

5.     Electrotherapy – the most common form of electrotherapy is transcutaneous electrical nerve stimulation (TENS) used to reduce back pain by using low voltage electric stimulation on the sensory nerve system. (TENS is effective in some cases and ineffective in others.)

6.     Chiropractic manipulation of the affected areas — sometimes beneficial.

7.     Cognitive therapy includes teaching the employee coping and relaxation techniques.

 

Both prescription and non-prescription medications are used by medical providers to control and eliminate pain. Several types of noninvasive pain drugs are:

 

1.     Aspirin, naproxen, ibuprofen, and COX-2 inhibitors, all nonsteroidal, anti-inflammatory agents (NSAIDs).

2.     Acetaminophen.

3.     Anticonvulsants and antidepressants used for “nerve” pain.

4.     Muscle relaxants used to reduce muscle spasms due to pain.

5.     Narcotics —  including opium, morphine, and heroin. These powerful drugs relieve pain but may entail the risk of addiction if not medically supervised properly.

 

 

The use of needles and surgical insertion to control pain is normally referred to as invasive pain management, one of the most expensive approaches to pain control. Several techniques for invasive pain management are:

 

1.     Epidural steroid injections (effective for providing temporary pain relief in severe cases).

2.     Facet joint injections (also effective in severe cases).

3.     Surgically implanted spinal cord stimulators and peripheral nerve stimulators (not always effective).

4.     Lumbar sympathetic blockage.

5.     Stellate ganglion blockage.

6.     Implantable opioid infusion pump to deliver an opioid agent direct to the affected nerve(s).

 

If the medical provider wants to refer an injured employee to a pain management clinic, review the clinic's website. If they specialize only in invasive pain management techniques, have your nurse case manager consult with the medical provider on the possibility of referring the employee to a pain management clinic that considers all three approaches to pain management, not just the pain control methods that earn the most money for the pain management clinic. There are generally 2 types of physicians that provide "pain management" services– anesthesiologists and physiatrists (physiatrists are called "PMR docs" which stands for 'physical medicine and rehabilitation'). The first tend to go straight to invasive techniques, while PMRs will often start with less-invasive techniques and work their way up.

 

Donald H. Marks, MD, PhD, a  principal in Cognitive Engineering, LLC,  mentioned that he has found in the past that validating objectively claims of pain is difficult. For the last several years he has adapted functional MRI scans which can actually show, illustrate, demonstrate the pain and cognitive impairment.   

 

As with other treatment options, pain management starts with the least invasive and less costly methods and steps up to more invasive and costly techniques to relieve the injured employee’s pain. It is very important to monitor progress to discover the best method achieving relief and to avoid a narcotic addiction for the patient.

 

Posted in Coordinating Medical Care, Medical Issues |

A fine of £60,000 ($97,116) was levied against Westwood Yarns following the death of a worker cleaning a baling machine. The employer was also ordered to pay £20,625 ($33,383) court costs.

 

 

A maintenance worker was killed when a baling machine he was working on re-activated according to information from the Health & Safety Executive (HSE). Bradford Crown Court heard that Gary Lee, an employee for 20 years, was untrained in the proper way to clean the baling machine. HSE, said management safety failings at Westwood Yarns Washpit Mills factory in Holmfirth were responsible for the worker’s death. (WCxKit)

 

 

The HSE investigation suggested Lee may have inadvertently obscured an electronic sensor, which re-activated the operation of the baling compressors as the machine was left in automatic mode, instead being completely shut down. HSE inspectors found a lack of supervision and consistency in work processes at the factory.

 

 

Also, a lack of equipment meant some procedures could not be properly carried out. Immediately after the incident, an enforcement notice was served on the firm requiring improvements to ensure cleaning operations of the baler was carried out safely.

This is ALSO a product liability claim. The machine should have been designed so that the electronic sensor could not have been re-activated inadvertently — a fail safe design.

 

Posted in Medical Issues, Product Liability, Safety and Loss Control, WC in Other Countries (International) |

A Justice Department indictment shows three defendants conspired to coerce the agricultural labor and services of Thai nationals by fraudulently inducing the recruits to incur substantial debts secured by the workers homes and family land, then confiscating the workers passports, and threatening to repatriate the victims to face destitution, homelessness and other serious harm if they did not remain in the defendants service for meager earnings.

 

 

The three men, Bruce Schwartz, 53, Sam Wongsesanit, 40, and Shane Germann, 42, pled guilty to human trafficking violations involving Global Horizons a Los Angeles-based recruiting company. Schwartz pled guilty to conspiring to commit forced labor, and Germann and Wongsesanit pled guilty to conspiring to commit document servitude. Each man faces maximum sentences of five years in prison. (WCxKit)

 

 

Another associate of the defendants, Podjanee Sinchai, was charged and convicted in Thailand with recruitment fraud and sentenced to four years in prison.

 

 

According to the Justice Department, a superseding indictment unsealed on January 18, 2011, charged eight defendants in connection with a scheme to lure approximately 600 Thai nationals to enter the United States under the federal agricultural guest worker program between 2001 and 2007.

 

Posted in California Workers Comp, Employment Law Issues, Safety and Loss Control |

The above title seems absurd. Why would anyone pay to be disabled? The answer is that far too many people see disability as an investment – especially for retirement or a lump-sum payment at the expense of employers and the workers compensation insurance system paid for by employers.

 

 

Disability is currently a vast industry. Workers comp, no-fault, Social Security, and long-term disability are disability programs that have experienced explosive growth in the past 40 years – and have established a firm presence on late night cable stations in the form of lawyer advertisements. (WCxKit)

 

 

Amazingly, many people who do not look, act, or feel disabled wish they did; at least in a submitted medical report, in hopes of getting “benefits.” Such reports are not free. They come at a price. Actually, two prices. One price is paid to the doctor for the report. The other price is paid by the patients in ways they never imagined.

 

 

Disability is not a hobby. It is a full time job. Furthermore, it is the most expensive job most people will ever have – and they, in the end, pay for these expenses. There simply is no free lunch. When you wish to present yourself as disabled your wish comes true. You begin to act, think, and finally BE disabled, although not entirely physically. One exchanges a full time job for activity of little purpose for less than half your former wages as an able person.

 

 

But what is the entry price for becoming disabled? Many doctors charge nearly $1,000 for an exam and a report. If the report is for a negligence claim it is far higher. And you need not fear the report will conclude you are healthy and in good shape. It won't.

 

 

Every workers comp lawyer has had a client at one time or another who was a convincing example of the ravages of injury and disability. However, at the time of the modest final settlement, the client will suddenly blurt, “If I had known this was all I would get, I would have gone back to work years ago!” See:  

 

 

A “successful” disability claim ought never to be measured in weeks, months, years or decades of disability; the goal is return to the prior disability-free life. The monetary payments are a measure of losses, not gains. Consult with your spouse and children before you consider a career change to “disabled.” (WCxKit)

 

 

Author Attorney Theodore Ronca is a practicing lawyer from Aquebogue, New York. He is a frequent writer and speaker and has represented employers in the areas of workers compensation, Social Security disability, employee disability plans, and subrogation for over 30 years. Mr. Ronca has 21 years experience in searching and retrieving medical records and many other types of documents for defense of workers compensation claims. Contact Attorney Ronca at 631-722-2100 or medsearch7@optonline.net.

 

Posted in Medical Issues, NY Workers Comp Issues, Risk Management, WC 101 |

Federal health regulators have passed along warnings to four manufacturers of hand sanitizing products for making unsupported claims regarding the bacteria-fighting benefits of their products.

 

 

According to the Associated Press, The Food and Drug Administration states the companies claim their lotions and gels can prevent a number of infections, including E. coli and bird flu. Companies that claim their products can stop a disease are required to submit scientific studies to the FDA prior to marketing them. (WCxKit)

 

The FDA sent warning letters to four companies: Tec Laboratories, JD Nelson and Associates, Dr. G.H. Tichener Antiseptic Co. and Oh So Clean Inc.

 

 

The warning letters direct each company to fix the unsupported claims within 15 days.

 

 

Meantime, federal safety regulators report a popular hair smoothing treatment known as Brazilian Blowout can release unsafe levels of the chemical formaldehyde, posing a risk to hair salon workers and their customers.

 

 

Formaldehyde, which has been classified by the U.S. Environmental Protection Agency as a likely carcinogen, can irritate the eyes, skin and lungs and mean breathing problems and skin rashes

 

 

Government regulators also report they have discovered the chemical in a number of hair products that are labeled "formaldehyde-free." The Occupational Safety and Health Administration claims it is investigating complaints from stylists and hair salon owners regarding the products. (WCxKit)

 

 

A large number of hair products contain formaldehyde; however government regulations specify the amount, labeling and safe use of the ingredient.

 

  

 

 

 

Posted in Medical Issues, Product Liability, Safety and Loss Control |

There are three types of workers compensation claim offices. They are:

 

1.      The insurance company claims office

 

2.      The third party administrators claims office

 

3.      The in-house claims office of the self insured employer.

[While their approach to handling the work comp claims may be very similar and all three types of claim offices must abide by the same regulations in their state, the organizational structure of the claims office will differ, sometimes significantly.]

 

 

What most people think of when they think about a workers compensation claims office is the claims handling by the insurance company. In the insurance company claims office, you have the typical structure – claims manager, claim supervisors, claims adjusters and support staff.  All of the staff are employees of the insurance company who sold the work comp insurance policy to the employer. The insurance company claims office will often have contact with the sales department and the underwriting department, as well as other departments of the insurance company. (WCxKit)

 

 

Where the insurance company has enough volume of claims to support having its own staff to handle the claims, they will utilize their own claims offices. However, in the areas where the insurance company has some volume of claims, but not enough to justify the cost of operating their own claims office, they will enter into a contract with a third party administrator (TPA) to handle their claims for them. 

 

 

The TPA claims office will be set up basically the same as the insurance company claims office. The primary difference between the claims office of the insurance company and the TPA is in the ownership of the claims office. The TPA is a separate company from the insurance company. The TPA claims office will have very limited, if any,  contact with underwriting, sales and the other departments of the insurer.

 

 

While the claims handling activities are transferred to the TPA, the insurer or the self-insured employer who contracted with the TPA for claim service remains financially liable/obligated to pay the cost of the claims. The insurance company can not contract away its responsibility to its policyholders.

 

 

The TPA will handle claims for several different insurance companies and/or self-insured employers at the same time. Through combining the claim volume of claims of several companies, there are enough claims to justify the cost of the claims office.

 

 

The reason large employers self-insure their claims are to reduce the cost of workers compensation. Since the self-insured employer does not have an insurance company to handle their claims, they have two choices, utilize a TPA claims office or create their own claims office.   The self-insured employer can create an “in-house claims office”.   The claim manager, claim supervisors, claims adjusters and support staff are all employees of the self-insured employer. By utilizing their own employees to handle the work comp claims, the employer reduces the operational cost of insurance. The primary drawback of an in-house claims office is the employer usually does not have the expertise necessary to adjust claims and must hire employees with the necessary skills. The in-house claims office is usually unrelated to the primary business field of the self-insured employer. 

 

 

The states vary in the licensing requirements for insurance company adjusters, TPA adjusters and the self-insured employer's adjusters. Some states require all adjusters to have an adjuster license, while other states will require only the adjusters of TPAs to have a license, while the adjusters who are employees of the insurance company or the self-insured employer will not be required to have an adjusters license. (WCxKit)

 

 

The primary reason there are three types of claims offices is the cost of administration of claims. The insurance company claims office is the most cost efficient way for it to handle a large volume of claims. The TPA claims office provides smaller insurers, self-insured employers and large insurers with limited volume in an area, with a lower cost way of administering claims than having their own claims office. The in-house administration of claims is also tied to the ability of the large self-insured employer to handle work comp claims more cost effectively than contracting the claims handling to a TPA.

 

 

 

 

 

 

Posted in Claim Audits & File Review, TPA and Claims Administration, WC 101 |

 

  

Finding that an employee's "injuries" resulting from improper dissemination of employee's HIV status did not arise out of her employment, a Tennessee court recently held the employee's tort action against her employer, a manager, and a coworker were outside the workers' compensation law and not barred by exclusivity [Doe v. Walgreens Co., 2010 Tenn. App. LEXIS 734 (Nov. 24, 2010)]. ), See -Larson's Workers Compensation Law, [Ch. 100, § 100.04 n16.1].

 

 

A North Dakota court has allowed information about an injured worker's earnings to be obtained pursuant to a subpoena of bank records. In State v. Hammer, 2010 ND 152, 787 N.W.2d 716 (2010), the Supreme Court of North Dakota affirmed a decision of a state district court that denied a workers' compensation claimant's motion to suppress bank records obtained through administrative subpoena duces tecum in a workers' compensation fraud case. The records had been sought to show that the claimant earned, but did not report, income through a mobile home repair business and in selling scrap metal. Based on the unreported earnings, the Workforce Safety & Insurance contended it had paid $ 24,132.85 in excess benefits. Issuance of the subpoena was within the investigatory powers of WSI. See -Larson's Workers Compensation Law [Ch. 39, § 39.03 n19.1]

 

 

 

Posted in Legal Doctrines |

A recent North Carolina Court of Appeals opinion analyzed issues of medical causation and liability in the state's workers comp cases.

 

 

The case, Gross v. Gene Bennett Co., involved a claim for workers comp benefits from a welder and steel fabricator who injured his back after falling through a suspended ceiling more than 10 feet to a concrete floor. (WCxKit)

 

 

According to management, the plaintiff initially missed approximately two months of work after obtaining medical treatment and occupational therapy and receiving a medical authorization to return to work. He applied for and received work comp benefits from his employer for the medical costs. But several months later, he wanted further diagnosis from an orthopedic surgeon, and a pair of MRIs showed bulging discs, extrusions and herniations at several locations along his spine.

 

 

Because his chronic back injury was worse than originally thought and had impacted his return to work, plaintiff applied for further benefits with the North Carolina Industrial Commission. The Commission came to the conclusion that his ongoing lower back condition was a compensable result of his original injury, and awarded him temporary total disability along with all related medical expenses that had accrued since his original release to return to work.

 

 

Plaintiff's employer appealed the ruling based on the Industrial Commission's application of a legal doctrine known as the "Parsons presumption."  In a 1997 case, Parsons v. Pantry Inc., the Court of Appeals held that the Commission can presume that added medical treatment has a causal relationship to a legally determined compensable injury. In such a case, the legal burden of proof moves to the employer to demonstrate that the present discomfort is unrelated to the original injury.

 

 

The three-judge panel reviewed the case record and found that there had been no prior finding of a compensable injury by the Industrial Commission due to the fact the original workers comp benefits proceedings had only been concerned with medical expenses. The Parsons presumption is only appropriate where one of three things has occurred: the employer was previously found to be liable for a compensable injury, the employer admitted to compensability, or the employer and employee had entered an agreement as it relates to compensation.

 

 

The court cited a 1953 case, Biddix v. Rex Mills, for the principal that acceptance of a claim on a medicals-only basis "cannot in any sense be deemed an admission of liability." Absent the legal presumption, the court analyzed the record to consider whether the plaintiff's orthopedic surgeon had established a conclusive relationship between the original injury and the chronic symptoms that emerged later.

 

 

The court said that the orthopedic surgeon's opinion regarding medical causation did not exceed the level of mere possibility, and therefore concluded that the Industrial Commission's findings of fact and resulting disability determination were not supported by sufficient evidence.

 

 

One aspect of the record that bothered the appellate panel was the fact that the plaintiff had noted a history of previous back injury during his examination with the first doctor immediately after the accident. (WCxKit)

 

 

Based on this assessment, the Court of Appeals reversed the Commission's decision and remanded the case for entry of a new opinion and award that did not offer benefits for the later diagnosis of injury.

 

 

http://corner.advisen.com/partners_wctoolkit_book.html

 

Posted in Coordinating Medical Care |

 

 

The use of social media to fight workers comp fraud is beginning to catch on when plaintiff attorney's start warning clients about social networking sites like Facebook, Twitter, LinkedIn, and MySpace. (WCxKit)

 

 

Nothing sinks a workers comp claim faster, from the plaintiff attorney's standpoint, than the picture of the employee rock climbing, while too injured to perform light duty work. It is amusing to think the employee actually posts these pictures on his (or her) Facebook page. Not so amusing to the plaintiff attorney is the date stamp on the picture.

 

 

When the employer questions the validity of the employee’s workers compensation claim a private investigator may be hired to check out the employee's personal blog, Twitter account, Facebook, My Space, Flickr (photo sharing) or LinkedIn pages. Or, the employer can do it pretty much for free with a little time and effort because the Internet has a wealth of information – yes, on just about everyone, even your employee.  Many investigators perform virtual searches in addition to in-the-field searches, a new way to investigate in the last 25 years, and there are investigative services that specialize in virtual investigations.

 

 

The employee, presenting a fraudulent workers comp claim, is usually motivated by greed but does not think a little thing like insurance fraud should interrupt his (or her) personal world. Some don't see it as a big deal. The employee continues to live the lifestyle he has been living, including posting non-work related activities, whether it is mountain biking or reading the latest New York Times bestseller. When the employee posts the pictures of his iron man triathlon, (occurring while his back hurts so much rising from bed is nearly impossible), most doctors when presented with such evidence release the employee back to work. The plaintiff attorney, of course, argues the employee was “having a good day” when he participated in the iron man triathlon.

 

 

In addition to searching social networking sites, search by the employee's name on Google, Yahoo, or Bing. If the name is a common one, add street, city, and state to reduce the number of search returns. If an employee is on one social networking site, look to see if there are links to other social media pages. Nothing is more fun than reading a “tweet” where the employee says something like, “Boy, do I have the workers comp doctor fooled.” Of course a YouTube video of the employee skydiving can also be very entertaining. Flickr commonly has photos of such events, oh so notable are these activities in the employee's life.

 

 

If you are having difficulty with your Internet search try using pay sites charging nominal fees ($1.99 or $4.95) to search the Web for you and compile the employee’s information. Search engines like Pipl.com and Spokeo.com scour the web for you and provide a lot of info on the employee. Almost all of it will be unrelated to your employee's workers compensation claim, but the occasional golden find makes it worthwhile. (Search your own name and be dismayed by the astonishing amount of information there is about you on the internet). Spokeo aggregates information about people from various accounts they open; it also includes their "wish lists" from Amazon and other sites.

 

 

Some employees with questionable injury claims do not post anything discriminating about themselves; however their “friends” do post pictures of the employee involved in their activities then append the employee's name to the photo images. When defense attorneys request information through the discovery process, employees often argue their privacy is being invaded. If the employee refuses to turn over the information on the social media sites, the defense attorney can obtain a court order and most social networking sites will provide the request information from the employee's web page. Generally, the rules of evidence are more relaxed in workers compensation cases than in criminal cases, and the social website information is admitted as evidence. (WCxKit)

 

 

Share with the claims adjuster and defense attorney any evidence you turn up showing the employee's injury is not as bad as claimed. Do not share the information with the employee, unless you want the information to “disappear.” Any social media developed evidence is used in conjunction with and to substantiate other evidence developed in the investigation.

 

 

Posted in Fraud and Abuse |