How Can My Florida Work Comp Doctor Say I am Fine When My Personal Doctor Says Surgery?

Palm Beach Workers Compensation Lawyer

Palm Beach Workers Compensation LawyerThis is a very common question injured workers ask when seeking workers’ comp legal advice.

The answer is that workers’ compensation doctors are being asked to make a determination as to the cause of your need for treatment that your personal doctor doesn’t have to worry about. For your personal doctor, their concern is: are you hurt, why are your hurt and how do they fix it. For work comp, it is more complicated.

In Florida, workplace injury attorneys are required to prove that the major contributing cause of the injury, basically the need for treatment, is related to the on the job accident or activity. And this is done through presentation of medical opinion evidence. Since the law requires medical evidence, controlling medical care is huge. So if you control the medical providers, many times you control the medical opinion.

This isn’t to say that all doctors who take work comp are in the insurance company’s pocket. Many doctors are true advocates for injured worker’s rights. But they are few and far between.

Major contributing cause is an odd theory. It does not mean common sense. Nor does it mean what any reasonable person would think regarding the cause of the need for medical care. What it does mean is that the law requires a doctor to issue an opinion that more than 51% of the cause of the injury, or need for care, as compared to everything else in your body or that happened to you in your life, is the work place accident.

What workers’ compensation insurance companies will do is try to say that if you fell at home a month before your workplace accident then that must be the cause of your need for treatment and not the fall at work. They will ignore the fact that you were able to work without restrictions or medications or treatment following the fall at work and it was not until the work comp accident that your leg gives out and pops and clicks and now you have a tear needing surgery.

Here’s another example. Let’s say you were in a car accident delivering pizzas and obtained an MRI that showed herniations. These herniations were causing tingling to travel down your leg into your calf and your toes were numb and falling asleep. – Your personal doctor tells you that you need surgery. However, your work comp doctor says the herniations are not herniations, they are bulges, and they are degenerative and not caused by the accident.

When asked what caused the numbness and tingling and pain, the doctor says the accident triggered it, but if you didn’t have the degenerative findings, you wouldn’t be having the ongoing problems or need for surgery.

Isn’t that crazy? Some doctors will even go so far as to say that it is 50/50: 50% of the need for surgery is work comp related, and 50% preexisting. But 50/50 isn’t enough. They need to say that the need for care is at least 51% related to the accident as compared to everything else in your life.

To everyone else in the world, that is plain silliness. If you were fine before the accident, then had an accident and now need medical care, the cause of the need for care is the accident. But as any experienced on the job injury attorney knows, reality and common sense have no place in Florida’s workers’ compensation system.

Contact Franks & Koenig today for a free case evaluation.