*As Published in the Hempfield Suburban News
Over the last couple of decades, I have handled several thousand workers’ compensation claims on behalf of injured employees, or claimants. Even though the same set of laws governs work-related injuries in Pennsylvania, each and every claim is different in many ways. One thing, though, that has been consistently present in every single claim I have handled is the employer’s and insurance company’s desire to minimize costs associated with the claim.
To be fair, there are certainly bad apples out there, trying to milk the system. But, the overwhelming majority of workers who get hurt on the job just want to get better and return to work as soon as possible. Unfortunately, workers’ compensation insurance companies have used the small percentage of bad apples to justify their all-too-common approach to claims; that is, instead of claimants getting the benefit of the doubt in the context of a work injury, insurance companies assume that every claimant is full of bologna until he or she proves otherwise.
Part and parcel of this mindset is a willingness on the part of carriers to spend a lot of time and money trying to find a way to show that a claimant should not be entitled to workers’ compensation benefits. Years ago, it seemed like insurance companies hiring “investigators” to conduct surveillance on claimants occurred rarely. In recent times, however, I have noticed a significant uptick in the number of occasions that carriers are employing this “cost containment” method.
What injured workers need to realize is that surveillance is a subjective and selective practice. What I mean by this is that an investigator could be watching someone for days and not see anything noteworthy. But, that one time when the claimant does something that could be construed in a negative light, I guarantee you that it will show up on video. What will not show up, though, is the price the injured worker pays for overdoing it, physically.
For instance, in his or her mind, a claimant with a work-related low back injury may have no choice but to shovel snow off their sidewalk. Rest assured that this entire sequence will make the investigator’s highlight reel. What will not appear, however, is footage of the injured worker couch-ridden and in terrible pain for the ensuing week as a result of having overdone it.
The moral of the story is this. A claimant should not have to stop “living” due to a workers’ compensation claim. But, given the fact that employers and insurance companies are paying an injured worker wage loss benefits and covering their medical expenses, anything that, arguably, could be considered controversial will most likely become an issue before a workers’ compensation judge. Therefore, my advice is to use common sense and always follow the restrictions and limitations recommended by your doctor.
Happy Spring, Hempfield…