If you’re injured at work and you request medical or disability benefits, you need to prove that the treatment you received is because of your work injury. Just saying that treatment is related, without providing evidence to support your claim, isn’t enough.
Background Of A Recent Case
A woman fell at work and bruised her shoulder in June. She went to urgent care the next day, where x-rays showed that she had some joint disease like arthritis but did not have any fractures. The doctor at urgent care gave her a note to not work for a few days.
Later, when her shoulder kept bothering her, she saw a doctor who she had previously seen for arthritis treatment. He ordered an MRI and surgery.
In December, the woman had surgery for a torn rotator cuff (the rotator cuff is part of the shoulder) and was off work for 12 weeks while recovering. She asked for medical benefits to pay for her treatment and temporary total disability starting with the date of surgery and continuing forward until she was cleared to work again.
The Virginia Workers’ Compensation Commission denied the woman’s requests, and after an appeal, upheld the denial.
Don’t Make the Same Mistake
The woman might have had a torn rotator cuff from the accident at work, but she never proved it.
She submitted her medical records from urgent care to the Commission, showing that she had bruising, x-rays with no fracture, and a few days off of work to recover.
She did not submit her medical records from her regular doctor for arthritis treatment, and she did not submit any medical records from the surgeon who performed the rotator cuff surgery. She submitted medical bills for the surgery, but not any documentation as to why the surgery was necessary or linking it to her injury at work. Since the only records she submitted were the urgent care ones, she was not given the medical benefits and disability benefits she was asking for.
When you’re injured at work, the law says that it is your responsibility to prove that your injury is the result of work. When you retain HammondTownsend, the team makes sure that all relevant records are submitted to the Commission as part of your case, so that you won’t have the same issue this woman had of not being able to prove that her torn rotator cuff diagnosis and subsequent surgery was a result of her injury at work.