Disability Law

Case Study: Cervical Injury Made Worse Due to Return to Job

By Jodi Ginsberg

Welcome to the 6th installment of my summer long series on Georgia Workers' comp case studies. In the following case study, I discuss a case in which a client's neck injury was made worse by a return to work.

Cervical injuries made worse by returning to the job

Mrs. B is a 20-year employee of a medical practice. As the office manager, she was involved in all facets of managing the practice, including patient care, insurance submission, and handling other patient paperwork. Mrs. B is also a licensed practical nurse and she also served as a nurse, frequently making rounds with doctors at the hospital during her work shift. Mrs. B was injured when she felt a "pop" in her neck while assisting two co-workers move office furniture and other office equipment.

After moving the furniture and equipment, Mrs. B started to experience severe pain in the arms and neck. Additionally, she noticed that she had numbness and pain in her right leg. Despite her pain and numbness, Mrs. B. returned to work the next day and continued working for 9 full months until the pain and discomfort became so intense at she could not function. Finally, Mrs. B returned to the panel physician who took her out of work and prescribed pain pills and physical therapy.

Perhaps because Mrs. B has a medical background, she sensed that the care she was receiving under workers' compensation was not sufficient, so she decided to seek counsel, even though she was receiving her weekly income benefits of $500 per week and the employer/insurer was not denying her claim.

When I got involved in this case, I recognized that Mrs. B's injury was most likely a surgical problem. After reviewing literally thousands of pages of medical records, I have a fairly good sense of which doctors I like my clients to see for various medical problems and I wanted Mrs. B to see a particular surgeon. The insurance adjuster would not agree to my preferred doctor so I directed my client to return to her panel physician and request a referral to this particular doctor, which he agreed to do. Under Georgia law, this referral from an authorized treating physician to another physician must be honored by the insurance carrier and the adjuster reluctantly agreed to authorize my preferred surgeon. In my view, all parties – my client and the insurance company will benefit from this surgical referral as my preferred surgeon is one of the best specialists in the state for neck surgery.

Mrs. B underwent a multi-level cervical fusion and followup rehabilitation. Mrs. B had expressed a desire to return to her job but, as I expected, the insurance carrier demanded a resignation as part of any settlement. Mrs. B recognized that she would not be able to return to her past work and she authorized me to enter in to settlement negotiations. Our final settlement consisted of cash and 24 months of "open medical" care with the surgeon

Full post as published by Georgia Workers Compensation blog on July 20, 2010 (boomark / email).