Safety and OSHA News

What do you do when a worker doesn’t report injuries for 3 months?

back-injury

See if you’ve ever experienced this one: Weeks or months after an at-work incident, an employee says, “I think I hurt myself at work.” How do you know the injury is really work-related?

That was the situation in this case from Louisiana.

Angela Ashworth worked for Administaff as a merchandiser. One day while at a store, a 700-pound display fell on her and pinned her to the floor.

Ashworth suffered three fractures to her right ankle and underwent surgery. That injury wasn’t disputed. Workers’ comp paid for it.

Almost three months after the display fell on her, medical records show Ashworth also complained of neck, shoulder and lower back pain.

Why no mention until three months later of the other pain?

Ashworth says for the first two weeks after the surgery, medication dulled the other pain.

She also claimed that she tried to address her other pains with various doctors, but they would insist that they could only treat her for the ankle injury.

On top of all that, Ashworth was involved in a car crash four years earlier. At first she didn’t tell any doctors about that crash. Then she said the only injury she received was a bump on the head from hitting the dashboard (she was in the passenger seat).

However, medical records show the emergency room physician who treated her after the crash noted low back pain, neck sprain and abdominal pain.

Here’s another complication: different opinions from doctors on whether the neck, shoulder and back pains were work-related. One doctor said it was. Two others said it wasn’t.

After a workers’ comp judge denied her request for benefits for the neck, shoulder and back pain, Ashworth took her case to a state appeals court.

The court said medical records didn’t support her testimony that she told doctors about her upper body pain prior to three months after the incident in the store.

The court said Ashworth didn’t prove that her additional pains were work-related. For that reason, she didn’t receive workers’ comp benefits for them.

(Ashworth v. Administaff, Court of Appeals of LA, Third Circuit, No. 10-0318, 10/6/10.) You can read the court’s opinion here.

What do you think about the court’s ruling? How do you deal with “late” reports of alleged work-related injuries? Let us know in the Comments Box below.

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  • Jan

    Well, its about time the courts sided with the company. I have so many claims from employees who claim they hurt themselves months ago but thought it was just a pull and would go away. I have two employees who retired, went to the comission and said they had to retire because they have repetitive motion injuries and could no longer work. It is so frustrating. Most of the time the courts side with the employee.

  • Mac

    This one’s easy. What might the outcome have been if the auto accident was never revealed, steering all the “blame” on the industrial accident???

  • http://SafetyNewsAlert Ralph Mingo

    This is a common occurrence, with in many industries. Workers tweak a muscle, and do not file a claim. Then a couple of months later they tweak the same muscle again, but are unable to perform and file a claim and say this is the second time this has occurred. We process the claim and care for the employee at work.

  • PO’d Safety Guy

    The court got it right.

  • Wayne

    It is curious that the shoulder, neck and back pains didn’t bother her enough to mention them to the attending physician. I think the correct judgement was made. Employees are supposed to be trained to report injuries immediately after an accident. She, apparently didn’t do that.

  • Karen Ekas

    It did sound familiar with my former company, so I made some real changes when I took a new job.

    When we do our initial orientation with each employee, a lot of time is spent on handling workman’s comp and exactly what is expected of each employee. They are given our rules and regulations, their rights and responsibilities, a list of our doctors and we have them sign a sheet that they received and understand all of this.

    They must report any injury, even if it doesn’t require immediate medical attention. I write it down in my daytimer and check on the person the following day. That way, if it turns into something later on, I have written confirmation. It is explained that delaying reporting an injury may negate having it picked up by our comp carrier. This has worked very well for our company because we have a good rapport with the employees since they know what to expect right from the start.

    Over the years, you will always find the few who want to get around the system, but we make it pretty difficult for them to blame work when nothing was ever said.

  • Mike J.

    Given the information presented it sounds like the courts made a enlightened decision. I only wonder why she pushed it to this level with all the evidence that was available showing that it was preexisting. She would have had a better shot at trying to say that the work injury aggravated the past injury; but again why the push to put it on as a workers comp item, regular insurance would pay for it .

  • Doni

    We have a Company policy that all injuries (whether they require meidcal attention or not) must be reported. We had a similar case in which an employee tried to claim a work related injury 4 months after the fact. We fought it and won. The key is to have a clearly written policy and have it communicated to employees and have them sign that they have received the policy.

  • Jan

    The reason they do it $$$$$$$$. Every time we have a settlement I have a few new injuries trying to get in on payout

  • http://www.goodwillnj.org Gene Ferguson

    This is a constant problem. Many workers are head strong in that they feel they “Can Handle It” ! This usually works until about 9PM when the pain wins out and they go off to the E.R. I have had adults thell me they do not want to go to the W.C. provider and even refuse in writing, when I and their supervisor both know that they need to be looked at. This is completely frustratating.

  • Alex

    Mike – They might not have regular health insurance…

    I currently have an employee off right now that slipped in applesauce back in February. The incident was reported and months went by without complaint. Then surprisingly, they complained of significant back pain, couldn’t sit or walk comfortably or with ease. Turns out they had a minor hernia and it took longer for the hernia to be complete and felt.

    I myself fell off of a deck and landed on my face and jarred my neck severely. I felt fine later that night… 8 months later I start having serious debilitating headaches that are stemming from my neck. Turns out I had broken my neck and rotated a vertebra almost 90 degrees and it was pinching a nerve. I had chiropractic treatments for 2 months to reposition it and all is fine again.

  • Randy

    I think they got it right!

    Within the past 6 years there have been at least 2 cases at my company where failure to report an on-the-job injury resulted in denial of WC. One involving a “scratch” to the knee which later became infected, requiring hospitalization, and the other an insect bite (spider) which became septic. In both cases the employee failed to report the incidents to their supervisor because they felt it was nothing to be concerned about. Both resulted in out of pocket medical costs and lost time to the employees.

    It was unfortunate because my company is very aggressive in making certain that our employees are taken care of. The only “catch”, simply tell someone. Their are no repercussions for getting injured. Failure to report however, is a serious violation of policy and is treated as a performance issue. I stress this in orientation, a 2 day process, informing them of their rights and the responsibility for reporting as employees of the company as well as the laws for getting treatment and/or compensation.

    The cost of treating an aggrivated injury is much higher than a so called “minor” if addressed early, which in my oppinion is the main driver in an employee’s decision to suddenly file a claim. They realize that the out of pocket cost through their private insurance exceeds what they are willing to absorb and the prospect of losing work for an extended period forces them to seek a way of off-setting it.

  • Steve

    Many companies tell them employees that they “MUST” report injuries immediatly when in fact state law often says the employee has up to 90 days. Instead of companies trying so hard to keep employees from getting workers comp benifits, maybe the companies could work a bit harder in making the workplace safer and thus avoid injuries all together. The case discused here states that a 700 pound display fell on the worker resulting in fractures that required surgery. Although we don’t know the exact cause of the accident, we can determine that the 700 pound display was not properly anchored to the floor or wall. This worker had to endure the pain of the injury, surgery, and the recovery process and all the employer worries about is the employee stating that she is now having additional problems that she believes is a result of a 700 pound shelve falling on her. I am certainly not for any employee lying about injuries or filing false claims, however when a legitimate work related injury has occured then the employee should receive fair and just compensation without having to deal with the employer fighting them as they recover.

  • H. Couture

    Crazy – I was recently a member of a Jury that heard a civil case regarding a similar situation of “suddenly I am in pain (3 months after)– and my attorney says I better go have Physical Therapy, and Chiropractic care,…and acupuncture…. and the woman responsible for the tiniest of fender-benders must pay!’ — long story short, we did not grant her the >$50,000 she was requesting! — The judge informed us of the problem of ‘court clogging’ and if these people would have a little bit of an education they would think twice prior to going to court!

  • Bill

    Its refreshing to see the courts use common sense. In PA she would have won!

  • Paul

    Right on court! Bout time we hear some people getting their ridiculous-intentionally misleading-ficticious WC claims denied! Take some responsibility people!

  • AdRi

    I’m sure this wasn’t in California either! LOL

  • Wow

    This case needed a forensic chiropractor or ergonomist to assess which injuries came from which event.

    In our state, workers have a year to reprot injuries and 2 for illnesses. It is also illegal to get treated and not to identify work-related injuries as such once you recognize that they are work-related.

  • Charles

    There is little common sense in these responses as a whole.
    The employee who is hurt is hurt. Pains persist and do not heal. Employees also clain unwarranted claims. I have been hurt, strained etc. and I finally got over it. It is what it is.
    None of that makes any difference in the matter of whether an employees was hurt or not. Those are other considerations.
    Generally what I see here is if I am paying I do not want to and if I am getting paid I want to do so.
    No solution.

  • Paul

    Charles:

    All due respect but what is your point? I’m not the sharpest tool in the shed, but I don’t understand statements like “it is what it is”, “hurt is hurt”, or your last sentence.

    Just trying to find out where your coming from and not start a blog brawl! :)

  • Karen

    Our company isn’t trying to “get out” of paying for any legitimate claims. We only want to make the employee responsible for themselves by letting us know that an event happened. We do investigate everything in order to help the injury from occurring again or to someone else. It’s the “users” we are trying to deal with that make or break a company.

  • Mike J.

    As I see it all injuries are paid for by the company to some extent either through WC or standard insurance. Our company spends over $1000 a month on standard health insurance per employee between S/LTD, health insurance and life insurance. If it is not work related we still pay the cost in higher premiums for the regular insurance. The problem for the company and all of us are the few individuals who try to game the system and drive up costs for all of us. I have never run across a safety nor HR professional who did not want an injury covered and the worker made whole if possible. (the bad ones are when it isn’t possible). For those who think that “it is what it is”, perhaps you have forgotten why we are in this field. It is to make the workplace safer and ensure that those injured are properly treated. I have always and will always strive to do these things. I also will do my best to ensure that those who game the system get their just deserts because they make it harder for those legitimately injured to get the attention they deserve by clogging up the system and making us all a little less receptive than we might otherwise be.

  • http://msn albert

    fell off truck and felt nothing, continued to work for two weeks no problem. Was installin pipe over head and it fell on neck and shoulders/ Reported to boss immediately that I was hurt// Began to receive treatment for pipe fall/ later told boss thai I had earlier frll off truck/he told claim handler/ now my benefits and surgery may be stopped/do I have rights for treatments and surgery still. should my benefits be stopped

  • Paul

    ALBERT:

    You have two different injuries at two different times. Did you report the fall to your supervisor the day it happened as required?

    What injury is linked to the surgery; the fall off your truck or the pipes cascading down on your neck and shoulders?

    Better question is, “Do you think your benefits should be stopped”?

  • http://msn albert

    I feel as though my benefits should be approved. Cascading of pipe on shoulder and neck actually caused damage. Fall off truck was more embarrasing than anything. We are talking about 4 inch rigid pipe that probally should have been dissambled before it was tried to work with. Never reported fall off truck until later. Had no injury from that, continued to work

  • work safe

    am agree with the court ruling in this case I have an employee that after 3 weeks of being laid off came to me and claim that he went to see his own doctor claiming abdominal pain and doctor didint find anything wrong with him he claim that he injurer at work and want us to send him to see a doctor he also said that do to his abdominal pain he wa not able exercise at home enymore and do his daily abdominal as he use to. any comment please .

  • http://www.kanpak.us Zach L

    Karen & Randy, way to go. Your statements both mirror my orientation & reporting procedures. Kudos to you both for your vigilance & dedication.