How to Defend High Exposure and Catastrophic Workers’ Compensation Cases – An Interview with SEAK Speaker Bruce Bonds, Esq.
Steve: We’re here today at the SEAK National Worker’s Compensation and Occupational Medicine Conference with attorney, worker’s compensation attorney, Bruce Bonds. Attorney Bonds, what’s the best way for an employer or self-insurer to recognize a potential high exposure client?
Bruce: Well Steve, some of them are obvious. Somebody comes into the emergency room having fallen 35 feet, and has no function of their legs, that’s pretty obvious. The harder part is looking at the ones that are ambiguous or you’re not sure of how they’re going to be. You know, any case where there is a serious injury is potentially high exposure, but as we have the aging work force, injuries don’t have to be as severe to create high exposure. Classic example being a 50 or 60 year old person who’s worked over head laying brick all their life, has a torn rotator cuff, has a permanent 50 pound lifting restriction, can’t go back to that job. Voila, you got a high exposure case. So, those are the kinds of cases that need special attention. And then of course, you have the ones that are brought by people who are repeat offenders that have filed case after case. Those kind of speak for themselves.
Steve: So, how can investigation and surveillance be used effectively in these claims?
Bruce: Well, that depends at what point of the process you’re at. The investigation needs to take place very quickly. I would only do surveillance early on if there was a case where we really suspected the person wasn’t injured at all. By way of investigation, I’m going to look to see whether there’s a pattern of claims. I want to know if he had prior injuries, prior similar injuries. I want to know if he or she had prior restrictions. There’s been times when I’ve done an investigation and found the person was previously restricted beyond what they are now. All those kinds of things factor into it. Perhaps the most important though is, we want to see all the medical records and particularly the medical records that start with the date of accident, the first history to the original treater, and I want to compare that to what’s on the accident report filled out by, to the employer down the road a few days or weeks when, hate to be cynical, perhaps they’ve hired an attorney.
Steve: So, we talked about prior medical records. How does an intensive review of prior medical records help an employer defend a catastrophic claim?
Bruce: Well, as I mentioned if you can find out what’s happened in their past, perhaps this is an injury that already existed. And you might, as I mentioned, Steve, that there’s permanent restrictions that they already were brought to the workplace, so you really need to see what’s going on. Also, I want to see if they’ve had treatment by doctors who they haven’t revealed to us. Maybe they’re hiding something. So, if I get all their records, there’s tons of little tidbits there.
Steve: So, last question. What should an employer do about severely injured workers to try to motivate them to return to work?
Bruce: Create relationships, especially in a clearly compensable case. Reach out to them immediately. Studies I’ve read have shown that the most single important factor in predicting a good result and a quick return to work is, the employer, the employer supervisor, and the insurance adjuster visiting the injured worker in the hospital or at home as soon as possible after the accident. And, bring them a fruit basket, create a relationship, show them that you care and ask them questions. What can we do for you? What is bothering you? What, if any concerns do you have? That’s the first step in developing relationships that will end with a quick return to work.
Steve: Thank you very much.
Bruce: Thank you.
Bruce Bonds Esq. is a past Chair of the Heyl Roster workers’ compensation practice group. He concentrates his expertise in the area of workers’ compensation, third-party defense of employers, and employment law. He served as a technical advisor to the combined employers group in the negotiations which culminated in the 2005 revisions to the Illinois Workers’ Compensation Act. More recently, Bruce worked as a technical advisor to the Illinois Chamber of Commerce as well as a number of Illinois legislators and State agencies in the process that resulted in the 2011 Amendments to the Illinois Workers’ Compensation Act. Bruce was appointed by Mitch Weiss, Chairman of the Illinois Workers’ Compensation Commission, to a committee of attorneys who reviewed and made recommendations for revisions to the Rules Governing Practice before the Workers’ Compensation Commission. With extensive experience before the Illinois Workers’ Compensation Commission, Bruce has defended employers in thousands of cases during the course of his career. As a result of his experience and success, his services are sought by self-insureds, insurance carriers, and TPAs. Bruce is an Adjunct Professor of law at the University of Illinois College of Law where he has taught Workers’ Compensation Law to upper-level students since 1998. Bruce has co-authored a book with Kevin Luther, Illinois Workers’ Compensation Law, 2012-2013 Edition. Bruce is a frequent speaker on workers’ compensation issues at bar association and industry-sponsored seminars. He was inducted as a “fellow” of the College of Workers’ Compensation Attorneys in 2013.