“What Constitutes A Workers Compensation injury/causality”??? Presented By: Dr. Clark Iorio OhioHealth Board Certified Occupational Health Physician and.

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Presentation transcript:

“What Constitutes A Workers Compensation injury/causality”??? Presented By: Dr. Clark Iorio OhioHealth Board Certified Occupational Health Physician and Medical Director of WorkAble

Clark D. Iorio D.O. Only Board Certified Occupational Medicine Physician in our area. Medical Director Ohio Health WorkAble Clinical Assistant Professor Family Practice - NEOMED Clinical Assistant Professor Orthopedics - OUCOM 2

Clark D. Iorio D.O. Co-Editor of Occupational Medicine Practice Guidelines 3 rd edition Knee Chapter Board Certified Occupational Medicine - AOBPM Board certified Family Practice - AOBFP 3

What Constitutes a Workers Comp Injury? –Employee “It had to happen at work” –Employer “That did not happen here” –Physician “ Who do you believe?” 4

General Approach to Initial Assessment and Documentation 5 Medical History Presenting symptoms and related information of the injury Identify body parts involved Date of onset Mechanism of Injury Incident report filed? Four W’s Where, When, Who and What

Legal distinctions do not alter the science involved in establishing an association (or lack there of) between work and health. 6

Causation Direct cause - both immediate trauma and the effects are observed. Health Problems may contribute to a potential claim such as carpal tunnel syndrome and hypothyroidism. 7

Likelihood and Certainty The Physician’s expressed opinion of likelihood should not be affected by administrative or legal context. The degree of certainty expressed by the clinician should be supported primarily by the available evidence and it should be a product of logic and informed judgement. 8

Likelihood and Certainty An aggravation of a pre-existing condition is a NEW EVENT which permanently worsens an existing condition. An exacerbation is a temporary aggravation of a prior condition by an injury which will eventually return to baseline. 9

Information necessary to file a claim. Incident report First Report of Injury (FROI) Job description Video?/ Witnessed injury? 10

Questions? 11

12