TRUE WORKERS COMPENSATION CLAIM
Monday, July 28, 2008
at 2:35:36 PM The worker in this case claimed not to be able to work from back and shoulder injuries he claims were work related.
The employer received medical note information from the workers doctor – telling employee must stay off work.
The employer requested a Functional Abilities Form to be completed by the doctor setting out the workers restriction as to what the worker can do:
1. The doctor provided the “FAF” clearly setting out the worker was totally unfit to work. In fact, based on this information the worker should be lying down in bed.
Up to this time the Claims Adjudicator agrees the worker cannot work.
The employer makes the decision to hire an investigator to carry out surveillance on this worker and does.
1. The employer finds on the first day of investigation the worker is driving and walking without any restrictions.
2. What is the second thing the worker is doing under surveillance? Worker is found to be able to drive and ride on mower cutting 4 to 5 acres of bush over very uneven ground rolling from side to side bumping up and down using his back and shoulders.
After videos were shown to WSIB Claims Adjudicator he/she could not believe it, but the worker can now do modified work, not regular work but modified work. After my client has spent $10,500.00 dollars to help the WSIB Claims Adjudicator make a decision and still the WSIB Claims Adjudicator is supporting the worker. In our opinion, this is a case where the Claims Adjudicator clearly is shown a material change and the benefits should have been stopped, worker should have been sent back to his regular job and WSIB should recover all the benefits paid out to the worker.
This is just one of many WSIB claims that employers in Ontario have to deal with every day with large financial losses due to documented misleading and dishonest information provided by worker and doctor.
This factual scenario is not intended to paint the entire workforce with the same brush, but simply an example of the other side of the story from the employer’s perspective.
When a worker is injured, whether a minor injury or a serious injury, the employer’s first concern is to the workers well being, but to take advantage of the system in place to protect the worker does nothing but impede the employers ability to ensure a fair and just process of prevention and recovery.
|
