Claimant is a chiropractor physician who maintains his office as the company owner, and states on a day the office was closed he fell from a six foot ladder while changing a light and injured both shoulders. Claimant stated that he didn’t want to give a work history because he didn’t want his insurance rates increased. The administrative law judge concluded claimant proved he had an accident to both shoulders, despite the absence of any documented history of an accident to the left shoulder. In a 2-1 decision, the Commission affirmed a finding of accident in a temporary award for nearly $85,000 in medical and TTD benefits. A dissenting commissioner noted claimant lacked credibility: he provided inconsistent medical histories, he previously advertised inaccurate claims that he was board certified, and he listed a doctor on his company’s web page whom the claimant admits is a “fake person.” Worth v West County Physical Medicine, DOLIR 4-27-11.
By contrast, the Commission about a week earlier affirmed in a different case that a claimant failed to prove accident and did not provide a history of a specific accident. “Being questioned by four different doctors about whether Employee had sustained any injury should have caused him to make a connection between his pinched nerve and the alleged October 28 incident (had it occurred) long before the co-worker allegedly planted the idea in his mind.” Fischer v Ameren UE, 4-19-11.
These two cases demonstrate the dynamic role between medical history and credibility. A claimant must prove accident, but the statute doesn’t require him to offer records documenting that he was ever injured at work. The lack of a consistent medical history, however, may be one factor to diminish a claimant’s credibility.
Source: Martin Klug, Huck, Howe & Tobin. Read Martin Klug’s Mo. Workers’ Comp Alerts.
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