Carpal Tunnel/Repetitive Stress Syndrome in TN-Workers Comp Issue

[kate]

Tizz Wrote:Ok here's an Update....

Next thing is her asking me all these strange question's like-Do I smoke,
What color is my hair,How tall am I,How much do I weigh etc. Whats
up with that? What do those things have to do with me filing a claim??

Those are typical (not strange) questions in an insurance claim. In fact most companies have a set questionnaire that they give to the adjusters and they must ask the questions and document the answers.

They don't always apply to every case, but, height weight mean something depending on the type of injury. So does smoking, drinking, etc. If you have to have surgery, smoking slows down the healing process.

I had an claim where the gentleman was 5'8" and 400 lbs with a knee injury. That is significant because of how someone who is extremely overweight heals with a knee injury. He was only in his 30's but because of his weight, smoking, drinking, etc. they couldn't do surgery and he couldn't heal with the weight on the knee. Therefore, an injury that may have been healed in 6 months, never healed and he was permanently disabled.

And in most cases, it doesn't even have any relevance. But the IC has to try to figure out what the claim may cost them in the long run and as the above situation describes, based on some of the answers, it can make a huge difference.

Physical description, Hair, eye color. any tattos, body piercings, etc., usually has several reasons.
1.) for the IC and adjuster is if they have to do surveillance, it's easier to identify the person on the video. However, they can get the description from the employer in most cases.
2.) There have been cases where someone sent someone else in their place because that other person did have injuries but no insurance and the "IW" really didn't have injuries but sent the other in their place for treatment and RX's.
3.) There have been people who have gotten treatment because they knew a friend had a WC claim and pretended to be the IW and then the IW appeared to be fraudulent because it appeared that they sent someone else in their place to get a larger settlement.

Again, that is a typical "First Contact questionnaire and most adjusters just go through every question regardless of whether it pertains.

I actually had a "trainee adjuster" go through the questionnaire and one question was "Do you have any dependents? Answer: NO

Few questions later, "Do you pay child support?" Answer: YES.

They never put together that if you have NO dependents, who are you paying child support to?

Don't overthink and stress about some of these details.

Just be honest about everything. Don't make up an answer to a question just because you feel pressured to say something. If you don't know, say so.

Otherwise, just answer the questions and don't get to concerend about the "ulterior motive" There isn't one. They've been given a set of questions to ask you because they have to.