GQ Corner
Q. Claimant is 26-year-old female employed by a staffing agency and contracted to work at for the client company as a Consultant since 06/06/2018. The employer reported that on 05/28/2019, claimant was walking back to the warehouse area from getting coffee when she lost consciousness for a few minutes. The claimant has not responded to our request for a recorded statement but the employer advises the claimant stated she was not feeling well when she came to work that morning. She went to lunch and on her way back to the building where she works, she fainted. Reportedly, after coming to and feeling well enough to leave, she went home. The employer stated the claimant said she did not know what caused her to faint. The claimant did not report any injury to the employer as a result of the fainting episode. The employer reported the incident only because it occurred at work. Is this a compensable claim in your opinion?
A. Based on these facts, there is a reasonable basis to question the compensability of this claim. There must be medical evidence to establish that the incident is a producing cause of any complaints, symptoms, diagnoses, or conditions, including fainting or loss of consciousness, alleged by the claimant. These may represent at most an ordinary disease of life to which the general public is exposed outside of the employment. The mere occurrence of symptoms within the workplace does not alone yield a compensable injury.
Q. We have a new claim with some very odd diagnoses. Claimant was involved in a minor MVA on 06/07/19. The other driver sustained a fair amount of damage to the front of his truck. The only damage on our truck is a bent rim. Claimant was taken to an urgent care facility where he was then referred to the ER for chronic atrial fibrillation, and blurred vision. Based on what I can see, the only physical injury is the lumbar strain/sciatica, and even the sciatica may be preexisting.
I have sent causation questions to the urgent care facility for clarification on what is/is not considered work-related. I have also requested the ER notes. My question is, provided causation is not addressed and/or addressed unfavorably, would you have any recommendations?
A. That is definitely an interesting situation. In a situation like this, I would recommend taking a recorded statement from the claimant to pin down the timeline of relevant events, the nature and onset of symptoms. I would also recommend sending all of the records you have to a doctor (such as a board-certified orthopedic surgeon) to review and complete a record review evaluating compensability and extent of injury. Specifically, you might ask the physician to address whether the evidence establishes damage or harm to the physical structure of the body, and if so, of what specific diagnoses or conditions the reported work event is a producing cause. Given the nature of these diagnoses, it is certainly possible that some or all of the conditions are pre-existing and degenerative in nature.
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