Honesty Is the Best Policy

While most people credit the proverb, “Honesty is the best policy” to Benjamin Franklin, Sir Edwin Sandys, the English politician and colonial entrepreneur, made use of the phrase as early as 1599. Whomever it was that imparted this wisdom to you, whether first grade teacher or grandma, it is still solid advice, and can play a pivotal role in your workers’ compensation claim.

In the case of a woman working for a food service company, there were inconsistencies from the start, including how many hours she had worked, what duties she had actually performed during the time period in question, and even in her description of symptoms. Almost every case can expect differences of opinion between claimant and respondent, and they are most often a result of misunderstanding or faulty memory, and eventually become immaterial. However, once a pattern of true dishonesty has been established, it can become very damaging, even overshadowing valid claims.

The claimant reported that during the course of her duties, which included the lifting and moving of heavy food products, the pain and swelling in her legs during a particularly busy three-day period became so intolerable that she was forced to miss work and seek medical attention. In order to corroborate her claims, video surveillance tapes were reviewed. They showed the claimant had been there, and that a lot of physical labor was performed, particularly on the first date in question. It could be argued that the fact that she did not appear to be in any particular physical distress at that time was due to it still being early in the shift, with the symptoms increasing over the course of that day and the next two days, during moments that were not caught on video. This mighthave been an argument, except for one important fact: The work in which the claimant was so diligently involved was the theft of company product. She is shown on three separate occasions carrying what look to be heavy boxes, “hipping” the door open without any apparent distress, and loading the same into her own car.

There are times when even a legitimate injury is difficult to pinpoint through diagnostic tests, and where the symptoms do not fall into a neat textbook scenario; in these instances, it is the strength of the surrounding facts that will help bolster the case. However, since the claimant’s credibility had come into question, every fact was now seen through a jaundiced eye. When the medical reports failed to spotlight a definitive injury, there was no basis for the claimant to prosecute her case.

Could there have been a legitimate injury during the course of her work for which the carrier should pay? There very well could have been. Is it fair to assume, based on one day in time caught on video, that the claimant must notbetelling the truth about her injury? Maybe not. However, once the shadow of doubt has been cast, it is hard to remove. Not surprisingly, the claimant lost both her job, and her appeal for continued benefits.

BAS, 11/10/14

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