Because good causation science guides better treatment
Getting medical facts right can mean winning a legal case, but getting the facts right in diagnosis guides the correct treatment and when done in a timely fashion optimizes patient outcomes.
Does the claimant have long COVID or asthma?
The symptoms might overlap but the treatment for the former is still ill-defined while the management of asthma is better understood, for the human being in the midst of a legal proceeding getting the answer as right as possible is critical to their outcome. Delivering the best possible care and facilitating return to work is the best way for employers to stay out of litigation on claims.
Where/when did the injury occur?
Is the injury infectious and able to be contract traced? Or is the injury traumatic and is there a biomechanical model to clearly explain the injury? Are there facts that the support time course or is the injury pattern inconsistent with the mechanism? These are important facts that need to be articulated in a coherent manner to the trier of fact. Are there gaps in the case, if so, what are the strengths, the weaknesses? The fewer the number of logical gaps the less maneuver rooms the other party has to work with. Understanding accident investigation, human factors, medical causation, biomedical and mechanical engineering is important to building a strong legal case. Equally important is understanding the limitations of evidence or causation in one’s case.
The process starts before litigation.
Waiting until litigation is underway to start analyzing the situation is a bad strategy. The injured worker and treating physician should seek to understand causation to guide treatment. The employer should seek to understand the causation to guide enhanced prevention efforts. Looking at the causation of of claims early and often is critical to understanding the chances of success and can help get claims closed. One of the key aspects of worker’s comp law is the tendency to presume work relatedness for the employee in exchange for more predictable costs for the employer. Employers in litigation should ideally put forth a robust alternate explanation for an injury should one exist, similarly on the claimants counsel side there is a compelling need to ensure that causation science supports the injury to achieve a quick and favorable resolution.
Results
Seek specialist inputs when causation is the concern as this can make or break a case in treatment as well as litigation. Understanding the facts is critical to formulating strategy going forward. In some cases, particularly on the employer’s side, it is helpful to define what winning looking like. Pivoting from a desire to win the legal fight to staying out of the court room is just one area where OccMedSource can help.