Non-Industrial Injury Claims
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Case Challenge #3
After having been discharged from care, a claimant called indicating further medical problems that she wanted to file under worker's compensation.

Our Solution
At the request of the claims examiner, we sent a nurse case manager to attend an appointment with the patient and an OCC Med MD, where they addressed the medical correlation between current symptoms with the industrial injury and prior symptoms. The doctor stated that the current problems were not related to a work injury, and that they seemed related to progression of diabetes, which would not fall under worker's compensation. This appointment prevented a second opinion or consultation under WC for a non-industrial condition, and possible time off work for evaluation.