Apr
22
2015

Check out the five most costly workers' compensation claims filed with The Hartford, one of the primary insurance carriers for the AAHA Business Insurance Program. Collectively, these five claims exceeded $1M. Workers' compensation coverage provides medical payments, disability, survivor benefits, rehabilitation expenses, and wage replacement for employees who experience job-related injuries or diseases, regardless of fault.

#1: Employee herniates disc while lifting large dog; complications follow
An employee was lifting and moving an 80-pound sedated dog on an exam table and experienced lower back pain. An MRI of the lumbar revealed a herniated disc. Treatment included pain medication; a side effect was constipation, which caused a perirectal abscess. The employee retained legal representation. The employee was referred to an orthopedic specialist for the herniation and to a colorectal specialist for the perirectal abscess. The insurance carrier approved the recommended treatment plan, which included an implanted InterStim therapy system to help the brain and the nerves communicate so the bladder and related muscles can function properly. After a final medical evaluation, the employee was given permanent work restrictions. The insurance carrier pain more than $472,300 in medical expenses and indemnity. 

#2: Employee injures back while lifting large dog on a gurney over a curb
An employee was transporting a large dog on a rolling gurney from the clinic to the parking lot. At the curb, the employee lifted the gurney to continue moving. The employee experienced pain, but proceeded to help move the dog from the gurney into the owner's vehicle. The employee sustained a lower back injury. Treatment included epidural steroid injections, pain management, and physical therapy. The employee retained legal representation. The insurance carrier paid more than $181, 900 in medical expenses and indemnity. 

#3: Employee tears rotator cuff during dog walk
During a walk, a leashed dog pulled away from the employee. The employee sustained a shoulder injury and was diagnosed with a torn rotator cuff and cervical radiculopathy. An independent medical examination also determined that the work-related injury had aggravated a pre-existing degenerative cervical condition. The torn rotator cuff was surgically repaired. The insurance carrier paid more than $136, 800 in medical expenses and indemnity.

#4: Employee's knee pops while lifting large dog
While lifting a 90-pound dog, an employee sustained a knee injury. The employee was diagnosed with a medical meniscus tear and chondromalacia and required knee surgery. After the first surgery, the employee sustained a subsequent recurrent tear, which required a second surgery. The insurance carrier paid more than $120,900 in medical expenses and indemnity. 

#5: Employee falls in unsalted icy parking lot
An employee was at an offsite parking lot (designated for practice employees) and slipped and fell while exiting a car. An ambulance transported the employee to the emergency room; the employee had sustained a severe left tibia fracture and required surgery. Post-surgery, an infection developed. The employee was readmitted for antibiotics, irrigation, and debridement. The insurance carrier provided a nurse case manager to ensure that the employee received appropriate medical treatment and equipment when transitioning from the hospital to back home. The insurance carrier paid more than $110,000 in medical expenses and indemnity, and the carrier is pursuing recovery against the parking lot owner for failing to maintain a safe property. The practice owner had previously advised the parking lot owner that the lot conditions during the winter were unsafe. On the day of the injury, it was reported that the lot was unsalted and icy. 

An experienced and highly trained team of claim adjusters oversees all workers' compensation claims activity. The team helps control costs and gets injured employees healthy and back into the workplace as soon as possible. 

Questions? Need workers' compensation coverage? 
Contact the AAHA Business Insurance Program at 866-380-2242 or visit aahainsurance.org/quote

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