Workers Comp Lawyer requesting opinion on surveillance footage.

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strike5858

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I got a letter from a workers comp attorney with a usb stick of surveillance footage of a patient I am a secondary treater on for pain management.

They patient has a upper extremity issue and is seen, mowing the lawn, using a blower and lawnmower.

The requested I offer an opinion on the footage and whether it changes my recommendation.

Can you all offer some advice on how to deal with this.

I would prefer not to offer an opinion on the matter. I will likely re-examine the patient in more detail next visit to see if there are any inconsistencies but I don’t want to get dragged into this and then get dragged into depositions or court.
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Too late. You clean it up or it will get cleaned up for you. No penalty. You just would be made to look like a dufus. And patient wc case is over.
 
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Sounds like you are already in it. Don’t overthink it....watch the video, then examine the patient and ask him about it. Document. Done.

I have a similar case where the attorney showed me a patient riding on a 39’ boat and holding up a 10lb fish on his public social media account. I said that doesn’t really change anything he’s allowed to ride on a boat in flat seas or a bus or any other vehicle. He wasn’t lifting the boat. His job was construction. Now show me him cleaning the boat for 2 hours and then it might change my mind.
 
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strike5858 said:
I got a letter from a workers comp attorney with a usb stick of surveillance footage of a patient I am a secondary treater on for pain management.

They patient has a upper extremity issue and is seen, mowing the lawn, using a blower and lawnmower.

The requested I offer an opinion on the footage and whether it changes my recommendation.

Can you all offer some advice on how to deal with this.

I would prefer not to offer an opinion on the matter. I will likely re-examine the patient in more detail next visit to see if there are any inconsistencies but I don’t want to get dragged into this and then get dragged into depositions or court.
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Did u know it was a workers comp case?
 
lobelsteve said:
Too late. You clean it up or it will get cleaned up for you. No penalty. You just would be made to look like a dufus. And patient wc case is over.
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It depends if your secondary (assuming Ortho is primary) ignore it and clarify your role in pain management in you next assessment and plan. fictional example wrist fracture s/p ORIF s/p hardware removal complicated by CRPS s/p(treatment) recommend (treatment plan). if the patient is post-surgical limit of function are set by the surgeon. if all limits are lifted then an FCE is reasonable. If they really had something sold they would summon the patient to an IME and close the case. Don't let them get a free medical option out of you. you give an option you could look silly either way
 
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btw you can bill for attorney conferences. If he/she wants a conference, they will pay for it....in advance. In Florida it is around $300 for half an hour.
 
Can you be certain it’s legally obtained and actually of your patient? I’d say you are under no obligation to render and opinion until they subpoena you.
 
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callmeanesthesia said:
Can you be certain it’s legally obtained and actually of your patient? I’d say you are under no obligation to render and opinion until they subpoena you.
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Why not just issue ur opinion ? I mean that’s what it is- an opinion. Not a fact?
 
have you determined any disability?

you stated you are treating for pain management.

you could state "wow, look at how well his pain is being controlled by my treatments! he's able to mow his lawn!"
 
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back when i was a resident, i saw a housekeeper with back pain after lifting injury. out of work at least 6 months. one of the few people i ever had to "determine disability"...

as i was walking in to the supermarket one Saturday, i see ahead a van with the back sliding door open. theres a guy with his back to me. he has left leg in the van, right on the ground, and lifts up what looks to be a gigantic hand made dollhouse (bookstore next door to supermarket was having an exhibit). 3 stories high, at least 3 feet by 2 feet.

the guy twists around to step out of the van, and i see my patient - one leg in van, one leg out, holding probably 40 pound dollhouse.

his only words when he sees me: "um... i guess the gig is up."

i smiled and said "see you in the office on Monday!"


i last saw him 20 years later (casually, not as his doc). he had worked hard enough to be promoted to manager, so he did something good out of it. he told me that period of disability was "my vacation time".
 
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Doctodd said:
btw you can bill for attorney conferences. If he/she wants a conference, they will pay for it....in advance. In Florida it is around $300 for half an hour.
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New to workers comp in California. It’s such a small part of my practice that I haven’t really dived in deeply. I simply usually just do some injections for the Primary treating physicians.

They sent a letter asking a few questions and asking I answer in my next note. No not sure how I could bill for extra.

But I agree , I will address it with the patient next visit and see if the explanation is legitimate.

Can we charge for watching the video? It was 60 min of footage. How would we bill?
 
strike5858 said:
New to workers comp in California. It’s such a small part of my practice that I haven’t really dived in deeply. I simply usually just do some injections for the Primary treating physicians.

They sent a letter asking a few questions and asking I answer in my next note. No not sure how I could bill for extra.

But I agree , I will address it with the patient next visit and see if the explanation is legitimate.

Can we charge for watching the video? It was 60 min of footage. How would we bill?
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Based on ur time I think.
 
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strike5858 said:
New to workers comp in California. It’s such a small part of my practice that I haven’t really dived in deeply. I simply usually just do some injections for the Primary treating physicians.

They sent a letter asking a few questions and asking I answer in my next note. No not sure how I could bill for extra.

But I agree , I will address it with the patient next visit and see if the explanation is legitimate.

Can we charge for watching the video? It was 60 min of footage. How would we bill?
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i only answer easy questionnaires directly related to my visit with the patient when the patient is in front of me. If he wants more specific questions, which is what it sounds like, you can order an FCE. If he wants you to watch 60" of video(unlikely).....then you can set that up as a very long conference. If he can edit them to be shorter, he should. Either way, it sounds complicated enough for a conference. Or they can depose you and it will cost them more to have opposing council, a court reporter, and transcription of the depo.

It's up to the attorney to establish the identity of the patient in the video to the judge. Obviously it should look like your patient, but they have to prove it to the judge, which is a higher bar. You will just say what you saw and what you opine.
 
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Doctodd said:
i only answer easy questionnaires directly related to my visit with the patient when the patient is in front of me. If he wants more specific questions, which is what it sounds like, you can order an FCE. If he wants you to watch 60" of video(unlikely).....then you can set that up as a very long conference. If he can edit them to be shorter, he should. Either way, it sounds complicated enough for a conference. Or they can depose you and it will cost them more to have opposing council, a court reporter, and transcription of the depo.

It's up to the attorney to establish the identity of the patient in the video to the judge. Obviously it should look like your patient, but they have to prove it to the judge, which is a higher bar. You will just say what you saw and what you opine.
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I agree with this. Not to mention that lawyers as someone else mentioned try to get freebies. There are too many unknowns. You really should be deposed/subpoena for this type of information, and you can serve as an expert witness. There is no legal responsibility that you have to provide any type of opinion if it's not within a specific legal framework/context. Just because the patient might be your patient doesn't mean you have to do this. Would a lawyer watch a 60 minute video for free? No. Why would you? As Doctodd mentioned, they can set up a conference, where they can pay you a reasonable rate, and they can ask you questions as long as they want - for an agreed upon rate.
 
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I really hate dealing with lawyers/disability/WC/etc and try to avoid them as much as possible, but here's how I would handle it.

1. Unless you've written a letter or filled out forms giving your opinion on the case, you don't have any reason to watch the video. Unless you did an IME, filled out disability forms, or gave work restrictions, the video does not change anything for you. Pain is not function.

2. I have a policy that I do not formally evaluate functional status of my patients. If they need a functional assessment, I order an FCE. This should theoretically evaluate malingering as well.

3. If you did an IME or completed legal forms for the patient (which I assume you charged for) AND they wish to give you more records to review (i.e. the video), then they must pay for the additional review of records time and for your amended report.
 
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Am I the only one who would watch the video for the entertainment value.

I have so many patients I wish I could be a fly on the wall...
 
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Agast said:
Am I the only one who would watch the video for the entertainment value.

I have so many patients I wish I could be a fly on the wall...
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You might watch the video (hopefully not the whole 60 minutes) - but do you really want to have to provide a medical opinion? for free.
 
Iamnew2 said:
You might watch the video (hopefully not the whole 60 minutes) - but do you really want to have to provide a medical opinion? for free.
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I would tell them honestly I’ve never mowed a lawn in my life, so I have no idea if that is considered strenuous. Is it any worse than pushing a shopping cart full of groceries and water up and down the aisle?
 
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Agast said:
I would tell them honestly I’ve never mowed a lawn in my life, so I have no idea if that is considered strenuous. Is it any worse than pushing a shopping cart full of groceries and water up and down the aisle?
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Have you dealt with lawyers? They are exhausting. They will twist words and make it into something else. I wouldn't offer any expert opinion unless they are willing to pay you for it.
 
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Agast said:
I would tell them honestly I’ve never mowed a lawn in my life, so I have no idea if that is considered strenuous. Is it any worse than pushing a shopping cart full of groceries and water up and down the aisle?
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its a lot harder, because most lawn mowers don't come with beer can holders like grocery carts do.
 
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callmeanesthesia said:
That’s why you need a riding mower. They have cup holders, and won’t ruin your fraudulent WC claim.
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I had a patient who was video surveilled and he was on the riding mower to get to his mailbox. They tried to make it like he could cut his grass and do everything even though he was unable to walk to his mailbox.
 
Agast said:
I would tell them honestly I’ve never mowed a lawn in my life, so I have no idea if that is considered strenuous. Is it any worse than pushing a shopping cart full of groceries and water up and down the aisle?
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We bought our first home 18 months ago and I got a manual push mower because I thought it'd be good exercise. It was great exercise - but it took me 2 hours and it was bedtime for the kids when I finished. I gave up quickly and hired out. Takes a 2-person crew about 12 minutes and $30 on the riding mower.
 
Agast said:
I would tell them honestly I’ve never mowed a lawn in my life, so I have no idea if that is considered strenuous. Is it any worse than pushing a shopping cart full of groceries and water up and down the aisle?
Click to expand...

That might be a little difficult, I had a landscaping company during undergrad. The tiger moms had heart attacks every time I would roll up in my Chevy pickup with the lawn mower in the back to tutor their kids.
 
masonjackson said:
Hello. I would like to know what typically goes into the day of workers compensation attorney. Are you basically collecting from Insurance Companies all day? What are your hours like? Is this an area of law in which solo practitioners can make a good living? Is there any activity in the field correlating with the uptick of undocumented workers that are employed in states that give them the same workers comp benefits as documented workers?
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Firstly,
You would check your soul at the check in desk. Most lawyers have this quickly removed shortly after law school though.
Next you listen to the police scanner to see if there are any fresh ambulances to chase.
Then tell your secretary to get some free updates from some docs.
Finally go and cheat at golf, cheat on your taxes, and your wife.
Make sure you billed 25 hours of work
Go home
Rinse and repeat
 
geauxg8rs said:
Firstly,
You would check your soul at the check in desk. Most lawyers have this quickly removed shortly after law school though.
Next you listen to the police scanner to see if there are any fresh ambulances to chase.
Then tell your secretary to get some free updates from some docs.
Finally go and cheat at golf, cheat on your taxes, and your wife.
Make sure you billed 25 hours of work
Go home
Rinse and repeat
Click to expand...
there are some ethical lawyers....how else would so many do civil rights and immigration law? Of course im only speculating.
 
Doctodd said:
there are some ethical lawyers....how else would so many do civil rights and immigration law? Of course im only speculating.
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there are some ethical lawyers.

but if you ARE an ethical lawyer, you are not going to go into personal injury.
 
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