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Diagnostic Tests — They Can Make or Break Your Workers’ Compensation Case

  • Dave Brown, Esquire
  • 03/09/2020

Much like DNA testing has changed the landscape of criminal cases as it has provided an important tool for prosecutors and defense lawyers to determine who committed a crime, the advent of diagnostic tests, notably MRIs in the 1980s, changed the way that doctors diagnose and treat patients and also has affected how judges decide workers’ compensation cases.

Let’s go through and show how diagnostic tests can greatly impact your workers’ comp. case. Suppose you injure yourself at work and go to the nearest emergency room. It is likely they will take x-rays on your injured body part — neck, hand, back, foot, whatever you injure — to determine if you sustained any fractures. MRIs are rarely done in emergency rooms.

If your symptoms continue after your e.r. visit, your physician may order an MRI. With this test, detailed pictures are taken from inside your body — specifically of your injured body part. You will undergo the test at an MRI facility. You will slide into a narrow tube. Depending on which body part is being tested, it could be over in 10 minutes or last more than an hour. You have to lie still while the pictures are being taken. If you are claustrophobic, you can undergo the study at an “open MRI” facility where the machines are not enclosed; this should alleviate your anxiety.

Some people are not able to undergo MRIs — for example pregnant women and gunshot victims who have bullet fragments in their bodies. If you cannot undergo an MRI, you may be able to get a different test, such as a CT scan, although the results of this study are not as detailed as the results of an MRI.

MRIs can provide valuable information about your injury. An MRI to your lumbar spine can show a herniated disc which could explain your severe low back pain; an MRI to your shoulder may show a torn rotator cuff, which would account for why you’re having trouble moving your arm overhead; if it is difficult for you to put weight on your leg and twist your leg, an MRI to your knee may show a torn meniscus. A radiologist, a physician with expertise in reading and interpreting diagnostic tests, will review the images of your MRI and write a report, detailing the findings. Your physician who ordered the MRI may also review the images.

Another diagnostic test frequently utilized by doctors to diagnose and treat injuries Is an EMG/NCS (EMG for short). This test is adept at recognizing nerve injuries. A physician with specialized training will administer the test. It can be somewhat painful because it involves the physician inserting needles into your skin. But the test can yield important information. If you are complaining of neck pain which radiates down your arms into your hands, or low back pain which extends down your legs to your feet, an EMG may show radiculopathy, a medical term for a nerve injury which causes radiating pain into the arms or legs.

The results of diagnostic tests often dictate how your injury will be treated. If an MRI shows a herniated disc or torn meniscus, your physician may be recommended surgery. If an EMG shows radiculopathy, injections may be recommended as a way to provide you with pain relief.

If your claim is denied by your employer’s insurance company, and your case goes before a Workers’ Compensation Judge, the results of your diagnostic tests could significantly affect how your case is decided.

For example, if you complain to your doctors that you are suffering from excruciating back pain which travels to your feet and makes your toes numb, but your MRI and EMG are normal, the judge may be skeptical about your complaints. On the other hand, if you insist that you have debilitating neck pain which shoots into your right hand, and the MRI and EMG are consistent with your complaints, the judge is more likely to believe that you are being truthful and grant your claim. The advantage of diagnostic tests is that they are objective — the patient has no control over the results of the tests. Pain, though, is subjective — it is based completely on what the patient reports to the doctor. So if you’re reporting high levels of pain, but your diagnostic tests are normal, that may be a “red flag” to the judge.

Here is our most important piece of advice: if you injure yourself at work, contact the lawyers at Pearson Koutcher Law, who specialize in workers’ comp. cases — it’s all we do. If your doctor orders a diagnostic test but the insurance company for your employer refuses to pay because your claim is denied, we will make sure that you undergo this test, and any others that are ordered, while your claim is denied.