Injuries that occur at one’s place of work are often evaluated and treated under an employer’s Worker’s Compensation insurance policy. Work injuries cost employers approximately $1 billion PER WEEK in direct costs (compensation payments, legal services and medical care). In addition, indirect costs can be enormous as costs associated with training replacement employees, accident investigations and implementation of corrective measures, lost productivity, repairs of equipment or facilities and costs associated with lower employee morale and absenteeism must be considered. Studies have shown that an injured worker that does not rapidly return to some form of work will likely have a long term disability, regardless of how minor the actual injury. The financial hardships incurred by both employer and employee can be substantial if the claim is not resolved promptly and appropriately. Thus, is is imperative that that the injured worker be evaluated and treated by a skilled physician, including specialists when indicated.
In the State of Arizona, it is unlawful for an employer not to provide this insurance. However, if an employee is alleged to have sustained an injury, a specific series of events must take place for this injury to be covered under this insurance policy. This includes timely reporting requirements by the employee, evaluation by an occupational medicine physician (or other initial employer-contracted provider) and, on occasion, an Independent Medical Examination, in order to determine Medical Causation. Clinical “correlation” does not equal “causation” and MEDICAL causation and LEGAL causation must both be proven to a reasonable degree of probability before the injury claim is accepted. Sometimes, one or all of these components can delay treatment substantially and lead to further problems or inability to treat the injury as effectively. When an injury is unclear or there are confounding variables (such employee credibility or pre-existing conditions) and the parties cannot agree on causation, an Administrative Law Judge at the Industrial Commission of Arizona is tasked with the responsibility of determining claim acceptance and benefits.
Dr. Bailie has treated worker’s compensation injuries at the request of employees, employers, law firms and referring physicians since 1996. He has mastered the nuances of the “industrial system”, and the unique requirements of healthcare providers to not only provide care and advocate for his patients but also maintain a proper line of communication with the insurance carrier and even the employer. He approaches work injuries in the same manner as he does with “in season” sports injuries (which in professional sports are considered worker’s compensation and governed by the same rules and regulations). This means the injury needs to be rapidly diagnosed, treated and the employee returned to the work force as soon as reasonably safe. His mission is to treat the injured worker as he would the highest paid athlete and is entrusted with their care and safety until treatment is complete. He is a preferred knee/shoulder specialist for many employers because of his proven track record of successful treatments, honesty and integrity and ability to return the injured employee safely to gainful employment.
click the subject to see more
Treating work injuries since 1996, Dr. Bailie is a preferred Orthopedic knee and shoulder provider to employees of many large companies, including American Airlines, City of Scottsdale, City of Mesa, City of Chandler, Dignity Health, Intel, Safeway, Scottsdale Healthcare (now Honor Health) and Southwest Airlines,. His prompt assessment, accurate diagnosis and cost-effective treatments minimize missed time from work, decreasing employer costs and financial hardship to the injured worker.
Dr. Bailie treats injured workers at the request of employers, insurance carriers, the injured worker directly and attorneys. He is respected for his treatment of industrial related injuries, not only for his medical and surgical skills, but also for his honesty and integrity, which will not allow a causation bias to affect his opinions and recommendations. As with his private patients, he works with his industrial injured patients to decide the best treatment approach, based on the diagnosis and options available.
In Arizona, Worker’s Compensation (industrial) is a “no-fault” system whereby an injured worker receives medical care and benefits regardless of who causes the job- related accident. As there are many rules and regulations that govern the procedure after submitting a claim, and whether or not a claim is accepted, we encourage you to visit www.ica.state.az to understand the process.
As a treating physician, Dr. Bailie will provide an accurate diagnosis and discuss all relevant treatment options so that the injured worker can make a decision regarding their care. However, he cannot comment on causation, as this is a conflict of interest in the care of an established patient. Whether a problem is caused by an on-the-job injury or not is NOT RELEVANT in regards to the care and treatment of the diagnosis, even though it may be very important in determining whether a compensable claim exists.
Most employers require evaluation at an occupational medical clinic prior to referral to a specialist such as Dr. Bailie. It is imperative that causation be established prior to seeing Dr. Bailie to avoid delays in care and ensure good outcomes. In addition, referral to a specialist should be made promptly if a worker has not improved after 7-10 days while under the care of an occupational medicine clinic.
Rest assured that regardless of causation, Dr. Bailie provides the best care available to treat the problem.
INDEPENDENT MEDICAL EXAMINATION (IME)
If there is a dispute regarding causation, whether medical or legal, the employer or insurance carrier may choose to have the applicant evaluated by an independent medical examiner, in what is termed an IME. This is an independent evaluation by a qualified physician who is tasked to determine the diagnosis, treatment and medical causation of the injury. Dr. Bailie performs IMEs on a regular basis at the request of insurance carriers, employers, attorneys and injured workers. He understands the importance of such exams and does not allow bias of any kind to influence his opinions, regardless of who requests the exam. During these exams, the injured worker is not considered a patient and therefore, the patient-physician relationship is not established. Thus, the law does not allow Dr. Bailie to provide medical advice to the examinee nor discuss his findings or opinions with them directly. All of the medical records and imaging studies are reviewed, a history is taken and exam performed. Opinions are then rendered in a formal report, provided to the requesting party. If further information is required, Dr. Bailie will request and receive the information and subsequently issue an addendum. If there is a dispute, it is typically resolved by an Administrative Law Judge at the Industrial Commission of Arizona. Dr. Bailie testifies at Industrial Commission Hearings regularly to clarify any opinions rendered in his report. Under special circumstances, not withstanding any conflicts of interest, he may be asked to take over care after an IME. This is acceptable if requested by the injured worker and Dr. Bailie agrees to the request. TO SCHEDULE AN IME and RECEIVE THE FEE AGREEMENT AND TERMS OF THE EXAM/PAYMENT, PLEASE CONTACT MICHELLE at 480-264-6095 or 623-521-1116 or at LEGAL@AZISKS.COM. ALL EMAILS WILL BE ANSWERED SAME DAY and ALL CALLS ANSWERED IMMEDIATELY Monday through Friday 9am to 5 pm.
