Workers’ Compensation – Medical-Legal Nurse Review

June 22, 2023


A 21-year-old male construction worker (claimant) with a history of current marijuana use fell from the rear of an ATV on the way to a job site. The fall reportedly occurred while the ATV was travelling at a high rate of speed, and the claimant sustained severe brain injury and a skull fracture. The driver reported being unsure of why the claimant fell but was also known to be impaired. A witness said the ATV hit a bump and the claimant was thrown off the back. The claimant went to the emergency room, where X-rays were taken, labs drawn, and IV fluids given.

Services Provided

Rimkus was tasked with answering the following questions. By collaborating with other consultants from the comprehensive Rimkus team, including the Biomechanical, Human Factors, and Toxicology practices, our experts were able to answer the client’s complex questions.

Were the injuries consistent with reports of the accident?

To determine if the injuries were consistent with accident reports, our Legal Nurse Consultants (LNCs) engaged Rimkus biomechanical engineers to review the available evidence. By applying significant knowledge of relevant physics and engineering principles, our biomechanical team determined if the injuries were or were not consistent with the reported accident.

Did the claimant’s position on the ATV contribute to his injuries?

To address this question, our LNCs collaborated with Rimkus Human Factors consultants, who applied their expertise involving human risk behavior. This includes issues related to risk perception, risk-taking in young males, social effects on risk-taking, influence of marijuana on risk-taking, and the reasonableness of the claimant’s relevant safety behavior or lack thereof. Our Human Factors experts also considered the appropriateness, comprehension of, and compliance with warnings. In addition to the claimant’s behavior, they considered the behavior of the driver and other passengers as potential contributory factors.

Did marijuana use contribute to the fall and diagnosed injuries?

In order to understand if marijuana use contributed to the incident, our LNCs teamed up with Rimkus toxicologists, who used case evidence, including blood THC concentrations and history of use, to determine if the person was acutely or chronically impaired. Our team also evaluated the impairment of the driver to determine if that could have been a factor in the accident.

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