Adjuster X

The Ride of Your Life

By: | December 1, 2013

This column is based on the experiences of a group of long-time claims adjusters. The situations they describe are real, but the names and key details are kept confidential. Michelle Kerr is the editor of this column and can be reached at [email protected].

I looked over the first report of injury. An employee had hurt his right shoulder while operating a ride at a popular local amusement park. I had fond memories of visiting that park as a child. Carl Summers, 18, was a summer hire at the park. He had been employed only six weeks when the injury occurred. I spoke with his supervisor, Joe. On the day of the incident, Carl came to him at 4:30 p.m., and reported injuring his right shoulder operating a lever on the Ferris wheel. Joe said all the rides in the park had undergone maintenance prior to the park opening and were in good working order to the best of his knowledge.

I contacted the treating doctor’s office. The nurse confirmed the diagnosis of a right shoulder sprain and indicated that Carl would probably lose a week or two from work. I got permission from Joe to try the Ferris wheel lever. It engaged smoothly.

Joe agreed to let me contact the employee who relieved Carl. The other employee, Bill, worked part-time at the park. By day, he was the chief mechanic at a car repair shop. Bill said the lever action on the Ferris wheel was “smooth as silk.” He said he routinely sprayed lube oil on the gears every night to keep it that way.

Next, I interviewed Carl at his parents’ home. He said he was pulling up the lever of the ride when it “hung up.” He said he used a great deal of force to move the lever, and immediately felt intense pain in his right shoulder. He reported the injury to Joe within a few minutes.

I mentioned to Carl that I had tried the level myself and it worked smoothly, and that Bill encountered no problems that evening on his shift. Carl said it could’ve been a one-time thing given the age of the rides. The next time I spoke to Joe, he said more or less the same thing.

“But something just didn’t smell right about this case. I asked Joe if Carl had a girlfriend.”

He said a local girl named Mary had been coming by quite a lot. He knew where she lived.

I went to visit Mary and told her I was helping Joe solve a safety issue. I mentioned Carl’s accident, and told her that we needed to find out the cause. I told her that tearing apart the Ferris wheel would cost the park a great deal of money and they were trying to confirm that there was a genuine problem before taking that step.

Mary fidgeted a bit in her chair. “I suppose it wouldn’t be fair to them,” she said. She looked away from me before saying, “I always go on the ride when he’s there. He usually starts doing outrageous things to get my attention. That day, he said ‘Hey Mary, watch this!’ and stood on his head and lifted his left hand off the ground to wave to me, but he fell over on his right shoulder. When he got up he was holding his shoulder and wincing.” Mary looked forlornly at me and said, “I hope I didn’t get Carl into trouble.”

I drove straight back to Carl’s and asked point-blank: “How did you really hurt your shoulder?” He stared at me for a few seconds, then looked at the ground and said, “I really did hurt it at work.” I agreed, but added that doing handstands to impress female patrons wasn’t in his job description. Carl made a formal statement about the circumstances of his injury.

I went back to Joe at the park and explained what I’d discovered. “You’re a regular Columbo,” he said. “Now, what do we do?” Carl was injured at work, but the injury did not arise out of his employment because he was engaged in horseplay. The injury wasn’t compensable and I advised Joe to deny the claim. Before I left, Joe told me that Carl would be fired for lying.

As I drove away from the park, I noted sadly that all my previous visits there had been a lot more fun.

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