Phil’s case shows how workers comp cases can be like baseball- it ain’t over til it’s over. At the end of a long, hard – fought case where the insurance company ignored its responsibility, we got a settlement for more money than the comp commissioner gave at the hearing.
No one deserved it more than Phil. Here’s how we did it. But first, here’s how we got there.
Work Injury and Employer Denial
After an 18-year military career, Phil eventually began working for an auto parts deliverer in Jonesville, SC. On New Year’s Eve 2013, he delivered a car front door to a body shop in Lexington, SC. It weighed about 50 to 100 pounds. After dropping it off the truck with a lift, he had to carry it himself about 20 feet to finish the delivery.
Unique injury. About 30 minutes later, while driving home, sharp pain developed in his shoulder like someone pushing a sharp pencil through it about 2 inches down from the top of his shoulder. He had the next day off, New Year’s Day. He went back to work on 1/2/14 and 1/3/14, with the same pain. He just worked through it those two days. The work ethic he learned taught him to work despite hurting. On Saturday, 1/4/14, he awoke in agony, like never before. He hurt from his neck into his shoulder and his left shoulder blade.
Denial. Despite his agony and integrity, both his employer and the insurance company denied Phil’s injury was caused by work. They denied his workers compensation rights to medical treatment and temporary disability income. Phil eventually got diagnosed with a serious nerve injury that kept him out of work for over a year, a desperate situation for most working folks. Still, neither his employer or the insurance company offered to help. Bewildered, he and his wife sought help from us.
Our Investigation and Case Development
Phil’s injury caused some head-scratching among even medical professionals. The first specialist he saw was an orthopedist who evaluated him for a rotator cuff tear. The orthopedist ruled that out, but realized Phil might have nerve damage, so he wisely referred him to a nerve specialist, a neurologist.
I met personally with both doctors to explore Phil’s injury so we could present the truth to the insurance company. The neurologist gave a clear diagnosis Phil’s injury got caused by work.
Diagnosis and treatment. Phil sustained a brachial plexus injury. The neurologist explained carrying that car door damaged the nerves running from Phil’s neck into his shoulder. He made clear Phil couldn’t work as a result. In fact, the injury essentially rendered Phil’s left arm useless for a long time.
Pain and Debilitation. For the first 3 to 4 months, Phil endured the worst pain he’s ever known. It hurt in his left shoulder all the way to the wrist, 24 hours a day. It felt like a vice grip clamped onto his arm pressing into the bone. It distracted him from activities. He fidgeted constantly because he couldn’t sit still from pain. His arm was frozen- he needed to use the other arm to move it. His wife helped him dress.
There was little medical treatment could accomplish, except prescribe him powerful nerve pills, which didn’t help much, and slowly rebuild strength and motion through physical therapy – almost a solid year of it.
At the hearing almost 2 years later, Phil testified he still struggled to lift 5 pounds with his arm extended. It was hard to lift a fish out of the water. It hurt to lie on it when he slept, awakening him with a sharp pang like he just got a shot. The crook of his elbow and forearm stayed constantly numb and tingly. While he had a new job, he couldn’t hold binoculars to see numbers on high shelves in the warehouse for inventory – it made his shoulder burn like fire. Flexing his arm gave him cramps.
New Job. Like many hard-working folks, Phil could only be held down so long. Once he got released by his doctor to work, that’s where he went. But not as an auto parts deliverer – Phil selected his new job based on his permanent limitations. He drives a forklift with power steering and a small steering wheel with a knob he can grab for easy turning.
Insurance Company Stonewalls
When presented with undisputed medical evidence Phil got hurt on the job, the insurance company still refused to do right. They even made Phil drive across the entire state to see a neurologist they hired. That went nowhere – he agreed Phil’s injury got caused by work, too.
Luckily, Phil enjoyed excellent health insurance from his military service, as he should. He also had military retirement income to rely on. But for our country taking care of this veteran, he might have been bankrupted by bills and no income.
We wasted no time requesting a hearing to get him justice.
Hearing and Result
The reality of a hearing before a workers compensation commissioner made the insurance company face the facts at long last. Just before the hearing, it caved on every single issue except the amount of temporary total and permanent disability compensation. After a 2 year fight, the insurance company finally admitted Phil’s injury got caused by work, plus they owed him for medical treatment and lost temporary disability income.
Commissioner Award. The commissioner awarded Phil:
- Back-owed temporary disability income, from the time the doctor took him out of work until he reached maximum medical improvement, totaling $23,819.33.
- Permanent disability award of 40% to the left arm, totaling $36,961.76.
After the commissioner announced his decision, the case took yet another turn.
Unlikely Settlement for More Than The Commissioner’s Award
The commissioner’s award satisfied us – we felt Phil got exactly what he deserved. But it got even better.
The insurance company offered to settle for more than the award. While that seems crazy, there’s a very good reason: South Carolina comp law makes the insurance company responsible for Phil’s future care for at least a year, or any time in the future if he ever gets worse. To end that exposure to an unknown liability, the insurance company offered a clincher. That’s a settlement where Phil releases the insurance from all future responsibility.
To get the clincher, the insurance company offered about another $10,000.00, resulting in a total settlement of $83,500.00, of which Phil repaid his health insurance $13,340.60.
Fighting The Good Fight Can Be Worth It And Sometimes It’s Necessary
We were proud to help Phil, and are so thankful for him he could rely on his military pension and health insurance to avoid financial devastation. That’s not the case for everyone. That’s why it’s so important for any injured worker to seek professional legal help at the first sign of stonewalling or denial by the workers comp insurance company to do right by you when you get hurt at work. As you’ve seen above, sometimes it takes forcing a hearing to get the insurance company to see the light. If you’re hurt at work and can’t get help from the insurance company, call and experienced workers compensation lawyer to get the benefits you need as fast as possible. While not every case is as tough as Phil’s, nothing would have happened if he hadn’t called a lawyer to investigate and take action fast to get him relief. If you think you might need help, you probably do. Feel free to start a live chat right where you are so we can schedule a free strategy session on the best way to help you.
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