CASE STUDY: Workers’ Compensation Insurer Tries to Reduce Benefits, Eden Rafferty Wins Client More Than Before

Insurance Offered: $100,000

We Got: $200,000

Background

Sometimes, insurers try to reduce Workers’ Compensation benefits even when it is clear that the employee cannot return to work. That’s what recently happened to one of our clients:

Our client was a skilled tradesman working in a factory. He was working with a co-employee who was operating heavy machinery. The second employee accidentally hit our client with the machine, knocking him over and injuring his foot. Our client was rushed to the hospital, where doctors diagnosed multiple fractures throughout his ankle, foot, and toes. He had surgery right after the accident to repair the fractures.

Despite ongoing treatment, rehabilitation, and physical therapy, our client was unable to return to work at full capacity. He could not even stand for more than one hour at a time. Nevertheless, the Workers’ Compensation insurer moved to reduce his Workers’ Comp benefits, claiming that the employee had some ability to return to work.

The employee knew he needed an experienced legal team to prevent the Worker’s Compensation insurer from reducing his much-needed benefits.

Approach

A few months after the employee approached Eden Rafferty’s Workers’ Compensation attorneys, the Workers’ Compensation insurer attempted to reduce his benefits based on an examination by a doctor the insurer hired. At this point, Eden Rafferty took the case to court and argued it in front of a judge of the Department of Industrial Accidents.

While this was going on, Eden Rafferty also advised the employee to file a claim for Social Security Disability Insurance benefits (SSDI) and assisted him with his SSDI application and ongoing paperwork to support his claim.

The Result

Our client did not need to wait for the court to issue its order, because our Workers’ Compensation attorneys negotiated a lump sum settlement with the insurer. The settlement represented nearly three years of the employee’s annualized salary at the time of his injury, plus he received lifetime coverage of ongoing medical costs related to this work injury.

Our client also received his Social Security benefits award less than one year after he applied for them.

The Workers’ Compensation insurer’s initial offer was $100,000. The attorneys at Eden Rafferty doubled that, getting our client $200,000.