Case Study : Workers' Compensation

Knee Injury

Don’t settle without speaking to an attorney

Juanita worked for a local hotel doing maintenance work. She tripped over an extension cord and broke her leg. After a course of conservative therapy – injections, physical therapy, etc. – she needed surgery. Isurity, the insurance company on the case, authorized this and she had surgery involving a bone graft. Following the surgery, though, her knee gave her problems. Despite this Juanita went back to work and attempted to limp along. Isurity refused to authorize any treatment for the knee.

Juanita hired a local attorney who filed a Request for a Hearing. The Industrial Commission ordered the case into mediation. At the mediation Isurity offered Juanita $19,000.00 to resign her position from the local hotel and to give up the right to future medical care. Her attorney strongly recommended that she take this.

Juanita was uncomfortable with that settlement amount because her knee was in pain and she did not have health insurance. She asked us to look at her case. We recommended that Juanita return to her doctor, get an out of work note, and allow us to pursue the treatment on the knee.

Juanita switched attorneys at no expense to herself and began following our advice. We quickly were able to have her removed from work, had her weekly checks reinstated, and then used a quicker alternative method with the Industrial Commission to get approval for the knee surgery.

Isurity reluctantly paid for the knee surgery, and continued to pay Juanita for another two years while she recuperated. Isurity paid to and for Juanita far more than the $19,000.00. In the end we negotiated a larger, more reasonable settlement on her behalf. After the case settled we gave Juanita’s former attorney a portion of the overall fee. Juanita only paid a total fee of 25% which was split between the two firms.

Is it wise to settle prior to getting medical treatment? Can you change attorneys? How quickly would you use up that settlement money? Will the Industrial Commission sometimes quickly approve medical treatment?

Lessons to be Applied…

  • Do not let an attorney pressure you into a settlement.
  • If you settle prior to having medical treatment have a plan in place for paying for this. Sometimes it’s wise to settle, sometimes not.
  • It’s a mistake to only look at the settlement in a case. Look also at the total amount of benefits received. Balance this against the money you may be missing out on with a new job.
  • In short… don’t settle without at least talking to an attorney! We’ll tell you if we think it’s fair or if we may be able to get more for you. And we can give you an idea of how long it might take to do so.