Defense Award in a Potentially Catastrophic Workers’ Compensation Case
Lynn Olmert recently defended a claim for workers’ compensation filed against a large roofing company. Claimant alleged that he sustained an injury to his back while lifting a large piece of wood while working for the Employer. Prior to involvement of defense counsel, the claim was accepted as compensable on a medical only basis, but income benefits were denied based on a termination due to insubordination. This fact was disputed, and a hearing was scheduled on Claimant’s request for income benefits. Throughout the course of discovery, Claimant changed his story about the accident and contended that he was lifting with a co-worker at the time of his injury and that the co-worker dropped his end of the board that they were lifting, resulting in back injuries. The co-worker denied this claim and had no recollection of any such incident occurring. Surgery was ultimately recommended by the authorized treating physician on the basis that the lifting incident aggravated Claimant’s pre-existing back problems. Following additional investigation, it was discovered that on the day prior to the alleged accident, Claimant had been seen by another doctor, in the same practice, and an MRI had been ordered for Claimant’s back based on reports of back pain and numbness in his legs. The Claimant never had that MRI done, but instead, sustained an alleged injury on the following day at work. Based on this newly discovered evidence, the decision was made to controvert the claim in its entirety. Following a lengthy hearing on all issues, the Administrative Law Judge found that Claimant did not sustain an injury arising out of and in the course of employment and denied the claim in its entirety.