I had a client that came to me because she was injured when she slipped and fell coming out of a walk-in freezer at a local fast food restaurant. Unfortunately, these type of accidents in restaurants are common. My client worked in a position that required her to be standing or walking nearly her entire shift.
In this particular case, my client injured her knee. She was out of work because she had problems with simple weight bearing, standing and walking. Yet, her employer was not paying her any lost wages. After I got involved, I was able to determine that the employer accepted the injury, but as a medical only. That means the insurance carrier agreed to pay medical expenses, but no wage loss. It is important to note that the carrier accepted the injury as a ‘knee sprain/strain’. You’ve heard that jargon before. The limited injury description provides the carrier leeway to deny medical treatment beyond what they determine to be the scope of a ‘strain/sprain’.
I filed a claim petition seeking wage loss and medical benefits. I also sought to expand the description of injury beyond a ‘strain/sprain’. After reviewing medical records and diagnostic tests, it was clear that the client had significant, pre-existing arthritis in her knee. The X-ray and MRI spoke for themselves. However, as we have written here before, pre-existing conditions are NOT a bar to workers compensation benefits.
Through testimony, I was able to establish, that although she had pre-existing arthritis in the knee, she was unaware of it, never treated for knee pain prior to the work injury, and was working her job without any difficulties prior to the work injury. The employer was not able to produce any evidence to the contrary. Second, through the testimony of her treating orthopedic surgeon, I was able to solidify the fact that there was no medical evidence of any knee treatment prior to the work injury, that the non-symptomatic arthritis became symptomatic because of the work injury, and the fact that since the injured worker failed all conservative treatment, that the total knee replacement was casually related to the slip and fall at work.
Another important thing to note here is that during the claim petition litigation, there were significant settlement discussions for a lump sum amount of money. The insurance carrier actually did offer fairly reasonable money on the case. However, the carrier did not offer to pay outstanding medical bills, which totaled over $10,000. I simply did not think it was fair that my client had to pay those outstanding medical bills out of her lump sum settlement. Therefore, in the end, we rejected the settlement offer, and instead chose to go to decision.
In the end, the Workers Compensation Judge granted the claim petition, awarding wage loss benefits to my client back to the first day she was out of work, and ongoing, of which she is still receiving weekly benefits today, payment of all medical bills, and expanded the description of injury to include “contusion of her right knee and aggravation of her pre-existing asymptomatic arthritis requiring a right total knee replacement”.
Many law firms just want to settle your case, because they want their fee. That’s what they want. Some apply pressure to clients to settle. For me, it is about what is right and what is best for each and every client. I certainly would not recommend settling any workers compensation case for any of my clients if I did not feel it was in their best interest. Representing injured workers is more than just a settlement fee. Way more. And that is what you get at Mooney & Associates. If you have been injured on the job, don’t go it alone. You can Count on Mooney. We can meet you in any one of our fifteen offices through Central Pennsylvania. Call for a FREE CONSULTATION today at 717-200-HELP.