Case Studies: Worker’s Compensation

Sample Workers Compensation Cases

Listed below are some examples of specific cases that we have handled at Guest & Brady, LLC.
Disclaimer: It is very important to understand that the results of each case vary according to the specific facts related to that case. No two cases are the same. There are no guarantees as to specific results in any case and no potential client should have a specific expectation in terms of dollar amounts or specific results. We do promise to work diligently and to be an advocate for you in a process that sometimes can be overwhelming to injured workers dealing with their injuries in a process that is totally foreign to them and for which they may not have had any previous experience.

Case One:

Worker injured discs in her back while working in an office environment. She received medical care including a back fusion surgery for which the insurance company paid. Worker was receiving weekly payments while out of work. The worker felt as though she was being treated fairly. When she finished her medical treatment the insurance company offered an amount for settlement of about $17,000.00 for her resulting disability.  That amount just did not seem right.

She called for a free consultation with us. After hearing her story it became clear that the insurance company was attempting to get the worker to settle for far less than she was entitled.  In working as her advocate, we determined that the worker had been paid less per each week while out of work than what she was entitled to receive. Also, the doctor’s impairment ratings (critical to a worker’s compensation case) were inaccurate.  We sat down with the doctor to determine the appropriate rating. The insurance company had not presented the appropriate questions to the doctor in obtaining the ratings. The insurance company was not advocating for the injured worker. In offering their original settlement amount, the insurance company did not appropriately consider the worker’s continuing health care issues related to the work injury. They did not inform the worker of what all they had failed to consider.  They were hoping that the worker’s lack of understanding about the system would work in the insurance company’s favor. The insurance company fought the injured worker’s claim for additional compensation all the way but in the end wound up paying $130,000.00 to the injured worker. After paying the attorney’s fee and costs, this worker increased her compensation dramatically over what she almost accepted from the “trusting” insurance company, and she continues her employment today.

Case Two:

Construction worker fractured his arm while at work. Employer says to worker “We will take care of you, but don’t you tell them at the hospital that you hurt yourself at work just tell them that you hurt yourself playing a sport.” So the trusting worker takes the employer at his word and fearing the loss of his job tells the hospital that he injured himself playing ball.  As the injured worker was recovering, he realizes that the employer is not “taking care of him.” He is receiving no weekly compensation, no one is paying his hospital bills and he has no means to support himself and his family. He comes to us for advice.

This case presented a challenge to us, because the client’s medical records all indicated a sporting accident as opposed to a work accident. We went to work finding witnesses, issuing subpoenas and obtaining depositions that would hold up in court of the exact circumstances surrounding the accident. In the end, this worker’s complete medical bills, weekly compensation and disability award were paid by the employer and its insurance company. This worker is now back at work with a different but better employer and making more money.

Case Three: Worker is traveling to a doctor’s appointment for a previous injury at work. She is rear-ended while turning into the doctor’s office and receives significant injury to her back. Employer denies her of any benefits from workers compensation. She is forced to file any and all medical treatment on her health insurance and to file for short term disability. As she attempts to recover compensation from the at fault driver, her health insurance and short term disability insurance step in and say that they want to be reimbursed from anything that the at fault driver’s insurance pays in this accident. Well this seems only fair, however it comes to light that the employer is self insured for the health insurance and the short term disability; they want all their monies paid out to be reimbursed and they refuse to negotiate in the reduction of their lien with the at-fault driver’s insurance. This put the injured worker in a terrible circumstance because with the limited amount of auto insurance available, the injured worker was going to receive very little after reimbursement to the employer and the employer was unyielding.She came to us for advice. This is where an attorney with an understanding of the worker’s compensation law can make a big difference for an injured worker. The staff at the employer were unaware of recent South Carolina Supreme Court cases deciding that when a worker is injured going or coming from a medical appointment related to work that the injured worker does in fact have a claim for benefits under worker’s compensation. After filing a claim on behalf of the injured worker with the Workers Compensation Commission, we entered into intensive negotiations with the employer’s defense attorneys and also with the at fault driver’s insurance company.  In the end, we were able to successfully resolve this case for the client. She received far more compensation than she would have otherwise and the employer dramatically reduced their demand for reimbursement of their liens. The client continued to work for the same employer at the conclusion of her claim.