5 Essential Facts to Know When Filing a Workers Compensation ClaimAugust 2, 2017
When a worker sustains an on-the-job injury, by law,1 that injured worker should generally be entitled to compensation for his medical treatments and lost wages.
In practice, however, it can be very challenging for injured workers to obtain these recoveries. This is largely due to the fact that employers and their insurance companies are commonly focused on protecting profits – even if that comes at the expense of justice and the injured worker.
A recent Texas case, Amigos Meat Distributors, L.P. v. Guzman, exemplifies these challenges. It also holds some essential lessons and takeaways for injured workers who may be preparing to move forward these claims.
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The Case: Brief Background
The plaintiff injured his back in May 2011 while working for Amigos Meat Distributors, L.P. Although Amigos initially agreed to pay for the plaintiff’s medical treatments, it stopped covering these costs after about three months when surveillance of the plaintiff showed him carrying a laundry basket.
The claim eventually went to trial, at the end of which the jury awarded the plaintiff $287,809.94. Amigos appealed this verdict, challenging the medical expenses and alleging that the plaintiff’s lawyers conducted “improper questioning and argument,” resulting in incurable error.
Though the court has yet to issue a ruling on the appeal, this case holds some important insights for workers seeking fair and just compensation for their on-the-job injuries.
The Takeaways: Important Insights for Injured Workers
- Invasive (& possibly unethical) tactics can be used to try to dispute a worker’s injuries – Even if an employer is willing to agree that an injury occurred at work, an injured worker can still be the subject of surveillance in an attempt to dispute the existence or severity of the injury. This surveillance can persist for days, even weeks. It can involve private investigators following injured workers, cameras set up outside of homes and other invasive tactics.
- The bottom line: After reporting a work injury, expect to be watched, followed and/or surveilled. Follow doctor’s orders. Don’t engage in any activities specifically restricted by a doctor. The above case shows how something as simple as carrying a basket of laundry can be enough leverage for disputing a worker’s injury.
- Beware of the “pre-existing injury” argument – This is another common tactic employers and insurers can use to try to avoid paying injured workers. It’s important to be aware that, if a work injury exacerbates a pre-existing injury, treatment for the injury should still be covered by the employer and insurer.
- The bottom line: Medical records and physician’s expert testimony can be essential to proving the presence of a new injury, including injuries that intensify, complicate or exacerbate a pre-existing condition.
- Even if the injury is not disputed, the cost of treatment can be – In the case described above, the defendant tried to argue that the medical costs were inflated and that medical expenses not directly paid to health care providers should not have been included in the verdict. The fact, however, that the plaintiff was still considered liable for these medical expenses subverts the defendant’s claim.
- The bottom line: Even if both parties agree that a work-related injury exists (and even if there’s an agreement regarding the severity of that injury), employers and insurers can challenge the costs of treatment. They may even argue that certain treatments were unnecessary in an attempt to minimize payouts to injured workers.
- A favorable verdict for a plaintiff may not be the last word in a case – Employers and insurers commonly have the resources and motivation to appeal verdicts in favor of injured workers. This can mean that some cases (like the one described above) can take years to resolve. Prolonging the resolution of cases can, itself, be a tactic used by the defense to avoid making payouts, exacerbate a plaintiff’s financial stresses, etc.
- The bottom line: The struggle for justice and compensation doesn’t necessarily end with the culmination of trial.
- Having the representation of an experienced lawyer can be pivotal to a successful outcome – A lawyer can protect an injured worker’s rights and effectively challenge the tactics and arguments employers and insurers use to avoid paying injured workers the compensation they deserve.
- The bottom line: You don’t have to stand up to an employer or insurance company on your own. Retain an experienced attorney – like a lawyer at the Amaro Law Firm – to be sure that your rights, interests, claim and recovery are fully protected. It can make all the difference in the success of your claim.
With experience in insurance defense, the attorneys at the Amaro Law Firm know exactly how the insurance business works, what strategies these companies use and how to effectively combat them.
Position Your Claim for Success: Contact a Houston Work Injury Lawyer at the Amaro Law Firm
If you or a loved one has been hurt at work, contact a Houston work injury lawyer at the Amaro Law Firm for clear answers and helpful advice regarding your rights and recovery options.
Call (877) 892-2797 or email our firm to set up a free consultation and get the information that can make all of the difference in the success of your claim. We provide virtual consultations, and we can travel to meet you if you are unable to visit our office.
With extensive experience representing injured workers, our attorneys have the skills, resources and knowledge to protect your rights and interests in any legal setting. We are ready to help you move forward with a potential claim and position it for the best possible outcome.
1: According to Texas (and other states’) workers compensation laws