A recent news article tells the story of a severely injured worker in Florida. It’s an all too familiar story. It’s a common story we frequently see in cases across Alabama.
What happened? A sudden workplace explosion! An employee badly injured and badly burned. Days and nights in the hospital followed.
Life after the hospital is often difficult for injured workers seeking treatment. The worker and his or her family are often left trying to navigate a maze of doctors, case nurses and insurance adjusters. For many injured workers the process is beyond frustrating.
What should be simple is made complex by adjusters who deny, delay and ignore treatment requests. That’s exactly what happened to the worker in this news article. While the insurance company in the case of the Florida worker paid for his hospitalization, it left him in the cold for many of his injuries.
In our cases, we believe family members can be strong advocates with the insurers. The injured Florida employee’s wife is a powerful witness. She spent 10 days and nights in the hospital by her husband’s side. She claims the insurance company Travelers continually denied treatment for his injured back and his traumatic brain injury (TBI). At our office, we also frequently see it — Insurers treat the obvious visible injuries (like burns) but ignore the others (like the back and brain). The reason why is obvious and the reporter tells us:
If there is no TBI to treat, that means less doctor bills for Travelers to pay as well as less in disability compensation.
In the Florida case, the wife is not the only one begging the insurance company for treatment. A psychologist who also saw the injured worker had this to say:
His is truly a traumatic and damaging experience.
The psychologist found classic signs of TBI and PTSD. He recommended evaluation and treatment. Travelers went beyond a denial. It also refused to allow additional visits with this psychologist. A second doctor also recommended TBI testing. Again, Travelers refused.
I recently went to trial in a similar case. In my northern Alabama case, the injured worker fell from a tanker truck in Decatur severely injuring his shoulder. He underwent surgical efforts to repair the horrible injury. He subsequently developed Chronic Regional Pain Syndrome (or RSD – Reflex Sympathy Dystrophy) from the injury. If you are not familiar with RSD, it’s a horribly debilitating condition. You can read more about it in a prior post I wrote titled Chronic Regional Pain Syndrome Is A Devastating Injury. Imagine feeling like you are on fire, constantly without end. RSD can be devastating. In my case, the employer tried to deny necessary treatment to control and manage the disability. And, when the worker needed psychological care because of his severe pain, the carrier simply ignored requests. Both of my client’s treating physicians testified the psychological care was necessary. Rather than provide it, the carrier even refused to pay already incurred medical bills. We went to trial. We won. But, we should not have needed to fight that issue. The carrier should have provided the care without a fight.
Why do workers comp insurance carriers deny necessary care? Why do these carriers ignore injuries? Why did the carrier in the Florida case ignore a serious TBI? The reporter who wrote of the Florida worker summed it up — “If there is no TBI to treat, that means less doctor bills for Travelers to pay as well as less in disability compensation.”
If the work carrier ignores treatment, it saves money on medical costs and disability payments. Keep in mind — Those costs do NOT disappear. Somebody pays. The insurance company that collected premiums promising to pay may save. The worker, his family and his community pick up the tab. It’s a huge tab! We all suffer (and we all pay the price) when work comp carriers ignore serious injuries and disabilities. The Alabama Legislature needs to examine this issue and strengthen enforcement for the benefit of our workers.
At the Blackwell Law Firm, we represent injured workers in Alabama. We have tried cases in counties across Alabama. If you have questions, give us a call. Consultations are always free and confidential.