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Carrier denied medical treatment claims for injured worker – $580,000 Settlement

Claimant was injured in a work accident that occurred on May 12, 2008.  The claimant was injured when he slipped and fell on a slippery floor at work, landing on his back and striking his head resulting in an injury to his neck. Although the claim was originally accepted, after the insurance carrier conducted surveillance of the claimant, the carrier filed a motion to stop the claimant’s check. Claimant’s counsel was then hired. Eventually, the parties conducted a mediation whereby the indemnity portion of the case was settled in September 2010 for $80,000.  The claimant returned to work with the original employer and continued to work there up until the time the employer closed in July 2014.

Immediately following settlement of the wage/indemnity portion of the case, the carrier began denying all medical treatment on the claim. This tactic continued for the next three years off and on, resulting in repeated hearing and appeals before the Virginia Workers’ Compensation Commission. The claimant prevailed at every hearing, successfully winning claims for specialized treatment that included Botox injections to his neck and his claim for Viagra, which was a consequence of his back injury.

Ultimately, the carrier was forced to expend in excess of $302,000 on medical treatment of the claimant by the time of settlement. Because of the covered future medical costs, the medical portion of the claim was ultimately settled for an additional $500,000. Accordingly, the full value and combined settlements was $580,000, and the total benefits received including settlement proceeds was approximately $900,000.



Type of action: Workers’ compensation
Injuries alleged: Neck, cervical spondylosis, neuralgia, left cervical radiculitis
Court: Virginia Workers’ Compensation Commission
Date resolved: November 2014
Verdict or settlement: Settlement
Amount: $580,000
Attorney for plaintiff: Stephen T. Harper, Richmond

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