AccuMed Blog

Case Spotlight: Work Comp Meets Personal Injury

May 04, 2017

Case Background: The plaintiff, a 25 year old solar panel installer, was a passenger in a low speed collision while at a stop sign. Rear bumper damage was $1,150 and no damage was reported to Defendant’s vehicle. Plaintiff was working at the time so he initiated conservative treatment for neck and shoulder pain at the workers’ compensation clinic. Injuries did not resolve and he developed severe contractures of his right shoulder and upper back. Continued treatment yielded no results and plaintiff eventually became addicted to pain medication and totally disabled. Workers’ comp bills swelled to $206,000 with significant future care needs. A civil case was pursued against the at-fault driver.

Challenges: Cased involved a low speed collision that resulted in a total disability in a conservative court district. Defendant asserted he was covered by a commercial garage policy of $1,000,000 but insurer proceeded under a reservations of rights based on a dispute as to whether the Defendant was in fact doing business at the time of the incident.

The Insurer hired an IME and was prepared to argue at trial that the array of injuries alleged by Plaintiff were unrealistic, not medically consistent, not causally related to the collision, and the incident was not covered under the Defendant’s policy.

Solutions: Plaintiff’s attorney leveraged the ongoing workers’ compensation claim to defang the Defense’s position. First, Plaintiff’s counsel opted not to retain its own IME, instead relying on the Agreed Medical Examiners from the workers’ comp system. Although AME’s are not typically trial seasoned, they are indisputably unbiased and their opinions would likely be received, even by a conservative jury, as neutral.

Additionally, Plaintiff’s attorney pushed for global mediation – which included the subrogation attorney for the workers’ comp lien of $206,000 – in order to ensure the Plaintiff wouldn’t be left with a lien that’s larger than the settlement. This also protected against a low causation verdict in a jury trial.

Outcome: After 6 hours of mediation, the Defense agreed to pay $637,500 to the Plaintiff. The Plaintiff agreed to pay off the workers’ compensation lien for $88,000 and structured the remaining settlement distribution to eliminate any future credit rights. This left Plaintiff free to pursue a $2,000,000 permanent life time disability and medical award in a claimant friendly Worker’s Compensation Court.

Credits: John Skeath of the Law Offices of John E. Skeath

Contact Info:
John Skeath
(408) 296-0900

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