Complex Injury Cases

About Complex Injuries

A workplace accident that causes more than one injury to the victim can result in a complex injury case. In our 30 years helping our friends and neighbors in the Coachella Valley, we have seen many such cases. For example, if you are a roofer, you may have fallen from a ladder and sustained not only a broken arm but also a brain injury and ruptured disc in your back. If you work in a restaurant kitchen, you may have suffered a burn, but also a torn shoulder rotator cuff trying to put out a kitchen fire. Multiple injury components often are not palatable to insurance carriers and they try and ignore the multiple injury components.

Overcompensation Issues

A second injury might also occur if you overcompensated for the first. Perhaps you injured your left shoulder in an incident that required heavy lifting. You compensated by overusing your right shoulder and in a short period of time, that shoulder also became injured. Or, you had knee surgery and during recovery you stumbled and fell and fractured your shoulder trying to break your fall. This is known as a compensable consequence injury. As a matter of law workers’ compensation benefits are available for the first injury and for the second, too. However, insurance companies almost always deny over-compensation injuries and compensable consequence injuries. And, high volume firms are often too overtaxed to pay much attention to overcompensation and compensable consequence injuries.

Damage to the Nervous System

A fractured bone or soft tissue injury, even a sprained or strained muscle, can result in damage to the nervous system, an issue that should be treated as soon as possible to avoid permanent harm. Nerves are vitally important in relaying messages from the brain to various parts of the body. Any kind of disruption to this system can be debilitating. Complex injuries that include nerve damage can develop from a variety of mechanisms:

• Penetrating injuries
• Falls from heights
• Electrocution
• Machinery accidents
• Crushing injuries
• Repetitive motion injuries
• Toxic substance exposure

A Look at Insurance Company Response

Complex injury cases often qualify for lifetime benefits. Because that is the worst possible result for an insurance company its team will fight once they realize where the case may be going. So, in nay serious complex you must have an attorney experienced in such cases who can build a strong case from the outset and can cut off defense tactics. That exercise regularly includes securing critical testimony from treating physicians. High volume firms, generally those that advertise on television, simply do not have the resources to handle serious complex cases.

Deposing doctors effectively requires preparation, skill and most of all experience. Most workers’ compensation firms, whether representing for injured workers or insurance carriers, simply do not have those assets in adequate supply. Defense attorneys, judges, insurance adjusters have all at one time or another commented that our examination of physicians is some of the finest they have seen.

One thing you need to keep in mind that is that insurance company is not there to help you, no matter what promises may have been made by a charming claims examiner early in the case. The insurance company is motivated only by money and is not looking at your case for what is the best result. A typical insurance carrier handles hundreds of thousands of claims a year and applies a template to claims handling. If it can delay benefits, frustrate injured workers or delay care a good many of those injured workers simply give up adding tens of millions to that insurance company’s profits. Your case is viewed from that perspective until it gets noticed by senior management because it is becoming scary. So, it is important to hire superior workers’ compensation counsel as early as you can in a serious complex case.

An Overwhelming Process

Insurance companies have accepted standards to follow and they retain teams of lawyers to protect their interests. These insurers can be tough to deal with, but remember that you do not have to face them alone. We have more than 30 years of experience in helping injured employees throughout the Coachella Valley get the workers’ compensation benefits they deserve — and we can help you, too. If you feel overwhelmed by the whole process of applying for benefits, or if your complex injury claim has already been denied, we will work diligently on your behalf to obtain the maximum benefits to which you are entitled. But, do not delay. The time to start building a case for trial in a serious complex case is right after the injury, not after months or years of denials of benefits and care.