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.
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
- Machinery accidents
- Crushing injuries
- Repetitive motion injuries
- Toxic substance exposure
Complex Regional Pain Syndrome (CRPS) or Regional Sympathetic Dystrophy (RSD)
CRPS or RSD is one example of nerve damage that can have long-lasting effects. Usually caused by a traumatic event, this is a dysfunction that causes the nervous system to send faulty or misconstrued signals to the brain. As a result, patients may experience severe chronic pain. CRPS and RSD are difficult diagnosis to establish and often it requires careful depositions of the treating physicians. Patients are frustrated because while there are in severe chronic pain, no one is making the proper diagnosis.
A Different Take
If nerve damage like CRPS and similar types is severe, you may not be able to work, and you would need workers’ compensation benefits probably for your entire lifetime. However, the insurance company will resist. So, hiring counsel experienced with complex cases who can properly prepare the case for trial is what is required. At English Lloyd & Armenta, we have considerable experience in prosecuting serious complex cases that involve brain injuries, nerve damage and CRPS or RSD diagnoses.
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.
In the state of California, five benefits are available for employees who have work-related injuries:
- Medical benefits
- Permanent disability benefits, which are paid on a sliding scale
- Temporary disability benefits, meaning wage replacement
- Supplemental job displacement, which refers to job retraining
- Death benefits, available to surviving spouses and dependent children
Your Rights and Responsibilities
At English Lloyd & Armenta, we offer a free consultation. We will help you understand your rights, what you are legally entitled to under California law and what your workers’ compensation claim is worth. Keep in mind that it is your right to see any doctor listed in an insurance company’s medical provider network, and your right to make decisions about your own care based on all available information. We accept the responsibility of defending your rights and helping you obtain full and fair compensation.
Even if you already have a lawyer, we can help. We specialize in serious work injury cases and our results speak for themselves, so please visit that page and check out our reviews. You will only ever pay one fee in a workers’ compensation case if you switch lawyers, so feel free to call for a free consultation.
If you were injured do not be afraid, arm yourself with education so you can make good decisions about your future. We are here to help and have been in the Coachella Valley for 30 years. We have a reputation as tough advocates for our clients and that is why judges, defense attorneys and even claims examiners regularly refer their friends and loved ones to us for their serious work injuries. Call for a free consultation.
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