Our client was physically threatened by a tenant by phone, text and in person resulting in post-traumatic stress disorder. The insurance carrier downplayed the injury and PTSD claimed that the panel qualified medical examiner’s reports were not persuasive. Our client’s prior lawyer agreed with the insurance carrier was ready to settle the case for less than $100,000.00. We advised KA that the offer was too low and that we recommended taking the deposition of the panel qualified medical examiner to defeat the defense arguments. KA followed our advice and we took over the case. Within a matter of months we effectively deposed the panel qualified medical examiner to bolster his opinions and pressed the case to trial. On the eve of trial the matter settled for $280,000.00.
Our client suffered a significant shoulder injury and underwent several surgeries by doctors selected by the insurance carriers and the surgeries were not very successful in restoring function. The insurance company offered to settle our client’s case for $75,000.00. We recommended that our client reject that he allows us to develop the evidence. He agreed and we developed both the medical evidence and the vocational rehabilitation evidence including the depositions of the treating doctors and the defense rehabilitation expert. That expert wrote in his report that our client was fully employable, but on cross-examination admitted that he had purposely omitted evidence of our client’s pain in his analysis and that if he included that evidence then our client was indeed likely not employable. The matter settled just before trial for $475,000.00.
People ex rel Alzayat v. Hebb, Sunline Transit Agency: In a case of first impression before the Court of Appeals we persuaded the Court that the Insurance Fraud Prevention Act liability extends to employers including public self-insured agencies and that the general litigation privilege does not immunize the fraud. We alleged that Hebb falsely denied that Alzayat has suffered and injury and made those false denial both in a written report and in a deposition. A courageous co-employee came forward and confirmed the injury event and workers’ compensation did pick up and pay the claim. Sunline claimed that government self-insured agencies could not be sued for workers’ compensation fraud and that any statements made, no matter how false, were privileged under the general litigation privilege and also subject to the exclusive remedy bar. The Court of Appeal rejected all of these contentions and ordered the opinion published. This case shows that bad actor employers can be held to account for falsely denying injury, falsely reporting wages, etc.
While lifting a box our client felt a sharp pain in his neck. The MRI revealed cord compression and our client should have been afforded immediate decompression surgery. Unfortunately Food 4 Less (Kroger) and its administrator Sedgwick insisted on returning our client to work. In fact, we uncovered an email that should the nurse case manager stating that although the doctor would likely not return him to work given the severity of symptoms the doctor should be persuaded to return him to work anyway. Our client’s prior lawyer selected this doctor and this doctor did return our client to work. Our client was frustrated and came to us and we immediately stepped in and secured surgery. The defense initially suggested a settlement of about $250,000.00 and we recommended rejection. It also claimed that the neck injury was really due to a prior dirt bike accident several years earlier, that there was a genetic defect component, or that this was not one injury but several which would have the effect of reducing the ultimate award. The Panel QME was deposed four times, the operating surgeon twice. We set the matter for trial as defense counsel would not respond to our requests to try and resolve the matter. On the day of trial Kroger Food 4 Less agreed to pay the full value of the case, about $2,500,000.00.
Our client, a journeyman plumber, suffered a cumulative injury over the years to his neck culminating in fusion surgery. His prior lawyer recommended a settlement of $165,000.00, which we recommended he reject because the evidence showed that additional surgery was need to fix a broken plate and we believed the offer to be too low. We secured that surgery which repaired the problem and settled the case for $465,000.00.
Our client underwent lumbar surgery and the result was not optimal. The defense insisted that the case rated out to no more than 28% disability and on that basis offered only $125,000.00 to settle the matter. We deposed the numerous doctors involved and secured a vocational rehabilitation expert report showing that our client’s pain profile due to the poor surgery prevented him from holding regular work. We settled the case for $525,000.00 shortly before trial.
Our client teacher tried to break up a fight and was punched and then her head hit the ground causing a fracture. School District consistently obstructed medical care including plastic surgery to repair the fracture near the eye and the nose. Our client’s rprio counsel did not secure that additional surgeries and treatment, but we did. The district offered $85,000.00 plus a resignation from the teaching position which our client rejected on our advice. Ultimately, our client was awarded full retirement, full medical care for her and her family and $450,000.00 to settle the workers’ compensation case.
The injured worker suffered third degree burns on his toros and legs and underwent lumbar surgery. He was injured when he was testing an underground pool heater which had been placed in an unventilated subterranean vault. Because of a lack of venting the gas accumulated and exploded during testing. The insurance carrier made a take it or leave it offer of $350,000.00, then $500,000.00 during trial. The jury returned a verdict of $6,750,000.00. Because of employer negligence the workers compensation lien has been wiped out and the workers compensation will also be obligated to contribute further.
The injured workers suffered cranial factures and partial blindness in one eye when the wheel from a hose cart separated when its tire was being inflated. The wheel was improperly designed and built by a Chinese manufacturer and it was then sold by a national hardware chain. One defendant settled for its insurance policy of $2,000,000.00. The other defendant offered $400,000.00 and the matter was prepared for trial. On the day of trial the second defendant also agreed to pay $2,000,000.00. The workers compensation carrier then waived all credit as the employer was also negligent and paid an additional $250,000.00, bringing the total gross recovery to $4,250,000.00.
Mr. C suffered a partial finger amputation that resulted in reflex sympathetic dystrophy or complex regional pain syndrome in the arm. Mr. C’s prior workers’ compensation lawyer recommended a settlement of $150,000. Mr. C thought this was inadequate and retained us. We settled the matter for $790,000.
Our client was kicked by a cow he was milking causing an arm injury. The employer denied that our client was disabled to any serious degree. After taking the deposition of the doctors involved and setting the matter for trial the insurer agreed to pay our client $500,000.
Mr. L’s prior counsel recommended a settlement of $100,000.00 after having the case for four years. Immediately upon being retained we secured an additional $14,000.00 of past temporary disability which prior counsel overlooked and then settled the matter for $460,000 within eighteen months.
Mr. G, a motorcyclist, contended he was cut off by JP and could not avoid rear-ending her car. Mr. G required shoulder arthroscopic surgery was a result. The insurer for JP denied liability contending Mr. G was speeding recklessly and that he caused the rear-end collision. The insurer was confident of its position because their expert was a former California Highway Patrol motorcycle officer and accident investigator. An offer of $20,000 was rejected on our advice. We obtained an award of $265,000.
Mr. R suffered and ankle injury when hit by a forklift. Defense offers began at $40,000 and rose to $75,000. Mr. R accepted our advice to reject these offers. The matter was set for trial and just before trial the case was settled for $265,000.
While driving the employer’s car Mrs. R was struck by a drunk driver and required arthroscopic shoulder surgery. The drunk driver’s insurance paid $15,000. PIC contending that the injury was not covered. The matter was settled for $250,000.
Our client suffered a low back injury and the defense offer was $35,000 and then at the deposition of a doctor the defense attorney stated that the new offer of $45,000 was final and not one penny more would be paid. The matter was settled at trial for $77,500.
Mr. R contended that even though he was called a manger and not paid overtime he was in reality a cook entitled to overtime. Employer contended that Mr. R was owed nothing because even though he may have been entitled to overtime he was paid on an agreed basis that included overtime. The matter was settled for $50,000.
Mr. C contended that he and his co-workers were owed overtime and meal pay. Employer contended that nothing was owed because the workers were managers and further that they had not worked overtime. The matter was resolved with Ms. C receiving $50,000 for his whistleblower fee and past wages and all his co-workers were also paid their past wages. The employer also paid our attorney fees.
Defendant denied that Mr. A was hurt as his job as his supervisor testified that no injury had occurred and that any back injuries were due to a prior automobile accident. We found co-workers that testified that the supervisor was untruthful in his reports. The matter was resolved in Mr. A’s favor for $40,000.
Plaintiff contended she was not paid for meal periods or overtime. Ultimately, Plaintiff was paid her past due wages with interest, a whistleblower fee for securing fines due the State of California, her co-workers were also paid their past due wages and the employer paid our attorney fees.
Defendant employer and its president owner denied ever having employer our client, Mr. S. They also denied, under oath, doing any construction business in the Palm Springs area. Through our investigation we located documents showing that the employer was being untruthful including construction invoices, cancelled checks, contracts, photos and other witnesses. The employer’s insurance carrier accepted and settled the claim and we turned over our investigatory materials to the District Attorney. The employer was charged with multiple felonies based on our investigation.
The above cases are examples only and you should not make any inference about the outcome of your case and each case is unique and dependent on its own facts.
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