After Denial of Benefits, Construction Supervisor Wins Case in DC

Construction Supervisors Wins Everything After Workers Comp Insurance Denies Benefits in DC

When you have a DC workers comp case, after you get hurt at work in DC or most of your work is done there, there are lots of reasons for the workers comp insurance to deny your claim - they say they are investigating it, they don't believe you, they say they don't have enough info, etc.

Most of the time, these are bogus reasons.  But the question is what do you do about it?  

We're pretty aggressive here - we request a Formal Hearing right away.  You see, we know there is a lot of delay built into the system.  We also know that with our track record, the best chance of getting your benefits paid is when we get close to a hearing in court - when they see how prepared we are and know our reputation, we can often get them to do the right thing even before we get to court.  

You can request an informal conference as well.  And a lot of lawyers do.  I think that just adds delay and is a big mistake - and I cover this in my book on workers comp.

We had several issues to prove in this case - it was clear that the insurance company didn't believe our construction supervisor, because the doctor's notes (which all said he got hurt at work) were a little different in the description of the accident - he was painting when he fell from a ladder and hurt his back - but the doctor's notes sometimes said he was painting and didn't mention the fall from the ladder until a couple of months into the treatment.

Here's a tip - look at your doctor's notes after a work injury and make sure he has it right and describes how you got hurt (let's face it, doctors aren't the best listeners).

Make Sure You're Getting Paid the Right Amount 

Plus, this man had 2 jobs, so he was entitled to "wage stacking" in DC.  That means we could add the income from the job he got hurt on to the income from his second job and his workers comp benefits would be based on the total - something the workers comp insurance company didn't agree with because they would have to pay him more. 

Our client did a great job at the hearing when he testified.  We prepared everything, all of his testimony, practiced questions and explained what to expect in court - and he absolutely crushed it.  It was clear from the decision that the judge believed him and relied on his testimony.

Here's a copy of the full DC workers comp decision.

Finally, since the insurance company didn't file what they were supposed to when they denied the claim (they filed this late) we were able to hit them with a penalty as well.  Here's the last page of the decision and we have the entire decision (with our client's name removed) above. 

 

Have you had your workers comp benefits been denied?

Don't worry - that's not the end of your story. Give us a call today at 202-393-3320 and you will speak to a real person today who wants to help.  

Confidential