GWB Defends Workers’ Compensation Claim While Claimant on the Golf Course
The claimant alleged injuries to the right leg (knee), left arm (elbow), and left leg (knee – overcompensation) after having fallen in an unwitnessed incident. Initially, the claim was admitted for the right knee and left elbow. However, after the claim was referred to defense counsel and additional investigation was conducted, the claim was subsequently denied for the following reasons:
- the event was unwitnessed
- the claimant had filed for bankruptcy several days prior to the alleged accident
- the claimant’s wife had filed a claim for an unwitnessed accident with the same insured several days after his alleged accident
- although being incapable of work, evidence indicated the claimant continued to play golf
- an evaluation of past medical records indicated a history of the treatment for identical symptoms/diagnoses, specifically treatment for a prior diagnosis of lateral epicondylitis
In light of this information, counsel recommended and subsequently conducted the deposition of the treating physician. Following an extensive examination of the physician, he ultimately confirmed that the he could not causally relate the claimant’s alleged injuries to a workplace accident.
Prior to defense involvement, the carrier had paid in excess of $19,000.00 in indemnity and medical benefits. As a direct result of the evidence obtained by defense counsel, which potentially subjected the claimant to a fraud claim, defendants were able to leverage a $100.00 settlement. This settlement fully and finally resolved the claim, eliminated ongoing and future indemnity and medical exposure, and mitigated litigation costs associated with defending the matter before the South Carolina Workers’ Compensation Commission.
Past results and testimonials from clients are not to be taken as a representation that the same or similar results can be obtained by the firm in the future.