MORE THAN A SETTLEMENT How We Won Medical Treatment for Our Client
Good News Rob requested another hearing, where he presented evidence to a workers’ compensation commissioner, showing why the surgeon recommended the operation. The surgery was not experimental; the only other option would lead to a full knee replacement at too early an age. In short, prompt treatment would give our client a better chance of regaining and preserving mobility. insurance company refused to provide care. She came to Rob, who convinced the insurance company that she needed her left knee treated as well. This case shows how aggressive workers’ compensation insurance companies can be in denying treatments so they can inflate their own profit margins. Several months later, the insurance company again denied treatment by refusing to pay for an operation recommended by the surgeon the insurance company selected. The insurance company claimed it shouldn’t pay because Medicare deemed the surgery experimental. Our client got hurt at work when she slipped on gravel at The Charles Lea Center’s basketball court in Spartanburg. In fact, she tore a right knee ligament — her ACL. The employer’s workers’ compensation insurance company paid for her initial treatment. But three years later, her right knee injury caused problems with her left knee, and the
At that point, the insurance company likely revealed the true reason for its denial: The procedure just cost too much. Rob overcame the insurance company’s arguments by pointing out that the overriding purpose of the workers’ compensation system is to reduce disability and achieve relief or a cure for work injuries. The law does not allow an employer or insurance company to dictate medical treatment. The commissioner concluded that denying the recommended surgery could potentially increase and prolong disability — by forcing our client into a knee replacement too early — and ordered that the insurance company pay for it. This case also shows how devastating some work injuries can be. As a result of her work accident, our client had seven knee surgeries in six years. We ultimately settled her case for $49,156.30, the rest of the money benefits she could get under workers’ compensation. But most importantly, the insurance company agreed to pay for all future medical care for both knees, which is especially vital since the surgeon virtually assured her she’ll likely need at least one of them replaced. This result is specific to the facts and law of that client’s case. Any result for a prior client does not necessarily indicate similar results can be obtained for other clients.
Healthier, Lighter Deviled Eggs
“In your anger do not sin. Do not let the sun go down while you are still angry, and do not give the
Inspired by LiveEatLearn.com
Ingredients
• 6 large eggs • 3 tbsp Greek yogurt • 1 tsp Dijon mustard
• 1 tsp lemon juice • Optional: Hot sauce, to taste • Optional: Paprika and chives, chopped, for garnish
devil a foothold.” Ephesians 4.26-27
Directions 1. In a large pot, add eggs and cover with water. Put on high heat, and then boil eggs for 10 minutes. 2. Once boiled, peel eggs by gently tapping and removing the shell. (Adding the eggs to an ice bath after boiling can make this task easier.) 3. Cut eggs lengthwise and place yolks into a medium mixing bowl. Set egg white halves open side up on a plate. 4. In a bowl, combine yolks, yogurt, mustard, lemon juice, and hot sauce (if desired) until smooth. 5. Transfer the yolk mixture into the egg white halves. Garnish with paprika and chives if desired.
“A new command I give you: Love one another. As I have loved you, so you must love one another.” John 13:34
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