I’m Brian Wiklendt with Garfinkel Schwartz. I’m here in Maitland Florida in our office and I’m coming to you today to talk to you about 3 DBA Cases 3 different outcomes in recent client developments.
3 DBA Cases 3 Different Outcomes
These are cases that happened in the firm with clients just to give you an idea as to how different cases work and progress: how long some of them take, how short some of them are so that you can have the patience and wherewithal to get the benefits you deserve.
Cases Can Take Years or Months
Sometimes they take years. Sometimes they take months. But there are three different examples that I have that happened recently.
The first example is what’s called a stipulation. We have a client who suffered from PTSD. He still does. Was involved in an IED explosion in Afghanistan. His claim was denied because he didn’t properly notice the insurance company according to them.
We went through some independent medical evaluations that we did on our own. They went through an independent medical evaluation that they did.
What basically happened was in lieu of going to trial we entered into stipulations that are signed by the Department of Labor that basically stated that yes the insurance company has now decided and agreed to pick up that person’s claim.
When I say pick up we mean accept that person’s claim and what that person got was a lump sum of the past compensation that was due from the last time he was paid. They have to pay for his future and past medical expenses going forward and they have to pay what his compensation rate is every two weeks indefinitely until something else happens in the case.
So that stipulation basically says that they’re going to accept the claim in lieu of us going to a trial with a judge. So that case that case is now standing before the Department of Labor just being monitored by us to determine what’s going to happen to him in the future because as of right now he cannot work and he’s seeking treatment from a psychiatrist and a psychologist that the insurance company finally has agreed to pay for.
Go to a Formal Hearing
Second another issue happened where we actually had to go to a formal hearing which we sometimes call a trial just because lawyers call it a trial. It’s the last thing you do in litigation but technically it’s a formal hearing with an administrative law judge and those can happen anywhere in the country pretty much. What happened there was after two and a half years of fighting and we to have to go through the entire litigation process… depositions were taken.
This case was denied based on an independent medical exam that said that this person a longshoreman could go back to work to active duty even though his back in our opinion was still injured. That doctor decided that he didn’t think the interpretation of the actual MRI was correct and he wanted to issue his own interpretation that went against both the treating physician and the radiologist that did the MRI and that’s what they held their hats on for two and a half years.
So that particular client didn’t get paid for two and a half years. He did go back to work at some point but we went through the entire formal hearing process. Luckily we won.
That was in Miami and what the judge ordered basically was the same thing that I talked in the stipulations. He was paid his past compensation. He was paid his past and future medical expenses for his back and whatever other residual earning capacity he may be entitled to every two weeks which could be zero or it could be a large number depending on what kind of work he can do now and he is back to work. So there is going to be a fraction of that money that goes to him every two weeks until something changes.
At Maximum Medical Improvement
Number three recently that happened was what happens a lot of times. Once a person gets to maximum medical improvement meaning they’re not going to be able to get any better than they are right now the insurance company does labor market surveys and things like that to determine what type of job a person can do if any.
Client May Have to Get a Job
Some of my clients actually get jobs but they get lower paying jobs that they can get overseas because physically and mentally they might not be able to go back into a warzone. That’s what called a lack of earning capacity.
Once a case gets to that stage this particular one was going on for over ten years in our firm. That person was getting paid every two weeks. We got to that point in time and we got to the stipulation stage and over this last maybe four or five years he’s been treated for various different orthopedic injuries and now he’s at the stage where he’s at maximum medical improvement.
Well that means then both parties can then calculate what we think the value of his lump sum settlement claim should be. So what happens then is you set up a mediation or you negotiate over the phone and try to come up with a lump sum figure to close the file out forever and in this particular matter this person was again he was a police mentor.
He was in a bunker. He jumped into a bunker and he suffered from a lot of physical injuries to his neck and his back and he also had PTSD so that’s three different things.
Claim is Settled and Closed
Once a stage happens where everyone can reasonably understand what this person’s lot in life is whether they can work again whether they can just do a desk job whether they can go back to active duty at a certain point that’s when we can evaluate the claim and get a lump sum done and that was done just here recently with a guy a very nice guy and he was happy.
The insurance company was happy and his claim is closed forever. He has a nice large lump sum of money to live on and he doesn’t have to worry about the insurance company denying medications here and there forgetting to do prescriptions getting his checks late.
All those kinds of hassles he doesn’t have to worry about anymore because he has the money in his own pocket and he can protect his own family with that money so a lot of times it’s in the best interest of all parties to get the case done in a lump sum.
So just in summary the things that I just wanted to try to have you understand is those three things happened very recently stipulation a trial and a trial result a formal hearing and a lump sum settlement.
So those are the three different that we strive for as your attorney representing claimants in these types of cases. If you have any other questions like that regarding any of this stuff please call me any time. I’m basically available for free any time to talk so don’t hesitate and I hope you learned something from this. I appreciate you listening. Thanks.