Case Conclusion Date: 06.10.2010
Practice Area: Workers Compensation
Outcome: We won. The injured worker was awarded medical care with a new doctor he chose, who helped him to recover and get back to work.
Description: Mr. C injured his shoulder when he fell onto the tarmac at the airport. The case was accepted, but after surgery Mr. C was still having pain. The insurance adjuster sent Mr. C to a well-qualified doctor for a second opinion, but that doctor felt that nothing was wrong with his shoulder that required treatment. Mr. C was dissatisfied with this opinion so he saw another surgeon on his own. That surgeon felt that another procedure would help to relieve his pain so that he could do his job without pain in the future. But the insurance adjuster refused to let Mr. C be treated by this new doctor who had a treatment plan. We went to a hearing to force US Airways to allow Mr. C to be treated by the doctor of his choice. In June 2010, the Deputy Commissioner ruled in Mr. C's favor, and he was treated successfully by the doctor who believed that he would be able to help him. The insurance company was required to pay for the successful treatment, rather than the pay nothing for non-treatment as recommended by the adjuster's doctor. The decision is posted on the Industrial Commission website in the Livelink section. NCIC case # 894452