The claimant, H.S., sustained an injury while performing work for a large national retailer. H.S. sustained an injury to his left knee and underwent multiple surgeries. The initial fight was whether a knee replacement that was recommended would be authorized.
Pothitakis Law Firm was successful in obtaining authorization by the insurance company for the knee replacement. While recovering from the multiple knee surgeries, H.S. began having back problems. He had been limping on his bad knee for a couple of years when his back pain became excruciating. The insurance company took the position that the back pain had nothing to do with the left knee injury and that benefits would not be provided for the low-back condition. Pothitakis Law Firm investigated the matter further and talked to H.S.'s doctors about the relationship between his left knee injury and his low back. Pothitakis Law Firm was able to obtain an opinion from the doctors that the claimant's low-back pain would now be permanent because of the length of time he had limped on his left leg.
The importance of including the low-back condition in the claim is based upon the complexities of the workers' compensation system and limitations as it relates to leg injuries. Under Iowa Workers' Compensation laws, one of the benefits that an injured employee is able to receive is permanent partial disability benefits. If the injury is to a hand, arm, foot, or leg, the amount that a person receives is based upon the loss of use of that body part. This is typically calculated based upon an impairment rating from the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition. This calculation results in a very limited amount of money and has no relationship to how the injury affects the person's ability to work.
If the permanent injury is beyond the hand, arm, foot, or leg, the calculation of benefits is them based on how the injury affects the person's ability to earn a living. For H.S., it was imperative to connect his back condition to his leg injury, as he was significantly limited in terms of returning to his prior employment because of both his leg and back condition. If the injury had been limited to the claimant's leg, he would be entitled to approximately $35,000 in total for his permanency benefits. Based upon the work of the Pothitakis Law Firm, we were able to obtain medical evidence supporting an injury beyond the leg, resulting in benefits in excess of $200,000.
When analyzing a worker's compensation case, it is very important for a law firm to explore all possible avenues to enhance the value of a claim. If one simply had concluded this were a leg injury, the recovery for the claimant would have been minimal.