GC was employed by a manufacturer in northwest Iowa. He had been a welder for 20 years. In late 2012 he sustained an injury to his low back while lifting sheets of steel. Although he hoped that his condition would simply get better, it did not and ultimately he needed to seek medical care. The claimant was finally sent for a surgical opinion and was told that he needed a low back surgery. This took place in 2014. Unfortunately, the initial surgery did not eliminate GC’s pain and discomfort and he had to undergo an additional surgery in 2015. This surgery was a fusion where plates and screws were placed in the back to stabilize the spine. Again, the second surgery did not elevate the claimant’s pain and the doctor determined in 2017 that some of the hardware had to be removed from the claimant’s low back.
Complicating the matter was the fact that the claimant had a pre-existing medical condition that made him more susceptible to injury. Although the insurance company contended that this somehow would limit or affect GC’s entitlement to benefits, the Pothitakis Law Firm obtain medical opinions that supported the findings that GC’s injury was a result of the work related injury. The Pothitakis Law Firm obtained multiple medical reports from the physicians supporting the finding that the claimant’s condition was work related, was permanent, and would result in lifelong difficulties for GC. The Pothitakis Law Firm sent the claimant for an independent medical exam with another physician to obtain opinions concerning permanency, restrictions, and recommendations for further care.
The claim was filed by the Pothitakis Law Firm in the summer of 2017. In the summer of 2018, the claim was scheduled for hearing. Prior to hearing, the Pothitakis Law Firm met with and had discussions with the insurance carrier concerning the claim. The insurance carrier continued to argue that the claim did not have significant value and that the insurance company would not provide significant value on the claim. After providing the insurance company the additional medical records and reports, as well as the independent medical exam, they changed their tune and ultimately agreed to a substantial settlement on the eve of trial. The settlement along with the benefits that were paid over the many years of the claim resulted in GC receiving hundreds of thousands of dollars to help him to get back into school to re-train for a lighter duty employment position.
It is important to note that just because an insurance company contends a condition is pre-existing does not make it so.
A goal for an insurance company is to keep costs and payments as low as possible. For this reasons, it is important to seek help from an experienced Iowa Workers’ Compensation attorney such as Niko Pothitakis