We are pleased to announce that Attorneys Jeffrey Raizner, Patrick Dennis, and Mike Doyle for being recognized as Top Lawyers of 2014 by Houstonia Magazine! Houstonia uses Avvo’s proprietary algorithm which rates all attorneys on a 10-point scale, factoring in peer endorsements as well as litigation experience, education, specialized training, speaking, publishing, and awards. Each year Houstonia releases a list of those leading the list and all three Partners of Doyle Raizner LLP were awarded this distinction.
Lowe’s Home Centers, New Hampshire Insurance, and Sedgwick Claims Liable for Worker’s Comp Bad Faith Following At-Work Injury
Doyle Raizner LLP has filed lawsuit against Lowe’s Home Centers (“Lowe’s”), New Hampshire Insurance (“New Hampshire”), and Sedgwick Claims (“Sedgwick”) for violations of the Arizona Workers’ Compensation Act, duties of good faith and fair dealing, and wrongful termination from the workplace.
Our client, a loyal and hard-working employee of Lowe’s, was descending a ladder after stocking shelves when he suffered tears to his achilles. He immediately reported the issue to his supervisor and later filed for workers’ comp benefits as he was unable to continue working.
Lowe’s required our client see a company doctor that provided Vicodin before releasing him back to full work duties though he was unable to walk without severe pain. New Hampshire and Sedgwick responded to the workers’ comp filing by placing an inadequately trained adjuster in charge of claims processing. This adjuster required our client visit the insurer’s Independent Medical Examiner (IME), who improperly concluded that scar tissue found around the ankle proved the Achilles injury occurred long before the date it was reported.
Our client visited a podiatrist through use of his personal insurance who concluded the tendon tears took place while working at Lowes, and that scar tissue in the ankle is unrelated and normally forms throughout a person’s lifetime. Relying only on the information of its hand-picked physicians, the adjuster emailed our client denying all benefits as “pre-existing.” In addition, she caused a Notice of Claim Status form to be filed with the Industrial Commission of Arizona, which ceased and denied all medical and income benefits.
This denial violates the duty of “good faith and fair dealing” by intentionally and knowingly terminating benefits without a reasonable basis. Pre-existing damages are still covered under workers’ compensation as long as an at-work accident aggravates and/or accelerates a prior condition. The defendants chose to misinterpret the rules and obligations of the Arizona Worker’s Comp Act to escape providing our client wage compensations and medical benefits.
Plant explosions may seem like they happen out of the blue, but there is always an underlying reason. Usually that reason can be traced back to a safety protocol that wasn’t followed. When an explosion happens, investigators must determine whether or not the problem was caused by the worker or by some other party. The results of the investigation weigh heavily on how much compensation an injured worker can get.
Take this recent explosion that happened at a biodiesel plant in Illinois. A flash fire happened at the top of a tank at Midwest Biodiesel Products LLC. Workers were doing welding repairs on top of 50 ft. tanks when ethanol in the tank exploded. According to the fire chief, the tanks were mostly filled with water with a small amount of ethanol residue at the top. The sparks from the welders ignited this.
This isn’t the first time that the fire department has had to respond to a fire at this particular plant, though the fire chief says that they pass their inspections and audits. The boom from the explosion was felt and heard from the next business over. 911 was called, but there was no means for employees to help put out the fire except for a small fire extinguisher. Luckily for the injured workers, none of the injuries they sustained were life threatening, though one worker did have multiple lacerations.
Even if a company does things by the book, accidents can still happen. One careless error can cause injury or death. When a workplace injury occurs, it’s important to get legal advice on what to do next. If you’ve been injured on the job, first report your injury in detail to your supervisor and get treatment. If your workers compensation will not pay out what is appropriate to cover your bills, call the law offices of Doyle Raizner LLP.
Scaffolding is a common site at construction yards. It is also a prime source for construction injuries. According to OSHA, 54 workers were killed in scaffolding accidents in 2009. The Bureau of Labor and Statistics also says that 72% of injuries are due to the planking giving way, the employee slipping, or an object falling from above. All of these are preventable injuries.
Yet still, accidents happen. A worker in Chicago is now in serious-to-critical condition after scaffolding collapsed completely while he was on it. Three stories of wood and metal came crashing down. Thankfully, the wounds he suffered are not considered to be life-threatening.
What can be done to prevent scaffolding injuries? First, OSHA has a series of guidelines for people setting up and using scaffolding. Knowing these guidelines and making sure they are followed is a good first step. These guidelines can be found on OSHA’s website at https://www.osha.gov/SLTC/scaffolding/.
Some of the things to notice include:
* Height to base ratio
* Presence or absence of fall arrestors
* Presence or absence of guard rails
* Distance from power lines or other energized wires
* Presence or absence of nets to catch falling equipment
* Barricades around the scaffolding to prevent unauthorized entry
* Regular inspections of the scaffolding to ensure stability over time.
* Proper gap between scaffolding surfaces
These are the sorts of things that OSHA would look for in a scaffolding accident. These are also the same things we would look for on behalf of our clients. Many construction accidents can be prevented if the proper gear and training is followed. When it doesn’t happen, injuries and death result. If you’ve been injured in a construction accident, we want to hear your case. Contact Doyle Raizner LLP for a consultation.
The Ninth Circuit Court of Appeals today rejected York Risk Services’ (“York”) attempts to conceal disclosure of internal documents regarding the wrongful denial of workers’ compensation benefits owed to 10 City of Phoenix firefighters and a member of the Phoenix police department. The decision is a major development in the RICO and Bad Faith case filed by the Plaintiffs because it ensures that York’s wrongful claim handling practices will be brought to light.
On September 3, 2014, Judge John W. Sedwick of the United States District Court for the District of Arizona found that York was not entitled to withhold from production various communications York and its adjusters had with attorneys retained by York to assist in the handling and denial of the Plaintiffs’ claims. The Court found that York was not allowed to claim that its actions were reasonable, while at the same time refusing to produce communications with York’s attorneys that may be used to establish that the adjusters’ actions were in bad faith.
York attempted to reverse Judge Sedgwick’s order by appealing to the 9th Circuit. The 9th Circuit summarily rejected York’s appeal on October 29, 2014 holding that York had not “demonstrated that this case warrants the intervention of this court.”
The experienced worker’s compensation lawyers of Doyle Raizner LLP will proudly continue fighting for these 11 emergency responders and their families. Our worker’s compensation bad faith team has a record of success in fighting against insurance company and third-party administrators who place profits over individuals and their medical needs. If you or someone you love has experienced bad faith tactics in their Arizona worker’s compensation claim, contact our firm immediately.
Doyle Raizner LLP proudly recognizes founding partners Jeff Raizner and Mike Doyle upon receiving recognition from the most respected peer-review publications in the legal profession. Best Lawyers awarded Attorney Jeff Raizner Best Attorney in Texas for this year and Best Lawyers of America awarded Attorney Mike Doyle in the practice areas of Admiralty and Maritime Law, Plaintiff Personal Injury Litigation, and Transportation Law.
Both publications are known for their credibility as lists are compiled by conducting exhaustive surveys in which tens of thousands of leading lawyers evaluate their professional peers. Nominations are combined with third party research and and weighed against the attorney’s professional achievement for that year.
Doyle Raizner LLP Carves Paths Of Relief Against Insurers and TPA’s For Worker’s Compensation Bad Faith Actions in Arizona
The JDSupra Business Advisor released an article highlighting the legal theories our attorneys’ designed to hold both a worker’s compensation insurer and its Third Party Administrator (“TPA”) liable for improper claims processions actions. In growing fashion, insurance companies “outsource” claims processing to TPAs in order to underwrite risks but still benefit from a TPA’s profit-driven tactics. In turn, the TPA escapes liability because it doesn’t enter into a contractual agreement within the policyholder; but times are changing.
Our client, a customer service representative for Stanley Steemer, fell in a staircase leading to her desk, injuring her knees, hip, and twisting her back. A nurse practitioner later provided a knee brace and issued work restrictions. The nurse practitioner found that, due to worsening pain, this plaintiff was unable to sit at a desk, walk up stairs or stand for long periods.
Through Hartford is Stanley Steemer’sworker’s comp insurer, the company contracted a TPA, Gallagher Bassett (“Gallagher”), to handle the claim. Gallagher’s assigned claims handler began eviscerating the claim. The handler interviewed our client and without speaking to the nurse practitioner concluded the work restrictions listed were “unreasonable.”
This adjuster then denied the nurse’s request that our client visit a pain clinic, and instead hired a private investigator so she could “utilize the results to push for a light duty work release.” She also demanded our client see the insurance company’s medical examiner, but this examiner validated the nurse’s findings. Given the repeated delays of payment, our client has been subjected to significant economic impact, humiliation, worry, distress, and continuing physical damage.
The article discusses our causes of action which were against Hartford’s for breaching its good faith duty to process our client’s claims fairly and equitably, and against Gallagher for aiding and abetting the insurer’s breach. The Arizona federal court agreed with our argument that “the unlawful tactics of a TPA may be imputed to the insurer since good faith is
Doyle Raizner LLP has initiated suit against Indemnity Insurance (“Indemnity”), Gallagher Bassett Claims, Inc. (“Gallagher”), and the assigned claims adjuster for defendants combined efforts in wrongfully processing plaintiff’s claim for workers’ compensation benefits following his at-work injury.
Plaintiff, a hardworking driver for Waste Management Inc., was carrying a heavy hose to and from sanitation sites when he suffered a crushing injury to his right hand. He continued working as pain radiated through his hand, shoulder, and back. The strenuous routine of handling the hose later caused spinal pain forcing him to report his extent of injuries.
Upon receiving our clients claim for workers’ compensation, Indemnity and Gallagher placed an adjuster over the case that performed an unreasonable investigation and caused a Notice of Claim Status form to be filed with the Industrial Commission of Arizona (ICA) – which directly denied our client all benefits.
Our client sought a medical examination through his own insurance due to continuing spinal pain along with right arm numbness that continued into his hand. Internal medicine physician Dr. John Post recommended Maricopa Integrated Health Systems perform an MRI which later revealed large disc herniations and severe cord deformity.
The defendants violated the duty to process our client’s claim “in good faith and fair dealing” by ignoring Maricopa’s medical documentation which found our client’s industrial at-work accident now required surgical intervention. With no other option, the plaintiff underwent fusion surgery through use of his own insurance and retained an attorney to continue the fight for wage and medical compensation.
A proceeding before the ICA finally secured long overdue benefits from Indemnity, but the defendants continued to withhold funds. The extensive delay and denial of assistance has caused this client continuing mental and financial distress, along with permanent disfigurement due defendant’s refusal to provide rehabilitation therapy. Our client has also been sued by a collection agency for surgery bills after the adjuster
Doyle Raizner Sues Truesdell Corporation and Salt River Project For Breaches In Safety That Lead To Plaintiff’s Injuries At The Horse Mesa Dam in Arizona
Doyle Raizner LLP has filed suit against Truesdell Corporation (“Truesdell”) and Salt River Project Agricultural Improvement And Power District (“SRP”) for negligent acts and omissions during reconstruction to portions of the Horse Mesa dam.
Our client was an employee of Safway, a subcontractor assigned to construct system scaffolding between a exterior staircase and elevator at the third floor of the dam. In an effort to complete the task our client attached his personal fall arrest system (PFAS) to the handrail of the maintenance platform of the elevator to satisfy the 100% tie-off requirement because he was not provided rappel gear or safety equipment such as lifelines. In addition, a protective safety net did not sufficiently cover the area below where he was suspended.
While attached to the elevator more than four stories in the air, an unauthorized user called the elevator to the ground floor. Unfortunately, SRP and Truesdell did not have an “authorized-personnel only” sign at the elevator call station and also did not maintain lock out/ tag out procedures. Our client began yelling for an immediate shut-off of the elevator, but the call station did not contain emergency shut-off devices.
The force of the elevator slammed our client into the safety cage of the elevator, then over the top of the cage. As the force continued to pull him down the face of the dam, he repeatedly slammed into the elevator and staircase before the handrail snapped and our client was left suspended in mid-air until co-workers reached him and provided medical care.
Our client suffered six broken ribs, three spinal fractures, tore his right meniscus and MCL, endured 25% tears in him forearm, lateral tears in his shoulder and also punctured his skull. Even after anticipated surgeries have been performed, physicians believe our client will not be able to return to scaffolding.
Because SRP is the owner and operator of the dam,
The Division of Texas Workers’ Compensation Has Not Been Charting The Race Of Applicants As Required
The Texas Tribune recently released an article inquiring into what could be systematic discrimination from insurance companies against minorities attempting to obtain workers’ compensation benefits.
The article focuses on a case handled by an Austin Lawyer who became convinced his client was treated unjustly due to the color of his skin. This caused the lawyer to wonder about the many African American and Hispanic workers seeking legal assistance and their rate of receiving assistance. The reply he received from the Texas Division of Workers’ Compensation was disheartening and provided no real answer.
Though a 1993 law requires the Texas Worker’s Comp agency to maintain information of the race and gender of every valid claim, it has failed to comply. The department responded to the inquiry stating; “Please note that race and ethnicity are rarely reported and, as discussed, [are] inaccurate and incomplete. Therefore, these numbers cannot be extrapolated for analysis.” The agency further says it does maintain records of the workers that report their race, though it’s a small percentage.
The article provides that this news prompted State Rep. René Oliveira, the Brownsville Democrat overseeing the agency as chairman of the House Business & Industry Committee, to press for immediate collection of this data. Rep. Oliveira also notes, “This is the second time in recent months that the department has not complied with its legal duties.”
The Division of Workers’ Compensation can’t claim charting this information is too daunting a task as records indicate the majority of claims were successfully tracked and included race data when the requirement was set in place in the early 1990’s. Today, some claims don’t have fields so a worker may provide it.
But why is charting race important? The article states that the U.S. Bureau of Labor Statistics found Hispanics have a greater chance of dying compared to other workers. Foreign workers not fluent in English or familiar with American safety regulations are also