Type of Case:   Workers’ Compensation

Legal Issue or Dispute:  Denial of claim for a repetitive thumb injury requiring surgery

Facts:   Our client worked for a large healthcare provider in northern Minnesota.  His job duties over many years involved repetitive work with his hands and thumbs. He developed a condition which required a significant hand surgery and the workers’ compensation insurer denied the claim.  They sent our client to an orthopedic surgeon for an independent medical exam (often referred to as an IME), who gave the opinion that our client’s problems were hereditary and unrelated to his work activities.  The case was scheduled for trial before a workers’ compensation judge in Duluth.

Result:   We obtained a medical report from the treating surgeon which stated that our client’s work activities were a substantial contributing cause of the development of his problems. Shortly before trial, we took the deposition of the insurance company’s doctor.  In his deposition under oath, he was forced to admit that  (1) there was no documented medical basis for his opinions regarding the hereditary factors he relied on for his opinions,  (2) there were no medical studies to support his opinions, and  (3) he had no special training or knowledge of genetics.

Less than one week before the scheduled trial, the insurance company accepted the claim in full, agreed to pay for our client’s surgery and paid him wage loss benefits while he was off work.  The insurance company was also required to pay our attorney fees for obtaining the surgical approval and wage loss benefits.

Leave a Reply