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Case Name: Pedro Velazquez v. Elite Staffing
Venue: Chicago – Arbitrator Lynette Thompson-Smith
Handling Attorney: Karolina M. Zielinska
Case No.: 12 WC 1242
Date of Accident: 1/4/2012
Date of Trial: 11/1/12 and 12/12/12 (bifurcated trial)
Benefits Awarded: Denial of Right Shoulder Claim and Surgery and Denial of Lower Back Claim

 

CASE SUMMARY:

Petitioner alleged he sustained several injuries after falling at work, including a right shoulder labral tear that resulted in operative treatment as well as an aggravation of a preexisting lumbar condition (spondylosis at L5-S1) that resulted in numerous facet block injections, epidural steroid injections and 11 months of physical therapy.

Petitioner was off work from January 10, 2012 through the date of trial on November 1, 2012.

Petitioner accumulated over $125,000 in medical bills for treatment regarding his right shoulder and lower back.

At trial, Petitioner was seeking payment for all outstanding medical, 11 months of TTD and future treatment.

TRIAL STRATEGY:

Our defense strategy consisted of putting together medical evidence in order to go after the Petitioner on cross examination in order to uncover the inconsistencies of his mechanism of injury.

Prior to trial, we spent a significant amount of time carefully reviewing the treating records and the histories contained therein. Upon doing so, it was apparent that Petitioner’s initial complaints when he presented for treatment were for his left shoulder, left elbow, left hand, upper back and neck. Diagnostic testing supported this. Nonetheless, as time went on, Petitioner began complaining of right shoulder pain and low back pain and underwent an unauthorized shoulder surgery.

Reviewing the treatment records as carefully as we did, we knew exactly what type of evidence we required at trial and we obtained that evidence by taking the deposition of our IME doctor.

At trial, we exposed Petitioner and relentlessly questioned him in regards to the specific mechanism of injury – how he fell, where his arms were, what his initial complaints were, what he told his doctors, and so forth. We then used Petitioner’s responses in our proposed decision and drafted an entire section exposing the inconsistencies and contradictions of his testimony compared to his documented treatment records and the opinions of our IME doctor.

Not only was the Arbitrator persuaded that Petitioner was completely not credible, but she relied on his inconsistent statements in coming to her findings and incorporated our proposed decision almost in its entirety.

CASE DECISION SIGNIFICANCE:

Ultimately, the Arbitrator found that Petitioner’s current condition as it relates to his right shoulder and lower back was NOT causally related to his January 4, 2012 work accident. As such, the Arbitrator denied Petitioner’s claim for medical benefits as it pertained to treatment for the right shoulder and back. Finally, the Arbitrator relied on the opinions of our IME doctor in awarding only two months of TTD benefits for which Petitioner was off work for injuries pertaining to his left shoulder and neck – versus the alleged right shoulder and lower back.

In the end, we were able to save our client over $125,000 in medical benefits and approximately $10,000 in past TTD benefits. Additionally, we saved our client future costs for permanency (approximately 40% MAW, or $60,000.00), future TTD, and future medical costs. Total estimated savings compute to $195,000.00.

If you should have any additional questions or thoughts about this decision, please do not hesitate to contact the undersigned or the handling attorney, Karolina M. Zielinska.

Very truly yours,

KNELL & O’CONNOR

Bradley C. Knell