The mark of a good attorney is when she finds a way to use her opponent’s evidence against them. August 2024 brought Attorney Lisa Pierobon Mays’ client K.K. (initials used to preserve client’s anonymity) a successful settlement by intimidating opposing counsel with his own medical expert’s report.
KK worked for a machine fabricator which required him to repeatedly lift 50-pound parts when fabricating grain shoots. From July 23 thru July 26, 2022, KK was tasked to repeatedly bend at the waist from floor to chest to lift, load, and unload heavy parts into a machine. In doing so, he felt a pop and pain sensation in his low back with ongoing throbbing pain. Realizing that this was more than a pulled muscle, KK promptly informed his supervisor of his pain who instructed him to go home to rest, apply ice, and medicate. The next day, KK had worsening pain, so he went to urgent care and then follow-up with his primary doctor. He was prescribed strong pain medication and physical therapy. Despite weeks of therapy, KK had no improvement so his doctor ordered MRI imaging of his spinal cord in October 2022. The 2022 MRI showed a disk herniation in his low back requiring surgery. The surgery was performed in July 2023.
Before the disk herniation discovery, the workers compensation carrier accepted responsibility for the claim, meaning they were paying workers compensation benefits and agreed that the injury occurred at work. However, once the insurance carrier got notice that an MRI showed a serious disk herniation, they scheduled KK for a medical examination with a doctor of their choosing. The insurance carrier self-named this examination an “independent medical examination,” however nothing could be further from the truth as such examinations are far from independent, complete or even honest.
The so-called Independent Medical Examiner met with KK only once in April 2023 and from that he declared that his work-injury was no more than a lumbar strain and that all he needed was a four-week course of physical therapy. With this, all benefits were denied, and KK was left to fend for himself in terms of his finances and medical treatment expenses. This was devastating for KK and his family; KK had never suffered pre-existing issues with any part of his back. He did everything his employer asked of him repeatedly, over days, lifting heavy 50-pound material causing injury. He reported his injury immediately, sought medical treatment, and tried everything to get better. When he became too expensive with an upcoming surgery, the workers compensation carrier found a hack doctor to deny his claim arguing that he suffered no more than a strain when an MRI indicated a disk herniation.
With the insurance denial, KK was forced to find legal counsel to fight for him. He contacted Mays Law Office and hired Attorney Lisa Pierobon Mays in May 2023 before his July 2023 surgery. The surgery was successful, and the surgical findings were consistent with the MRI for a disk herniation. KK was able to return to work and is now working without restrictions.
Attorney Lisa Pierobon Mays filed an appeal with the State for the workers compensation insurance carrier’s denial of benefits. A hearing was scheduled for August 1, 2024. Before this hearing, the insurance company expressed interest in settlement. Attorney Pierobon Mays responded that while Client KK would be interested in settlement short of going to hearing, the settlement monies would have to be enticing if the insurance carrier wanted a closed file. Attorney Pierobon Mays told opposing counsel that she would not discount the claim too much as she felt confident that she would win the claim at hearing. Attorney Pierobon Mays noted to opposing counsel that the report of their doctor was poor. First, the report pre-dated the July 2023 surgery, so it was missing any discussion of the July 2023 surgery and the surgical findings which proved that KK suffered more than a lumbar strain, and in fact had a disk herniation with stenosis. So, the surgical findings substantiated the seriousness of the work injury and undermined the credibility of the insurance doctor. Moreover, remember the insurance company’s doctor accepted that an injury had occurred at work and that physical therapy was necessary with a period of healing and restricted work. Yet, the insurance carrier never paid the therapy bills nor did they pay KK a lost time benefit while he was unable to work without restriction. Failure by an insurance company to pay conceded benefits is illegal in Wisconsin under our Workers Compensation Act. Attorney Pierobon Mays made it clear to opposing counsel that, if a successful settlement was not reached prior to the August hearing then she would file a penalty claim (awardable up to $30,000) for failing to pay a conceded/undenied benefit. Opposing counsel fought back very little because he knew that he was trapped due to the poor handling of the claim and the facts and evidence were in favor of a win for KK.
KK‘s workers compensation injury claim was settled before the hearing giving KK more money in his pocket than if he had gone to hearing and won! Moreover, the insurance carrier was responsible for paying back the private health carrier and a large portion of the unpaid medical expense. KK was very happy with the results that Attorney Lisa Pierobon Mays got for him. He avoided having to testify at a hearing, got more money in his pocket, and did not have to worry about past medical treatment expense. He has returned to work with no residual symptoms from his back injury and working without restriction.
Mays Law Office is proud to announce another successful representation and result for a Wisconsin injured worker who recovered workers compensation benefits. Feeling frustrated too? Call Mays Law Office at 608)257-0440. Attorney Lisa Pierobon Mays is only a call away for a free consultation to answer all your questions