Gits Mfg. Co. v. Frank, a case from the Iowa Supreme Court, involved a claimant who began working for employer in 1997. She worked as a spot welder and on the assembly line. In February of 2006, claimant’s doctor diagnosed her with constrictive bronchiolitis causing pulmonary dysfunction.
Both claimant and employer stipulated that this was a work-related injury. Her doctor placed her on medical leave and recommended that she stop working for employer. Her doctor continued to treat her and concluded that she reached maximum medical improvement in March of 2009.
As our Boston workers’ compensation attorneys can explain, maximum medical improvement (MMI) means that doctors have done everything feasible to treat a patient for a particular condition and no further treatment will be beneficial. This does not mean that the patient is cured.
The commission determined that claimant was totally disabled under a theory that she could not reasonably compete for or perform any jobs in the workplace. She had not worked since leaving employer, and both she and her husband testified that she has good days and bad days. On good days, she can do some housework and on bad days (at least two days a week), she cannot even get off the couch.
While she could work in a sedentary environment, she would need to trained in the use of computers, take classes, and find an employer willing to hire her given that she should would need at least two days off per week depending on how she was feeling.
After receiving a rating of permanent total disability, employer appealed this decision to the court of appeals, and the court found that claimant was not motivated to work and was happy to receive disability benefits and was simply choosing not to work again.
At this point, claimant appealed to the state supreme court, which reversed the lower appellate court’s findings. The court found claimant to be totally disabled.
One of the things to keep in mind is that insurance companies are generally in the driver’s seat in workers’ compensation claims administration. Even if your employer says they are on your side and wants you get all of the benefits to which you are rightfully entitled, the insurance company claims process may get in the way.
Workers compensation insurance carriers, along with other types of insurance carriers, take in trillions of dollars in premiums each year and are generally far more concerned with their bottom line and profitability than they are with a worker injured on the job getting the benefits that he or she deserves.
Many valid claims will be rejected, or a lower than appropriate disability rating will be determined to reduce the total benefits payout. This is also an extremely complex area of law, and the system is set up in way that puts unrepresented claimants at a significant disadvantage. Once of the best things you can do to help get the benefits you are seeking is to speak with a workers’ compensation attorney as early in the process as possible.
If you are injured on the job in Massachusetts, call the Law Offices of Jeffrey S. Glassman for a free and confidential consultation to discuss your workers’ compensation claim: 1-888-367-2900.
Gits Mfg. Co. v. Frank, October 17, 2014, Iowa Supreme Court
More Blog Entries:
LeFiell Mfg. v. Super. Ct.: Workers’ Compensation Exclusivity and Rare Exception, August 18, 2014, Boston Workers’ Compensation Lawyers Blog