Attorneys Together Chalk-up Win!
They say it takes a village to raise a child. In a similar manner, it may require a group of specialized attorneys working together to get justice for our clients. Such was the case with my client Victor (not his real name but a real client) who was referred to me by a local workers’ compensation attorney.
Victor worked as technician in a local business. He developed PTSD after witnessing a shooting at work. With treatment Victor improved, was placed at Maximum Medical Improvement (MMI) from a physical standpoint and returned to work. However, he would periodically relapse requiring time off from work.
During a recent relapse, Victor filed a claim for workers’ compensation benefits. However, under Florida law temporary benefits due to psychiatric illness are not payable six months after reaching physical MMI. Since he couldn’t work, he then filed a short-term disability (STD) claim under his employer-sponsored Short-Term Disability Plan with Prudential. Prudential denied his claim for STD benefits advising that STD benefits aren’t payable for disabilities caused by his workers’ compensation injury.
We obtained a copy of the Short-Term Disability Plan which states, “Occupational sickness or injury means an injury arising out of, or in the course of, any work for wage or profit regardless of employer, or a sickness covered, with respect to such work, by any workers’ compensation law, occupational disease law or similar law.”
With the help of his workers’ compensation attorney and the defense attorney, we obtained a Notice of Denial from the workers’ compensation carrier and successfully argued that since Victor was not entitled to wage loss under Florida workers’ compensation law because it was more than 6 months after being placed at MMI, the workers’ compensation exclusion to coverage under the STD policy did not apply.
Victor won his benefits because a group of experienced and specialized attorneys worked together on his case. Sometimes, it takes a village of attorneys to fight for and receive justice that our clients deserve. Case Closed!
If you have a client with an injury who has been denied benefits under their employer-sponsored disability plan, please send them my way for a free review of their claim. Why? Because it’s what I do to protect their rights.
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