In a case that highlights the dedication and perseverance of our legal team, Texas Workers’ Compensation attorney Izzak Banda successfully secured income benefits and medical treatment for his client after a grueling battle with Acadia Insurance Company, the employer’s insurance carrier.
This case serves as a testament to the importance of thorough legal representation against unjust denials of workers’ compensation claims.
A Story of Denied Insurance and Unjust Termination
When the claimant first approached Banda for help, he was in desperate need. The client, a skilled glazier, had been terminated after suffering a serious injury on the job in June 2023. A simple misstep while carrying a heavy glass door led to a fall that caused significant physical damage, including a right shoulder injury and a left hip labral tear. Despite the clear link between his injuries and the workplace accident, Acadia Insurance refused to pay workers’ compensation benefits. Additionally, the insurance carrier only agreed to accept liability for minor bruising and sprains, denying medical treatment for the more severe conditions.
The injuries had a profound impact on the claimant’s daily life and ability to work. The labral tear in his left hip and the strain in his right shoulder caused constant pain and limited mobility, making it impossible for him to perform the physically demanding tasks required in his job as a glazier. These injuries not only resulted in significant loss of income but also affected his quality of life, preventing him from engaging in routine activities and enjoying his usual standard of living.
Determined to minimize their liability at the expense of the injured worker, Acadia Insurance mounted an aggressive defense against the claim, arguing that the claimant’s condition did not warrant compensation. The insurance company’s strategy included using multiple required medical examinations (RMEs) and peer reviews to stack the odds against the claimant. They even attempted to undermine the claimant’s credibility by asserting that his employment was terminated for cause, and that the termination was unrelated to the injury.
Originally diagnosed with minor injuries by the company doctor, the claimant’s persistent pain led to further investigation. An MRI eventually revealed a left hip labral tear, a serious injury requiring specialized medical treatment. The insurance company, however, immediately denied liability for the labral tear, claiming that the extent of the client’s injuries included nothing more than a left hip contusion and shoulder strain. As a result, the client was refused necessary orthopedic examinations and further medical treatment.
To make matters worse, the employer had terminated the client’s employment under the pretext of job abandonment, asserting that he had neglected his duties following the injury. The reality, however, was starkly different. Predictably, Mr. Banda’s client was left without income, employment, and necessary medical care for his job injuries.
Go-Time: Taking The Case to Trial
At trial, Mr. Banda spearheaded the legal effort to overturn the insurance company’s unreasonable denials. At the hearing, presider over by Administrative Law Judge Hsin-Wei Luang, Banda meticulously presented evidence supporting the claimant’s version of events and used the insurance company’s own medical evaluations to demonstrate the legitimacy and seriousness of the injuries.
Leading the claimant through oral testimony, Banda was able to put the full story into perspective. The client testified that he had been promised a light-duty position that was supposed to accommodate his injury-related limitations. However, when he reported to work, he found that the position required the same physical demands as his regular job. Unable to perform these duties due to his injury, he communicated his concerns to his employer. Instead of accommodating his medical restrictions, however, the employer terminated him, which the client believed was an act of retaliation for his inability to work at full capacity.
Banda argued that the client’s injuries caused significant pain and limited mobility, preventing him from performing his job – a job he would still have if not for the unjust termination and cessation of benefits.
The Verdict
After reviewing the evidence and applying the law, Judge Hsin-Wei Luang found the claimant’s testimony credible and ruled in his favor, concluding that the injuries were indeed work-related, that the extent of injury included the left hip labral tear, that the claimant was not at maximum medical improvement (MMI) due to the denied treatment, and that income benefits were owed for lost income following the injury.
The victory means that the claimant will finally receive the medical treatment he needs for his hip tear, and he will be compensated for his period of disability. This case underscores the importance of diligent legal advocacy and serves as a beacon of hope for other workers facing similar challenges.
By standing firm and presenting a compelling case, Izzak Banda ensured that justice prevailed. This case is a win for the claimant and a reaffirmation of our commitment to tirelessly fight for the rights of injured workers.
Abbott, Clay and Bedoy, LLC – Texas Workers’ Compensation Lawyers
If you or someone you know is grappling with a workers’ compensation claim, don’t go it alone. The complexities of workers’ compensation law require the expertise of a seasoned attorney who understands the unique challenges each case presents. At Abbott, Clay & Bedoy LLC, we have been defending the rights of injured workers since 1997, bringing decades of experience and dedication to every client we serve.
Hiring an attorney with specialized experience in workers’ compensation is vital. Izzak’s willingness to take on such a challenging case, despite the daunting difficulties, exemplifies the commitment and tenacity our firm offers. His triumph against a formidable opponent like Acadia Insurance underscores the importance of having a skilled and determined advocate by your side.
Our legal team is dedicated to standing up against powerful insurance carriers and ensuring that injured workers receive the justice and benefits they deserve. We are well-versed in the intricacies of the law and the tactics insurance companies use to deny claims. With a proven track record and a deep commitment to our clients, Abbott, Clay & Bedoy LLC is the ally you need in your corner.
Contact us today for a consultation and take the first step towards securing your future. Let our experienced attorneys fight for you, so you can focus on your recovery. Your battle is our battle, and we won’t rest until you get the compensation you deserve.
