The claimant, who was the owner of a company that provided maintenance services to commercial entities, suffered a severe traumatic brain injury with multi-lobe cerebral hemorrhage following a fall from a ladder.
Other injuries included pelvic fractures, left clavicle fracture, and a torn left rotator cuff. After the fall, the claimant was kept in an induced coma in the ICU for approximately four days, spent two weeks in the trauma unit, and then spent a month in a rehabilitation hospital. Dr. Zasler, who oversaw the claimant’s treatment, diagnosed him with a severe traumatic brain injury.
Neuropsychological evaluations performed by Dr. Hunter revealed a major neurocognitive disorder and significant neurobehavioral impairments related to his TBI. An FCE performed by Dr. May found the claimant incapable of performing any form of gainful employment based on the physical impairments attributable to his TBI. Dr. Zasler, Dr. Liebowitz, and Dr. Hunter provided reports indicating that the claimant was permanently disabled from all gainful employment based on both his physical and neurocognitive impairments.
The claimant obtained an award and received weekly indemnity benefits for several years. The carrier then filed an application to terminate his benefits based on the ludicrous allegation that he was capable of performing his full duty job running the company. The carrier’s only evidence was surveillance depicting the claimant “pretending” to prepare estimates and take photographs at former job sites. These were supervised activities, however, being directed and monitored by his life skills counselors as a means of building his self-esteem. Meanwhile, the claimant’s wife was forced to sell the business. The claimant countered with a bad faith claim for attorney’s fees and costs and sought 4-5 hours of daily attendant care based on Dr. Zasler’s recommendation.
Prior to making a settlement demand, Dr. Scott Bender was hired to perform a mental capacity evaluation, which found the claimant was competent to provide his wife with a power of attorney without a guardian or conservator. The settlement was the result of a mediation conducted by Deputy Commissioner Temple Mayo. The all-cash settlement allocated $100,000.00 towards future medical expenses to consider Medicare’s interests based on an opinion from John Cattie, Esquire at Cattie, PLLC. The carrier had paid $1,060,000.00 in compensation and medical benefits prior to the settlement.