Jim Murphy And Chris Mason: Case Analysis
I attended a telephone conference call regarding the above-referenced matter on 05/12/2017. Other participants in the conference Jim Murphy and Chris Mason.
We discussed the above-referenced matter and strategies for limiting liability and avoiding another large schedule including accepting and amending the case to include the neck with a possibility of a classification instead of a schedule loss of use of the shoulder and also the possibility of a Section 32 Agreement.
By way of background, this case is established for the overuse of both shoulders with a date of disablement of 02/13/2013. The claimant has had total shoulder replacements on both arms. The claimant has already received a 65.83% schedule loss of use of the left arm equal …show more content…
to 205.3896 weeks of compensation which totaled $129,107.41. The claimant has not yet received a schedule for the right arm, although the right total shoulder replacement was done on 06/23/2016. The case is therefore becoming ripe for permanency on the other shoulder.
If January 2017, you received an MG-2 from Dr. Kuhar requesting epidural steroid injections at C4, C5 and C6 in the neck. These were authorized without prejudice.
You advised me you had a recent file review in this matter and it came up the claimant left the ARC with bad feelings. I gather it was felt she exploited her situation as director and they were not happy with the fact she did not have extensive lost time but still received a large schedule of use and they face the possibility of paying her another large schedule loss of use.
I reviewed the medical evidence and I stated at the conference I felt there was sufficient medical evidence to raise a claim for the neck and we could pursue the strategy of amending the case to include the neck.
I did express reservations regarding this strategy in that if we were successful we would then own the neck and therefore be responsible for any treatment associated with the neck.
I was also concerned if the claimant did not have permanency from the neck we might just pay some additional medical bills and the claimant would still get the large schedule loss of use to the right arm.
I did think the right arm schedule loss of use is likely to be equivalent to the left arm schedule loss of use as the claimant had the same surgery. I think it is reasonable to anticipate a similar schedule loss of use.
If we were successful in establishing the case for the neck and establishing there was permanent disability to the neck that would preclude the claimant from receiving a schedule loss of use of the right arm and would force the claimant to be classified under Section 15(3)(w).
I stated if we assume the claimant was to receive the same schedule for the right arm as she did for the left arm our total liability would be approximately 410 weeks of
compensation.
If the claimant is classified we would get credit for the balance of the schedule that did not represent actual lost time. I calculated if the claimant was found to have a PPD with a loss of wage-earning capacity of 75% or less you would start to receive some benefit from this strategy. The total number of weeks the claimant would be entitled to would be less then the two schedules combines.
In review of the decisions in this case reveals no actual lost time was awarded to the claimant and so the entire represents permanent partial disability and the entire schedule constitutes a credit against further awards. We would only get credit for part of the schedule against future awards, the portion representing actual lost time would be considered temporary benefits. However, in this case there was no actual lost time and the entire schedule will move to the claimant.
Hypothetically, if the claimant were to be classified with a 50% loss of wage-earning capacity she would be entitled to 50 weeks of compensation from the date of the classification onward. I believe we would have a full credit for the 205 plus weeks of the prior schedule since none of those weeks represented actual lost time or temporary benefits. In this scenario we would still owe the claimant approximately 95 weeks of compensation.
If the claimant were classified with a 75% loss of wage-earning capacity she would be entitled to 400 weeks of compensation. We would deduct the 205 weeks of compensation for credit on the prior schedule and we would owe the claimant 195 weeks of compensation. These weeks would be paid out over time.
As a result of our discussions it was agreed the possibility of a Section 32 Agreement might be the best way to resolve this matter. I agreed to reach out to the claimant’s attorney, which I have done. I spoke to Mr. Rubin immediately after our conference and explained the situation to him that the claimant had two shoulder replacements for which she received a schedule loss of use for one. No there was evidence of a neck involvement which might preclude another shoulder schedule loss of use. I asked him to speak with his client about this and see if they could put together a Section 32 demand for us. Mr. Rubin did indicate he would do that but he would be open to receiving a reasonable offer from us. Normally I am not in favor of making an offer prior to receiving a settlement demand but in this case given our motivation to resolve this matter it might be worth putting some money on the table.
I will let you know as soon as I hear back from Mr. Rubin. Please let me know once you have received some settlement authority and we can discuss a strategy for moving forward.
If I can be of any further assistance or if you have any additional questions, please do not hesitate to contact me. Our statement of services will follow under separate cover.
We discussed the above-referenced matter and strategies for limiting liability and avoiding another large schedule including accepting and amending the case to include the neck with a possibility of a classification instead of a schedule loss of use of the shoulder and also the possibility of a Section 32 Agreement.
By way of background, this case is established for the overuse of both shoulders with a date of disablement of 02/13/2013. The claimant has had total shoulder replacements on both arms. The claimant has already received a 65.83% schedule loss of use of the left arm equal …show more content…
to 205.3896 weeks of compensation which totaled $129,107.41. The claimant has not yet received a schedule for the right arm, although the right total shoulder replacement was done on 06/23/2016. The case is therefore becoming ripe for permanency on the other shoulder.
If January 2017, you received an MG-2 from Dr. Kuhar requesting epidural steroid injections at C4, C5 and C6 in the neck. These were authorized without prejudice.
You advised me you had a recent file review in this matter and it came up the claimant left the ARC with bad feelings. I gather it was felt she exploited her situation as director and they were not happy with the fact she did not have extensive lost time but still received a large schedule of use and they face the possibility of paying her another large schedule loss of use.
I reviewed the medical evidence and I stated at the conference I felt there was sufficient medical evidence to raise a claim for the neck and we could pursue the strategy of amending the case to include the neck.
I did express reservations regarding this strategy in that if we were successful we would then own the neck and therefore be responsible for any treatment associated with the neck.
I was also concerned if the claimant did not have permanency from the neck we might just pay some additional medical bills and the claimant would still get the large schedule loss of use to the right arm.
I did think the right arm schedule loss of use is likely to be equivalent to the left arm schedule loss of use as the claimant had the same surgery. I think it is reasonable to anticipate a similar schedule loss of use.
If we were successful in establishing the case for the neck and establishing there was permanent disability to the neck that would preclude the claimant from receiving a schedule loss of use of the right arm and would force the claimant to be classified under Section 15(3)(w).
I stated if we assume the claimant was to receive the same schedule for the right arm as she did for the left arm our total liability would be approximately 410 weeks of
compensation.
If the claimant is classified we would get credit for the balance of the schedule that did not represent actual lost time. I calculated if the claimant was found to have a PPD with a loss of wage-earning capacity of 75% or less you would start to receive some benefit from this strategy. The total number of weeks the claimant would be entitled to would be less then the two schedules combines.
In review of the decisions in this case reveals no actual lost time was awarded to the claimant and so the entire represents permanent partial disability and the entire schedule constitutes a credit against further awards. We would only get credit for part of the schedule against future awards, the portion representing actual lost time would be considered temporary benefits. However, in this case there was no actual lost time and the entire schedule will move to the claimant.
Hypothetically, if the claimant were to be classified with a 50% loss of wage-earning capacity she would be entitled to 50 weeks of compensation from the date of the classification onward. I believe we would have a full credit for the 205 plus weeks of the prior schedule since none of those weeks represented actual lost time or temporary benefits. In this scenario we would still owe the claimant approximately 95 weeks of compensation.
If the claimant were classified with a 75% loss of wage-earning capacity she would be entitled to 400 weeks of compensation. We would deduct the 205 weeks of compensation for credit on the prior schedule and we would owe the claimant 195 weeks of compensation. These weeks would be paid out over time.
As a result of our discussions it was agreed the possibility of a Section 32 Agreement might be the best way to resolve this matter. I agreed to reach out to the claimant’s attorney, which I have done. I spoke to Mr. Rubin immediately after our conference and explained the situation to him that the claimant had two shoulder replacements for which she received a schedule loss of use for one. No there was evidence of a neck involvement which might preclude another shoulder schedule loss of use. I asked him to speak with his client about this and see if they could put together a Section 32 demand for us. Mr. Rubin did indicate he would do that but he would be open to receiving a reasonable offer from us. Normally I am not in favor of making an offer prior to receiving a settlement demand but in this case given our motivation to resolve this matter it might be worth putting some money on the table.
I will let you know as soon as I hear back from Mr. Rubin. Please let me know once you have received some settlement authority and we can discuss a strategy for moving forward.
If I can be of any further assistance or if you have any additional questions, please do not hesitate to contact me. Our statement of services will follow under separate cover.