Brain-Injured Man Fights For Lifetime Workers’ Compensation

On behalf of Lovett Law Firm posted in Brain Injury on Friday, February 12, 2016.

What defines when someone is too ill or injured to work? How can you be sure you or a loved one qualifies for the care you need? That’s an issue brought up in a case out of Texas.

An injured man in Texas is fighting for lifetime workers’ compensation after an injury left him with the mental functionality of an 11- or 12-year-old, according to his doctor. He was told he’d need care for the rest of his life, since he had suffered a very severe traumatic brain injury. Still, that wasn’t enough for the insurance company to award him lifetime payments; instead, it claims he’s not disabled enough.

Despite his severe disabilities, a specialist used to review the filings by the insurance company claimed that the man could be retrained and reintegrated into the work force. Under Texan law, if a physically traumatic injury to the brain leads to incurable imbecility or insanity, a worker can obtain lifetime workers’ compensation benefits. What is imbecility, though, and does the man qualify? Prior cases claim it means a person has a mental age of 3 to 7 years of age, making the man’s injury less severe and potentially one that does not qualify.

Is that fair, though? His attorneys claim that he has irreversible brain damage that affects him so badly that he can’t engage in normal cognitive processes. One court ruled in favor of the insurance company, but a three-judge panel in the Texas 1st District Court of Appeals reversed that ruling. The court determined that the standard was set in 1917, and the term “imbecility” was outdated and offensive in today’s world. The case will now be reviewed again to determine if he now meets the qualifications in a lower court.

Source: Business Insurance, “Injured man’s comp benefits turn on definition of ‘offensive’ legal standard,” Sheena Harrison, Feb. 10, 2016