Joye Law Firm Injury Lawyers fought the system to secure a workers’ compensation settlement for a client whose initial injury claim was denied.
A devoted home health aide spent years caring for patients with chronic illnesses. She was inspired to enter the field after witnessing firsthand how devastating these conditions can be for families. This lived experience guided her to treat each patient with empathy and a big heart.
She never could have imagined that a painful shoulder injury would change the course of her career or that workers’ comp would deny her claim.
This case study explores how Attorney Sophie Dieckhaus of our North Charleston office, along with assistance from Case Manager Lynette Lemon, made the impossible happen and helped our client achieve a workers’ comp settlement to get her life back on track.
Home Health Aide Suffers Shoulder Injury
Our client had been employed as one of several round-the-clock aides for a man with a chronic and debilitating illness. After a few months on the job, the family asked her to accompany them on a trip to New York, so she could continue to provide care during their vacation. While in New York with the family, she attempted to reposition her patient when she felt a painful tearing sensation in her shoulder. She went straight to the hospital that day. Scans confirmed what she already knew: she had suffered a severe injury to her shoulder rotator cuff.
Denied Workers’ Comp Benefits Despite Clear Evidence
The family employed multiple caregivers and carried workers’ compensation insurance. So, our client was shocked that despite her clear documentation, her claim was denied and her treatment was not authorized. Instead, the insurer leaned on the fact that our client had private health insurance, hoping to avoid responsibility altogether. However, as we all know, health insurance doesn’t cover everything, and since this injury occurred on the job, our client felt she was wrongly denied.
This case presented several significant obstacles. Although the injury occurred in New York, her employment was based in South Carolina, which raised jurisdictional issues. The insurer also pointed to a history of shoulder problems stemming from a teenage car accident, arguing the injury was not work-related. To make matters worse, she was terminated on the same day she was injured due to a disagreement with her employer. In South Carolina, however, losing employment does not bar a workers’ compensation claim if the injury occurred while performing job duties.
Despite these hurdles, Attorney Dieckhaus pressed forward, filing for a hearing and fighting for her client’s right to compensation.
From Denied Claim to Legal Victory: Fighting for Compensation Through the Workers’ Comp System
Unable to work after the injury, our client relied heavily on her husband for support. She longed to continue her career in caregiving but worried that her limited shoulder mobility (which was likely about 30% according to her physical therapist) would prevent her from safely doing so. Attorney Sophie Dieckhaus incorporated this assessment into her initial demand to the insurance carrier. The claim was also strengthened by the client’s meticulous documentation of her hospital visits and treatments, even while stranded out of state.
The insurer initially responded with a $50,000 offer, all while disputing whether the injury was even compensable. Dieckhaus refused to let them dismiss the claim. Through persistence and negotiation, she secured a $75,000 settlement, a result that gave her client closure, financial relief, and the ability to continue treatment on her own terms.
Standing Strong for Injured Workers
This case highlights the importance of persistence when insurers deny or delay valid claims. With Joye Law Firm’s advocacy and our client’s meticulous recordkeeping, justice was achieved even in the face of multiple obstacles.
For others facing similar challenges, the takeaways are clear: always report and document injuries right away, never assume a denial is final, and remember that legal representation can make all the difference.
At Joye Law Firm, we fight for injured workers across South Carolina. Even in complicated cases involving out-of-state injuries or pre-existing conditions, we fight to get our clients the justice they deserve.
If you or someone you care about is in a similar situation, give us a call. Your consultation is totally free, and if you decide to retain us, you will benefit from our No Fee Guarantee. That means you won’t owe any legal fees unless we obtain a settlement for you. If your workers’ comp claim has been denied, don’t go it alone. Just Call Joye.
Disclaimer: Past results do not guarantee future outcomes.
