Shocking Story of Denied Workers’ Comp Claim

Jolene was a 32-year-old beautician when she suffered a significant wrist injury working for her employer.3 Her wrist was hurt so badly that within a few months of her injury, she needed surgery to get better. Then she spent a lot of time out of work and couldn’t earn wages.

The workers’ compensation insurance company should have accepted responsibility for Jolene’s injury and paid her benefits, but it didn’t. Instead, the insurance company denied the claim. (Shockingly, this happens more than you might realize.)

This is the story of how the workers’ compensation attorneys at the Law Offices of James Scott Farrin successfully fought the insurance company on Jolene’s behalf.1

Workers’ Comp Insurance Company Pretends to Do the Right Thing

Jolene's story was used to deny her workers' compensation claimIn the early weeks after Jolene was hurt at work, the insurance company acted like it was going to do the right thing. It sent Jolene to the doctor to see why her wrist hurt and why she couldn’t lift anything with her arm. An honest individual, Jolene told the doctor that during her freshman year in college, she had a few minor problems with her other wrist, but nothing that ever required medical treatment.

That was all the insurance company needed to know. Even though Jolene’s prior wrist issues happened over a decade earlier and never required medical treatment, the insurance company used this irrelevant medical history to deny responsibility for the recent work-related injury to the wrist.

Workers’ Comp Insurance Company Denies Rightful Claim

By the time Jolene got to the Law Offices of James Scott Farrin, her claim had already been denied. We see this a lot. Some people may not consider hiring a workers’ comp attorney until their claim is denied. Waiting until the claim is denied, however, is often a mistake for many reasons – not the least of which are medical considerations.

As we typically do, we went right to work and filed a hearing request to challenge the denial. This would get us in front of a judge so we could plead Jolene’s case. But, as sometimes happens, this can take time. Meanwhile, Jolene got medical treatment using her husband’s health insurance – treatment that included wrist surgery, numerous follow-up visits with the doctor, and extensive physical therapy.

Before an injured worker can make their case to a judge, they and their attorney have to meet with the attorney for the workers’ compensation insurance company to try to reach a settlement. This is called mediation. At Jolene’s mediation, the workers’ compensation insurance company tried to lowball Jolene and pressure her to accept an insultingly low settlement. We told Jolene we should take the fight to court, and she agreed.

Having an attorney by your side when going through a workers’ comp claim can help you avoid making any costly misstatements. Call us today at 1-866-900-7078 for a free case evaluation.

We Convinced Judge to Order Insurance Company to Pay Up1

After the first hearing in Jolene’s case, the judge ruled that she was indeed hurt on the job and that the insurance company was responsible for her injury. The judge ordered the insurance company to pay Jolene medical and wage benefits. Jolene had waited a long time for this decision – two years after her injury, in fact.

The insurance company wouldn’t stop fighting. It appealed to a panel of several judges. Again, the judges ordered the insurance company to accept responsibility for Jolene’s injury and to pay medical and wage benefits. By this time, Jolene was on the hook for tens of thousands of dollars in medical bills and was owed tens of thousands of dollars in wage benefits.

The insurance company in Jolene’s case hoped she would just go away or accept a lowball offer.

But Jolene didn’t do either. With the help of her workers’ comp attorney and the worker’s comp team, Jolene had her day in court and got several different judges to tell the insurance company that they were wrong to deny her any longer.

Insurance Company Ignores Judge – Still Won’t Pay

Alas… the fight isn’t over. As sometimes happens, work injuries (any injury) can require subsequent medical treatment. Jolene was recommended to undergo another surgery, and the insurance company started its old tricks again – refusing to pay for the surgery. And just like last time, Jolene and the Law Offices of James Scott Farrin went back to court to fight them, so she could get the treatment she needed to get better, get back to work, and support her family.

Free Workers’ Comp Case Evaluation From James Scott Farrin

This story could be any one of a hundred cases we handle at any given time.

It is not until some injured workers realize that they may not be in good hands with their workers’ comp insurance company that they come to us.

If you have been injured on the job, contact us immediately or call 1-866-900-7078 for a free case evaluation. We’ll let you know what we can potentially do to help you try to get maximum benefits for your injury.

3Name and personal information have been changed to protect privacy.

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About the Author

Michael F. Roessler practices workers’ compensation law in North and South Carolina for the Law Offices of James Scott Farrin. Michael is among the less than 1% of attorneys licensed to practice in North Carolina who are North Carolina State Bar Board Certified Specialists in Workers’ Compensation law.a He has contributed several written pieces to legal publications, including the North Carolina Law Review, the Charlotte Law Review, and the Southwestern Law Review. He is a member of the North Carolina Advocates for Justice and the North Carolina Bar Association. In 2022, Michael was named to the “Best Lawyers”b list for Workers’ Compensation Law by Best Lawyers in America.

aFigures provided by the NC State Bar as of 2/21.

bFor more information regarding the standards for inclusion, please visit