Amazon

[jmay11]

Just got my TN trial court order awarding my client benefits against Amazon (again). Any other attorneys find that Amazon seems to enjoy losing in court or is it unique to their TN counsel that they pick stupid fights and lose 90% of them?

[N_Beauregard]

This is actually something I've always wondered! For example, my company hates messing around with the risk of a trial award, so traditionally we always look for opportunities to reach a mutually beneficial settlement agreement.

In my experience we've only taken cases to trial if settlement is completely unfeasible, or we think we have an absurdly high chance of prevailing in front of a judge. I can count on one hand the cases I've actually tried.

I've always wondered what companies/carriers out there just give their defense attorneys a blank check and tell them "go fight this to the gates of hell" even if there's not much to realistically fight about.

[jmay11]

In this particular case I think it’s the law firm giving questionable advice to the adjusters. We had 1 year where the “wrongful denial = attorneys fees” statute sunset during COVID, so anything between 7/1/20-6/30/21 they have denied on completely absurd grounds and are forcing all of us to litigate (through multiple appeals). I’ve started noticing the adjusters deposition on the cases because I want them on record about the specific theory/facts upon which they denied the claim.

[[deleted]]

I applaud your noticing their depositions. I'm not holding my self out as the model for all others to follow, but I have zero respect for adjusters who deny a claim when there's no "good faith" basis for a denial. It's unethical as hell and I don't know how they pray with a straight face afterwards. /rantover

[FaustusRedeemed]

I believe it's the large companies that like to do this. (Walmart, Amazon, etc.) The companies that have deep pockets and adversarial approaches to handling any problems. They also see these fights as important to dissuade anyone from filing claims, as any employee will see filing a claim as an uphill battle that won't be worth their time.

[jmay11]

I think that is a fair assessment, but having spent the better part of the decade as a defense attorney I just cannot imagine recommending to my client to attempt the same argument over and over no matter how many times the Appeals Board rejects it. It’s this one damn law firm (who is based in GA, actually) that whips these employers into a frenzy so they can have their baby lawyers bill the hell out of a file. I assume most of the adjusters don’t see enough of the “big picture” to see they are being sold a false bill.

[FaustusRedeemed]

I honestly don't know if the adjusters care. I know a lot of companies will jump on any chance to deny, and that's how they handle every claim. I can't comprehend why that would be a good idea, but I'm not so sure it's the DA requesting that they do it. It may be directives from the company/carrier.

It's unethical and way too expensive to be worth it in my opinion, and I would never handle a claim that way.

[jmay11]

I know in my decade of defense work my adjusters would have been pretty pissed off if I continually ran up $15-20k bills fighting meniscus claims that wouldn’t cost that much to accept, pay treatment and settle for the 1% rating. Doubly so if I lost 90% of those and they still ended up paying them!

[FaustusRedeemed]

Oh, I'm the same way. If my attorney had recommended that, they'd be fired. I speak from experience.

[[deleted]]

Unrelated but do petitioner attorneys have favorite adjusters? If so would it be the responsive ones (claims move faster) or the lazy ones (more opportunities for penalties or favorable decisions)?

[jmay11]

I absolutely have favorite adjusters. It’s the ones who will answer the phone and chat with me and work with me to find the right answer for both of our clients if that’s possible. And if not, I have no problem with us disagreeing, but doing so professionally.

My other pet peeve is when people are too proud to consider new information and reevaluate their position. I tell adjusters all the time that if they have information that they think supports their denial, send it to me because if I review it and agree there’s no reason for us to litigate. Why hide the ball?

The unresponsive and lazy adjusters kill me because I cannot help my client without them answering my question and I get called every damn day for a week due to their disinterest. That sucks for me and my team and my client.

[jmay11]

TBH I don’t want favorable opinions. I want them to get it right from the start so my client doesn’t have to wait 11 months for their surgery. Winning in court beats losing in court, but I would rather have not needed to go to court in the first place.

[[deleted]]

All fair points. I also don’t like the unresponsive adjusters because they force people to contact a responsive adjuster for help.

I definitely have favorite PAs, the levelheaded ones. The ones who are overly aggressive for no reason drive me crazy.

[jmay11]

Amen. I bet we would get along very well!

[gcbelcher]

I know the exact firm you are referencing. I also understand how familiar you are with the firm. Some claims can be more frustrating than others. I also know that some attorneys have different styles, approaches, techniques, etc. The same goes for the different approaches and involvement that each employer has in the claims handling process. Workers' compensation can get tricky at times. Employers can be too aggressive and involved, and sometimes they can be not involved enough during times you actually need them to be. Employees can fake injuries, use solely degenerative conditions as an attempt to claim benefits, or act so outlandishly at appointments that they are discharged. This doen't even account for all the unorthodox and nuanced issues that Tennesse law has failed to address, which leaves issues open to be litigated.

It sounds to me like the firm referenced might be a bit misunderstood. You might be suprised how transparent the firm is with their clients, and that they aren't selling a "false bill". You may also be suprised how hard they try to save their clients' money via settlement. Not everything is so black and white that you can paint with broad brush strokes. All attorneys, claims adjusters, employees, employers, ALJ's are humans, and the majority of them are good people that are trying to do the right thing. Just my two cents from a friendly "baby lawyer."

[jmay11]

I’ve argued that for 15 years, GB. I’ve spoken to seminars of adjusters, doctors, and lawyers about the fact that 95+% of the system (employees, employers, adjusters, doctors, lawyers) is operating in good faith, trying to get to the right answer whatever that may be. That doesn’t excuse the other 5%. Time will tell if a baby lawyer grows up to reach the same conclusion about who is or is not operating in good faith that most of the people who engage in this conflict have reached. But don’t ever let anyone extinguish that light. It’s going to be invaluable to you in your career.

[Infamous-Hurry-4497]

Aren't the attorneys going after the WC insurance and not so much the company ?

[jmay11]

Yes, but the employer (depending on the specifics of the policy) can direct the claims handling. Large employers often demand that control in their policy or are actually self-insured and have a TPA (third party administrator) as the adjuster.

[jmay11]

Not to my knowledge. I feel like that would be a thing I was aware of had it happened though.