Case details

Roofer claimed he requires ongoing care for head injury

SUMMARY

$2150000

Amount

Settlement

Result type

Not present

Ruling
KEYWORDS
brain, brain damage, brain injury, chest, cognition, fracture, impairment, mental, psychological, rib, subarachnoid hemorrhage, traumatic brain injury
FACTS
On April 3, 2018, applicant Santiago Jimenez, 60, a roofer, was in the course and scope of his employment with Challenger Builders Inc. when he fell off a roof and landed approximately 12 feet below. He sustained to his head and chest. Jimenez filed a workers’ compensation claim against his employer, Challenger Builders Inc. He brought a claim against the respondent in an attempt to collect workers’ compensation benefits., Jimenez sustained a traumatic brain injury in the form of a subarachnoid hemorrhage. He also sustained a fractured rib. Jimenez was rushed to Henry Mayo Newhall Hospital, in Valencia, where he was admitted as a trauma emergency. He underwent multiple imaging studies, including CT scans of the head, face, cervical spine, chest, abdomen and pelvis. Upon discharge, Jimenez was admitted to a Centre for Neuro Skills facility to participate in an intensive, inpatient, post-acute neurological rehabilitation program. Jimenez’s subarachnoid hemorrhage resolved on its own and did not require surgical evacuation. However, he claimed he suffers from cognitive and physical deficits as a result of his injury. Jimenez’s primary treating physician and other treaters opined that Jimenez’s cognitive and physical deficits represent a potential risk to his ability to function safely and independently in his home and in the community. Jimenez and his counsel felt that Jimenez’s medical needs were not being met and that Jimenez was regressing and required more in-depth medical management. His treatment team and regimen were eventually adjusted to better suit his needs in his activities of daily living, self-care, mobility, communication, cognition, behavior and safety awareness. Jimenez’s counsel asserted that as a result of Jimenez’s participation in multi-disciplinary neurorehabilitation, Jimenez gradually acquired the necessary skills and simple strategy points to continue improving and maintain his progress. Jimenez’s counsel claimed that Jimenez would require medical care from multiple specialists and long-term care in a structured living environment to prevent regression. The respondent’s counsel disputed the nature and extent of Jimenez’s alleged . Counsel asserted that Jimenez was not totally disabled and did not require the extensive care that Jimenez sought to secure for the foreseeable future.
COURT
Workers' Compensation Appeals Board, CA

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