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Texas man faces benefit cuts after 2 decades

A Nederland man hired a lawyer to mount a challenge after an insurance company that paid benefits to him for more than 20 years due to a work-related accident suddenly decided that his injuries were not severe enough to merit those benefits. The man received a letter on Feb. 1 informing him that the condition that had required him to undergo surgery was actually no more than a back sprain, according to a new doctor's appraisal.

The man was a mechanic in 1991 at American Petrofina when he slipped and fell, injuring his back. This eventually led to two surgeries after medication failed to adequately treat his chronic pain. A number of doctors had recommended surgery over the years, and he also had repeated diagnoses from doctors saying that he would need to be treated for the injury indefinitely.

The new doctor, who was asked to review the case by the insurance company, has claimed in late 2012 that the type of injury that the man suffered could not have happened as a result of the accident that he had. The man is considered permanently disabled by the Social Security Administration and retired due to medical reasons by his former employer.

This man's experience may be part of an overall trend in which insurance companies that have been paying out benefits for injuries for many years are now downgrading and denying them. Following a work injury and a denial of coverage of this type, an individual may wish to seek the advice of lawyer. Among other strategies, the lawyer might argue that a doctor whose review caused the denial of the claim has not personally examined the patient or is going against many other professional opinions.

Source: Texas Tribune, "Worker's Benefits Cut Off Two Decades Later", Jay Root, April 28, 2014

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