Workers’ Compensation Injured Under The Influence

Coworkers attempted to take the Claimant to the hospital, but he refused, informing them that he had smoked marijuana that morning and wanted to avoid any potential drug testing. The Claimant instead left the job site on his own and later that day sought out medical assistance on his own. The Claimant was diagnosed with contusions and fractures.

After reviewing the facts of the case, we quickly sought out the Claimant’s coworkers to gain more information regarding the claim. Due to our thorough investigation and interviews, it was revealed that the Claimant had smoked marijuana the morning of his fall. We obtained as many witness statements as we could, confirming the Claimant was under the influence at the time of the fall. As a result, we advised the Third-Party Administrator (TPA) to deny the Claimant’s claim based on NRS 616C.230.

The Claimant wished to appeal the TPA’s claim denial determination. Upon filing with the Hearing’s Division, HM&C was assigned to the litigation and Claimant’s counsel decided to withdraw from the case, forcing the Claimant to obtain new counsel.

Leading up to the hearing date, HM&C worked with the employer to secure character and fact witnesses to support denial of the claim on the date of the hearing. Ultimately, at the Hearing on the matter, we provided superior legal representation and the Hearing Officer, relying almost exclusively on the witness statements that we had obtained and submitted, held as follows:

The Employer doubted the validity of the claim based upon the Claimant’s confession to smoking marijuana prior to working. The Insurer provided three witness statements from the Claimant’s coworkers. The coworkers state that after the Claimant fell, he refused immediate medical care stating that he did not want to be drug tested as he smoked marijuana that morning. The Claimant left the worksite prior to the arrival of the Employer to the site of the accident.

However, the Claimant appealed the Hearing Officer’s decision. It was at this time that the Claimant’s counsel again withdrew his representation of the Claimant. Nevertheless, the Claimant retained his third individual to represent him. We then began to diligently prepare arguments and witnesses in preparation for the Appeals Officer. However, the appeal was ultimately dismissed in favor of our client.