A warehouse worker and delivery helper with a catastrophic leg injury obtained a $2.1 million workers’ compensation settlement after the insurance company refused to approve medically necessary home health care.
When workers’ compensation attorney Thomas DeBenedetto took over the case, he challenged the denial, built the medical foundation for home health services, and pushed the matter into litigation.
This case shows how strong medical documentation and focused advocacy can turn a complete denial into long-term financial stability and essential in-home support for an injured worker.
The worker suffered a severe injury to his left leg while performing his warehouse and delivery duties. The injuries left him unable to walk or stand safely for extended periods. Routine tasks in his home became difficult and unsafe without assistance.
Chronic pain, reduced independence, and isolation led to depression and stress-related gastrointestinal complications that further undermined his health.
Because his physical and psychological conditions were intertwined, he needed regular assistance with activities of daily living. Bathing, dressing, meal preparation, housekeeping, and safe transfer were essential.
Without structured support, he faced the risk of further injury, worsening symptoms, and avoidable hospitalizations.
Despite multiple medical providers documenting his limitations and recommending in-home assistance, the workers’ compensation insurance company initially refused to authorize home health care.
The denial overlooked key factors:
As in many serious workers’ compensation cases involving long-term services, the insurer questioned the scope and duration of home health care, focusing on cost rather than the medical realities of his condition.
The legal strategy centered on building a clear, medically grounded record tying in‑home care directly to the worker’s leg injury and resulting complications.
The approach emphasized:
By aligning medical opinions, treatment records, psychological evaluations, and functional limitations, Thomas DeBenedetto framed home health care as essential medical treatment—not a convenience—and demonstrated that the worker could not realistically live independently without it.
After litigation and a strong evidentiary presentation, the defense reversed its position on home health care, and the parties reached a global settlement that accounted for the full impact of the injury.
The settlement also recognized that his in-home assistance was a necessary component of his ongoing workers’ compensation medical care.
The case ultimately resolved for $2.1 million, a result that reflected:
This recovery provided the worker with financial stability for future medical and support needs, along with formal recognition that his home health care was a necessary and compensable part of his work-related treatment.
For warehouse workers, delivery helpers, and others whose jobs involve heavy physical demands, this case underscores how a single serious injury can affect nearly every area of life. When mobility is significantly limited and mental health or gastrointestinal conditions develop as a result of the injury, the need for coordinated medical care and in-home support can increase dramatically.
If a work-related injury has left you struggling with daily activities, especially when combined with emotional or digestive issues:
This case shows how experienced representation can secure essential medical benefits, home health support, and long-term financial relief even when a claim is initially denied.
To learn more about how our firm helps injured workers through complex cases like this, visit San Diego Workers’ Compensation Attorneys.
Stop struggling and speak with an experienced work injury attorney who can get you the benefits you deserve — Thomas DeBenedetto, San Diego’s Workers’ Compensation Attorney since 1992.
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