Seeking a better life for his family, Rafael Pineda agreed to relocate more than 200 miles from his wife and three children to work on an industrial project in Long Beach, California.
On 12/07/17, this 30-year-old iron worker was struck by a car while riding to work on his motorcycle. The car hit Rafael’s motorcycle at such a high rate of speed that he flew through the air into a parked truck and then bounced off into a fire hydrant and then a wall, striking both with his helmet.
Rafael’s motorcycle was not the only thing that was destroyed in that accident. Rafael’s brain and spine were irreparably damaged. His doctors diagnosed him with a severe traumatic brain injury which requires him to receive care from another for the rest of his life in order to live.
After being turned down by four law firms, Rafael’s wife/registered nurse, Alexis, spoke with a fellow nurse who referred her to the Law Firm of Hiden, Rott & Oertle, LLP in San Diego, California.
The reason that the first four law firms turned down Rafael’s case is that his claim was being denied by his employer’s insurance company due to a little-known exception called the “Going and Coming Rule”.
Shortly after being retained by Alexis, the insurance company’s lawyer offered $10,000 to settle Rafael’s entire claim. Since $10,000 would not even pay for Rafael’s much needed hospital bed, attorney Michael Rott did extensive research of the law, spoke with witnesses, and formulated a solid game plan.
In the end, after a lengthy trial, and a motion for reconsideration (which is an appeal in the workers’ compensation court system) filed by the insurance company, who had lost at the trial level, the insurance company agreed to accept the claim and began paying Rafael and his family nearly four years of past disability payments. When the insurance company then delayed important medical benefits such as a wheelchair accessible van, two caregivers to provide 24/7 care, and ADA housing, attorney Michael Rott went back to Court to get these benefits for Raphael. Shortly after that hearing, negotiations for settlement of the largest reported claim in California Workers’ Compensation history began. Nearly two weeks later, Rafael’s wife and guardian, Alexis agreed to a settlement that would take care of Rafael and his family for life. As part of the settlement, Rafael’s mother, Yolanda, also received a settlement for the home healthcare services she provided while Raphael’s case was denied.
This is an extremely important settlement, not just for Rafael and his family but for all injured workers who have been catastrophically injured in California.
