April, 2025 – Our client sought immediate care at a local emergency room and then began a course of care with a chiropractor, pain management physician, and a neurosurgeon. He was prescribed MRI imaging studies of his cervical and lumbar spine, which were positive. The MRI study of the cervical spine revealed multiple herniations requiring future care, but his lower back pathology was of greater concern. The lumbar spine MRI revealed an L3-4 disc herniation with migration of disc material, a focal annular tear adjacent to the right S1 nerve root, and an L4-5 disc herniation mildly asymmetric to the left paracentral position. An EMG/NCV nerve study, revealed evidence of left L5 radiculopathy. He suffered with continued pain radiating down his left leg to the foot, characterized as throbbing, shooting and annoying. His pain management physician then performed a series of lumbar epidurals at L3-4 on the left side, which provided minimal relief. His lower back pain continued to radiate to the buttocks down the left posterior thigh and into the foot with significant pain especially when sitting and driving long distances in the course of his job. As a result, his neurosurgeon performed a left-sided L-3 to L-5 lumbar microdiscectomy decompression surgery in the hospital, followed by extensive PT and prescribed medications to relieve his pain. A lumbar MRI taken after this surgery continued to show L3-L4 and L4-L5 neural compression. He also underwent lumbar facet nerve injections at L3, L4, L5. Ultimately, his neurosurgeon opined that further decompression at L3-L5 and a likely S1 fusion surgery would disable our client for at least six months from his work duties selling high-end luxury boats. While this surgery would have the goal of improving his pain, the treating spinal surgeon concluded that the procedure would create a permanent loss of range of motion and thereby limit repetitive physical activities and pose a significant risk of his not returning to work. He estimated future surgical care and periodic need for pain management and ancillary costs at over $500,000, and causally related over $48,000 of out of pocket and ERISA lien obligations. Our client also had been diagnosed as having anxiety and major depressive disorder, by a psychiatrist, for which he was prescribed medication. The defendant had $2M in coverage and our demand for the policy limits, per NJ’s bad faith legal doctrine led to a prompt favorable resolution.
**Results may vary depending on your particular facts and legal circumstances**