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Insurer ordered to cover ongoing care for manager shot 12 times

A very interesting workers' compensation case recently came to a close in the state of Nebraska concerning whether a clothing company and its work comp insurer were obligated to cover the costs of post-traumatic stress disorder and drug treatment for an employee shot multiple times while on the job.

Back in June 2011, two men robbed a Gen-X Clothing store in Lincoln, threatening the store manager not to report the crime to the police. The 37-year-old manager, however proceeded to do just that and the two robbers were arrested.

Shockingly, a brother of one of the robbery suspects showed up at the store two weeks later and shot the manager 12 times to prevent him from testifying. Amazingly, he survived and testified at trial, making sure that all three men were sent to prison for a long time.

In the aftermath of the shooting, Gen-X Clothing and its work comp insurer, Farmer's Truck Insurance Exchange, paid the manager's medical bills and temporary disability benefits while he recovered from his physical injuries.

Problems arose, however, when the manager sought coverage for the PTSD and associated chemical dependency issues diagnosed by two different mental health professionals in the aftermath of the shooting. Specifically, payment was denied for the costs of inpatient treatment and ongoing associated expenses.

The matter eventually came before the state's Workers' Compensation Court, where, after careful consideration of the evidence presented, Gen-X Clothing and Farmer's Truck Insurance Exchange were ordered to cover the costs of the manager's inpatient treatment, ongoing medical expenses and temporary disability benefits.

The parties appealed to the Nebraska Supreme Court, which upheld the decision last week, ensuring that the manager, who has been unable to work since the shooting due to his ongoing mental health/addiction issues, will get the assistance he needs.

"He's a pretty brave guy, to be treated this badly," said the manager's attorney. "It's been very unfortunate that, in addition to having to face down those who tried to kill him, the employer's insurance company made it so difficult for him."

While cases like these are obviously not the norm, they do serve to demonstrate just how important it is for people to strongly consider consulting with an experienced legal professional if they are encountering problems securing the work comp benefits to which they are entitled.

Source: The Omaha World Herald, "Nebraska Supreme Court: Workers' comp includes PTSD, drug treatment after store shooting," Chris Machian, April 12, 2014

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