In September 2021, Murphy Law Firm prevailed in a week-long trial in Montana’s Workers’ Compensation Court in the case of a woman seeking benefits for lower back injuries from her employer’s insurance company. In Candida Krezelak v. Indemnity Ins. Co. of North America, 2021 MTWCCC 16, Matt Murphy succeeded in exposing flaws in the medical opinions of the doctor hired by the insurance company, successfully securing significant benefits for Mrs. Krezelak and her family.
Candida (“Candi”) Krezelak, a married mother of 4, was working as a nurse in September 2009 when she suffered low back strain while trying to lift a patient in the operating room. A lumbar MRI revealed mild degenerative disc disease, but no definite herniated disc. She was treated with physical therapy and cleared to return to work with no restrictions in January 2010.
In 2012, Candi was hired as a nurse case manager for Coventry HC Workers Comp., Inc. Her new role required driving long hours and distances in order to meet with patients in various cities. It wasn’t unusual for her to drive 80 hours and up to 1,000 miles in the course of a workweek.
From 2010 to 2016, Candi would occasionally experience a flare-up of pain and discomfort in the SI joint and hip due to the injury she had sustained as a nurse, but she was usually able to relieve it with stretching so she never sought treatment.
But on April 28, 2016, Candi’s life changed forever.
While driving home from a work appointment, her car hit a sheet of ice and slush.
“What I remember from the day of my car accident, primarily, is the fear I felt when I hit the sleet on the road and lost control of my car,” said Candi. “As my car began to spin I remember grasping the steering wheel very tightly, closing my eyes and praying. At that moment I knew that if I was going to survive this wreck, I didn’t want to relive it over and over again in my head so I closed my eyes and left it in God’s hands.”
Her vehicle spun several times and came to an abrupt stop when the passenger side of her vehicle hit a fence. While her memory of what happened immediately after the crash is blurry due to her confusion and shock, Candi recalls people stopping to help and her husband showing up at the accident scene around the same time as the ambulance.
There were no obvious signs of serious injury like blood or broken bones, so Candi decided not to take the ambulance and instead went home with her husband. While attending her child’s school for a program later that night, her condition started deteriorating rapidly. She started experiencing an intense headache, nausea, confusion, body aches and pains everywhere, but particularly in her left shoulder and mid-back. She asked her husband to take her home, hoping that all she needed was some rest.
“I didn’t know how to process everything, but I did know that I was blessed and thankful to be alive.”
Unfortunately, her condition continued to worsen.
The evening of her car accident, Candi submitted a completed First Report of Injury form to her employer—Coventry—noting that she planned to obtain medical care.
Four days after the accident, on May 2, Candi attended her first accident-related doctor’s appointment. By this time, she reported pain in her upper, middle, and lower back, as well as both of her shoulders. She was also experiencing numbness in her left arm and hand, as well as paresthesia in her left 4th and 5th fingers.
When Candi first spoke with her employer’s insurance company—Indemnity Insurance Company of North America—on May 6, she complained of pain in her neck and back.
Over time, the chronic low back pain and numbness in her left arm and fingers began to negatively impact her work, as driving and typing tended to make these symptoms worse. What began as a dull ache worsened and spread to other areas of her body, including her hips, legs and buttocks. She quickly realized that this was a different kind of pain than the mild discomfort she had experienced in her hip prior to the crash.
When Candi initially found out that her insurance company wanted to investigate further into her low back symptoms and treatment, she understood their reasoning. After all, she had been working as a nurse case manager for workers’ compensation for many years and knew the next steps.
But as time went on and treatment was delayed, she became overwhelmed and frustrated.
Early on, she felt some soreness in her low back, but it wasn’t her primary focus—that is, until the pain became unbearable and started affecting her daily activities. Her health and well-being significantly declined after the car accident. She started struggling not only with ongoing issues from the accident, but also several other health conditions and surgeries.
“Chronic pain can change a person and their ability to cope,” said Candi. “For me, one of the hardest components was to continue working as a nurse case manager for workers’ compensation.”
To maintain a professional working relationship with the insurance company, physicians, attorneys and injured workers when she was in so much pain and feeling alone became increasingly difficult.
There were many times where she couldn’t even sit in a waiting room with the injured worker because of how much pain it caused her. Other times, she would trip when standing in the room with the physician and patient because her leg would give out.
Sometimes, the pain would be so unbearable that she would start sweating and get nauseous, or have to pull over to get out of her car and walk around because she could only drive for 30 minutes at a time until the pain set in.
“I don’t bring any of this up for sympathy,” said Candi. “I bring this up because I always maintained my professionalism and nobody knew what I was going through because, at the end of the day, it wasn’t about me. It was about what I needed to do for my job and what treatment I needed to coordinate for my injured worker. It was so hard for me to be an advocate and set up treatment when my own treatment was being denied by the insurance company.”
In addition to work, her personal life was also greatly impacted.
Despite losing weight in an effort to better manage her SI joint and hip pain, Candi’s symptoms worsened. The pain soon made it impossible to go to the gym regularly as she had been doing before the accident, and she was even forced to halt personal training sessions when her trainer requested that she seek medical clearance before resuming the program.
Determined to stay active, she started taking frequent walks with friends, but gradually those too became quite painful. By the end of 2016, Candi could no longer walk with her friends because of her low back pain.
Nevertheless, Candi’s doctor initially reported that no further treatment was needed and she had reached maximum medical improvement (MMI). He released her to return to work without restrictions and no impairment rating.
Several doctors, chiropractors and months later, Candi had a follow-up lumbar MRI done in October 2019. Based on the radiologist’s findings of disc herniation, she realized for the first time that she was likely dealing with a serious low-back injury caused by trauma—and that the trauma was the work-related car accident.
At this point, Candi was diagnosed with low-back pain, degenerative disc disease at L4-5, and a possible concurrence between her chronic health condition and a spine-related phenomenon. Later, she was diagnosed with lumbar radiculopathy and chronic low back pain.
Despite Candi’s doctors agreeing that the low back injury had been exacerbated by her motor vehicle accident, the physician employed by the insurance company to conduct the independent medical examination (IME) reported that, in her opinion, Candi’s lower back pain was not related to the accident. The IME doctor also said she didn’t think Candi’s accident aggravated a pre-existing condition.
As a result, the authorization request for low-back surgery was denied. The insurer also denied Candi’s doctor’s request to refer her to a different surgeon to talk about a different approach to lumbar spinal fusion.
“As treatment was denied and my back worsened, I started to question the system and myself.”
Candi’s doctors filed disagreements with the IME assertion that the back pain was not related to the car accident. Around this time, she underwent L4-5 decompression and fusion surgery. Once she recovered from the operation, Candi returned to more like her “old self,” such as being able to take walks with friends with less pain.
By April 2020, though the pain dissipated, she was still experiencing numbness in her left 4th and 5th fingers. Her doctor recommended an ulnar nerve injection, but again the IME doctor concluded that Candi’s left-and right-sided cubital tunnel syndrome wasn’t caused by the accident and Indemnity denied liability (and benefits).
The insurance adjuster testified that the 3-and-half-year delay in diagnosing cubital tunnel syndrome was a “significant factor” in denying liability. Indemnity also denied liability for Candi’s left carpal tunnel syndrome.
Candi reached out to Matt Murphy at Murphy Law Firm as soon as her treatment started getting denied.
As a nurse case manager, she had established a strong professional working relationship with Matt built off of trust. She felt like they both worked long hours to provide quality services, and she quickly saw how much passion Matt put into his work and his clients. While she had some expertise as a nurse case manager, she knew she needed Matt’s expertise for her case.
“Matt responded to my message within minutes and was 100% by my side the entire time, even before I signed a retainer. Matt has a servant’s heart and it shows through his high-quality work for his clients.”
During the trial, Matt Murphy argued that the opinions of Candi’s 2 doctors that the accident caused or permanently aggravated her L4-5 condition should be given more weight than the opinion of the IME doctor because Candi’s doctors had better credentials and more experience treating such conditions. They also spent more time with Candi over a longer period of time, so they had more knowledge of her medical history and symptoms.
During the week of the trial, Candi prayed for a positive outcome. In her heart, she trusted that the Court would rule in her favor. Nevertheless, she was overjoyed when Matt Murphy called to tell her that her prayers had been answered.
“I remember the day I signed the retainer with Matt and what he said I will never forget. He told me to always tell the truth and God will take care of the rest, and that’s what I did.”
In the end, the Court agreed with Candi, finding:
“Although not conclusive, the opinion of a treating physician is generally afforded greater weight than the opinion of a competing expert… Taking into account that the standard of proof is a preponderance of the evidence, this Court finds that [Candi] met her burden of proving that her L4-5 condition was caused or permanently aggravated by the MVA.”
The Court cited 2 reasons for this finding:
- Candi’s neurosurgeon was given more weight than the insurance IME doctor because the neurosurgeon was the plaintiff’s own treating physician and (as the IME doctor conceded) he had the best credentials to determine the cause of Candi’s symptoms.
- The argument made by Candi’s neurosurgeon that the trauma caused by the accident accelerated or aggravated her back pain was persuasive to the court as they were based on objective and solid evidence
In addition, the Court found that Candi was a “credible witness.” The Court also found it unlikely that all 8 friends and family who testified on her behalf under oath, though naturally biased, were lying.
Candi’s Motion to Compel Indemnity to Accept her Claim and Pay all Benefits Due Was Granted.
“I will forever be grateful to Murphy Law Firm, especially the ones I worked the closest with throughout my case (Matt, Catherine and Tommy). I feel blessed and have so much gratitude for Matt, the judge and the system. I have a huge sense of relief now that I can start to close this chapter and move on.”
Candi’s number one goal was to have her voice be heard. She wasn’t afraid to go to trial. On the contrary, she hoped that her voice would be heard by someone else who could be warned about what she went through.
“Even if it changes the system by just 1 percent for others fighting the same battle, it is a win in my mind. No one should have to go through that and feel like they did something wrong from a work-related injury.”
For Matt and Tommy Murphy, this is exactly the type of case that makes fighting the good fight for injured Montanans worth it. The entire Murphy Law Firm team is thrilled that we were able to secure a positive result for Mrs. Krezelak and secure the benefits she justly deserved.
“This decision was not only important for Mrs. Krezelak and her family,” said Matt Murphy. “It also positively impacts all injured workers in Montana who are denied benefits by an insurer relying on a biased medical examiner.”
If you, like Candi, were injured in a work-related accident and have been denied benefits, we urge you to consult with the experienced Montana workers’ compensation attorneys at Murphy Law Firm as soon as possible. You might be surprised at what we can do to secure the compensation you are owed.