LOS ANGELES, Feb. 5, 2016 /PRNewswire/ — California Court of Appeal, 2nd District granted former San Francisco 49ers George Visger and his law firm Asvar Law, PC a pivotal win against Travelers Insurance by rejecting Travelers’ appeal petition, and thereby, affirming the findings of the Workers’ Compensation Appeals Board (WCAB) in favor of Visger. The ruling compels Travelers, the workers’ compensation insurance carrier, to pay for long-overdue medical care to this former NFL player.
In the 1980-81 season, Visger played for the 49ers as a defensive lineman. In time, and after multiple concussions, Visger was diagnosed with hydrocephalus, which is the building up of fluid in cavities deep within the brain. The pressure of the fluid can damage brain tissue and cause a large spectrum of impairments in brain function.
In 1984, after three shunt surgeries to drain this fluid, the WCAB “awarded” Visger with 35% permanent disability which amounted to a payment of $10,552.50 for all his troubles. But, the award compelled Travelers Insurance to provide “Such further medical care as is necessary to cure or relieve from effects of his industrial injury.” And according to Visger, that is when the pattern of delays and denials began.
By the time Asvar Law accepted the representation of Visger in 2012, Visger’s once-active and promising life was in tatters. Visger had gone on to need 6 more corrective shunt surgeries. Against all odds, Visger had earned his environmental biology degree post-brain injury, and had set out work as a biologist for several good years. He had married, had three kids, started his own business, but now the steady cognitive decline had caught up with him, and as a result, his work had stopped and his family was in distress. No meaningful medical treatment was being offered to Visger to deal with this gradual decline. As Visger’s attorney Chris Asvar remembers, “There was every indication that this ship was sinking and that George needed urgent help.”
As attorney Jonathan Perez of Asvar Law recalls, “We contacted Travelers and their counsel to find a way forward, so that the parties could work together to help this injured former player.” In response, Travelers hired Paradigm, a catastrophic consultancy company to assess Visger’s condition. Travelers even hand-picked the Paradigm nurse case manager, Douglas Ardley, to provide the report. On April 10, 2013, Ardley, who himself holds a law degree, met with Asvar and Visger at Zachary’s Pizzeria in Berkeley, California, where he personally assessed Visger based on the extensive medical reports in his possession. Ardley asked whether Visger would agree to an intensive brain injury treatment program. Visger said he was ready to do whatever it takes to get better.
As has been reported, Ardley would later testify that once Travelers learned about the costly brain injury treatment recommended in his report, Travelers immediately asked Ardley to bury the report and not issue it. Unfortunately for Travelers, Paradigm had already generated the report that would become the basis for the ensuing litigation over treatment. “In any other branch of insurance industry, except worker’s compensation, this would be the very definition of ‘bad faith’ with serious consequences”, explains Asvar. “But Travelers has gotten away with nearly three years of denials and delays of life-saving care that their own experts believe is necessary, because of our broken system here in California.”
On March 12, 2015, after more than two years of litigation solely on the issue of medical treatment, Judge Davidson-Guerra found that Traveler’s mishandling of Visger’s physicians’ requests for medical authorizations compelled Travelers to furnish the medical treatment at issue.
Undeterred, Travelers continued with its scorched-earth litigation policy and misrepresented the evidence in the case to the WCAB’s 3-judge Appeal Board. The WCAB rejected Traveler’s arguments, and siding with Visger, denied reconsideration on October 29, 2015.
As Asvar explains, “Unfortunately, we have not seen the last Junior Seau, or the last John Mackey, or the last Ken Stabler – folk heroes who put all they had into their professional carriers. But some majestic life force within George has kept him fighting and kept him going. Time is not on our side, and years of heart-breaking delay in treatment do this man no favor. And Travelers knows that very well.”
Dr. Bennet Omalu, the first physician to diagnose football-related traumatic encephalopathy and whose life is the subject of the recent Will Smith movie “Concussion”, has been an observer of Visger’s fight for treatment. Dr. Omalu commented on this news by saying: “Our professional athletes should never be denied the medical care they deserve after their time on the field. I have known George for eight years, and I am deeply joyful that he is going to get the care that he desperately needs.”