Skip to Navigation
The Collaborative Clearinghouse for Lawsuits and Other Claims Against ACE Group Insurance Companies

California Appellate Court Rejects ACE American Attempt to Evade Workers Comp Payment to Paramedic Stroke Victim.

May 15, 2012 - The California Court of Appeal has rejected an effort by ACE American Insurance Co. to overturn a decision by the state’s Workers’ Compensation Appeals Board affirming an award against ACE.

The court’s review, in which three judges in the Second Appellate District concurred, held that the ACE Group unit and co-petitioner American Medical Response “have not supported their theory of the case with evidence.”

Ronald Westerman was employed as a paramedic with American Medical in March, 2009, when he suffered a stroke following a 36-hour shift at work.  He underwent emergency brain surgery and was hospitalized for more than two months; he has not returned to work and requires home care assistance.

Arthur Lipper, who became the primary treating physician for Westerman, concluded that his patient’s stroke had an “industrial component.”  ACE American and American Medical contested that position, and the matter was submitted to a qualified medical examiner, Paul Grodan.

Grodan theorized that Westerman’s stroke was a result of a blood clot. But the court said his conclusion was conditioned upon detecting a hole in Westerman’s heart.  A medical procedure would be required to find such an abnormality, and ACE said that it has authorized such a test.

However, the court determined that there is no evidence the petitioners actually demanded that Westerman undergo the test. At oral arguments, lawyers for the insurer did not produce a letter they said purported to demand the test.

Further, the judges wrote that there was no evidence that Westerman, or his guardian acting on his behalf, refused to take any such test.

The Workers’ Compensation Administration Law Judge had found that Westerman sustained a stroke in the course of his employment.  In affirming the board’s decision, the appeals judges said that the initial determination was supported by substantial evidence.

Like us on facebook!

Please note that article images are for illustrative purposes only. Images do not necessarily depict the actual facts, events, or people discussed in this story.