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Claims and Denials

St. Petersburg Times
9/28/2008

Jamie Dolan arrives at a Starbucks clutching his wife’s arm and the first thing you notice is he seems fragile, weighted, broken.His left eye is covered with a patch; his fingernails are long.

Four years ago, a gunman walked into the Gateway Mall RadioShack where Dolan worked and started shooting. Three people died, including the shooter. One bullet traveled into Dolan’s temple and took out both his eyes.

The community rallied around the young husband and father of three. The television show Extreme Makeover: Home Edition built him a 3,500-square-foot home. The episode ended with a joyful, overwhelmed Dolan surrounded by family, cheered by his neighbors, optimistic about the future.

But he is no longer the man you saw on the show. Since then, the Dolans have almost lost the house, and the community donations are long spent.

“We had to borrow from everyone we knew to keep food on the table for the kids,” Dolan says at Starbucks, surrounded by his four attorneys.

He has learned to live in darkness, but he struggles with an enemy as unexpected as the gunman: His insurance company.

As he talks, he starts to perspire and breathe heavily. He clenches and unclenches his fists. He feels the familiar pain as it travels up his arm, mimicking a heart attack.

His wife whispers in his ear. They get up and head to the bathroom.

It’s another panic attack. He is used to them by now.

– – –

Because Jamie, now 34, was injured on the job, the family will depend on workers’ compensation insurance for the rest of his life, unless he can work again. Liberty Mutual, RadioShack’s provider, covers his medical costs and 66 percent of his former pay – about $1,300 a month.

The Dolans have fought with Liberty Mutual for three years. Jamie and Christina say the battle has been as difficult as dealing with his blindness.

Until recently the company wouldn’t pay for Christina to care for Jamie – even though a doctor ordered a caregiver and the law requires it. Liberty Mutual even ignored a judge’s order to do so. It took the company four months to approve his visits to a psychiatrist, even though he had gone to the emergency room with symptoms of a heart attack and been diagnosed with panic attacks. Company representatives tried to send him to job interviews, even after the psychiatrist diagnosed him with post-traumatic stress disorder and panic attacks.

In depositions and testimony filed with Jamie’s workers’ compensation case, the insurance company has said Christina turned down benefits. She denies this. Later, the company said the couple didn’t need them.

Patricia Rose Richert, a Liberty case manager, visited Jamie in his home a few months after the shooting. He could get around the house, eat and was able to take a shower.

“He was able to get his basic needs,” Richert said in court documents.

The company believes Jamie Dolan should be living and traveling independently.

“A lot of blind people do,” Liberty adjuster Mendi Benbrahim said during a hearing last January. On Friday, exhausted and fed up, the Dolans filed a lawsuit against the insurance company for the emotional distress caused by years of wrangling over benefits.

Jamie’s lawyers say he is an example of the struggles injured workers face getting help since the Legislature drastically cut lawyer fees in 2003.

Consider a case now before the Florida Supreme Court. A lawyer hired to handle an injured nursing assistant’s claim was paid $650 for 80 hours of work. (The Dolans’ workers’ compensation lawyer, Brenda Furlow, has received about $30,000, but says she has put in hundreds of hours on the case.)

Tom Carey, one of the Dolans’ lawyers in the emotional distress suit, said the new law has produced a “bunker mentality” in which insurance companies reject claims with impunity because so few lawyers are willing to handle these cases.

“If they’re doing this to us and we’re so in the spotlight, how many other little people are they doing it to?” Christina asked.

Liberty Mutual wouldn’t talk about the Dolan case for this story. The company referred questions to William Stander of the Property Casualty Insurers Association of America.

Stander said the 2003 law rooted out a lot of fraudulent claims and businesses pay much lower workers’ compensation premiums as a result.

“They say the law keeps people from getting attorneys, but they’re obviously representing this man,” Stander said.

– – –

Christina and Jamie Dolan return to the table after his panic attack. He has recovered but is still shaky. His answers to questions begin with a huge sigh.

The Dolans are hesitant to share their story. They don’t want to come across as ungrateful.

They know they’re lucky. They have each other. They have their three kids, Charles, 16, Haley, 10, and J.T., 6. Their massive custom home dwarfs every house in the Bay Pines neighborhood where Jamie grew up.

It has walls textured in bamboo, stone and cork so Jamie can find his way around, a carpet path that keeps him from tripping over furniture, a voice-command computer that allows him to turn the lights on and off.

But after the Extreme Makeover crews left, the hard work began.

When Jamie came home from the hospital, he was completely dependent on Christina. His eyeballs had been removed so she had to clean out his eye sockets, apply ointments and dressings, help him take a shower, dole out his pills.

He couldn’t go to the bathroom by himself, couldn’t walk to the living room. More surgeries followed to repair his eyelids so they would accept prosthetic eyes.

But Jamie was determined to resume his life. He took courses to learn how to get around, cook and use a computer. He got a guide dog.

Still, Christina, who had worked as an administrative assistant for Sand Key Realty earning $12 an hour, said there was no way she could return to work. He needed her.

Soon, she began to notice a change. He had been such a gentle man before the shooting. She couldn’t remember a time he yelled at her in 13 years of marriage.

Now he was snapping at her and the kids over little things, like when they made too much noise. “You can only say ‘Daddy doesn’t mean it’ so many times before they look at you and say ‘Why does he keep doing it then?'” Christina said.

At the same time, he felt guilty.

“One of the hardest parts about all of this for me is feeling like I’m not providing for my family the way I should,” he says.

The first panic attack came about two years ago. He felt uneasy. His arm hurt, then he couldn’t breathe. He felt pressure on his chest.

“I went from having a good day to being completely scared out of my mind,” Jamie said, “to feeling like I was going to die.”

The attacks grew in frequency, sometimes to several a week. He wouldn’t leave the house for weeks on end.

While he struggled with the panic attacks, their money began to run out and their credit card debt grew. They owed Target more than $7,000 and Citibank about $2,500. Their Plymouth Voyager was repossessed.

Living in a bigger home compounded the problem. The Dolans’ old house had cost them $1,300 a month; the spacious Extreme Makeover home cost $2,200. The mortgage was the same, but the taxes and insurance ballooned.

The electric bill also went up. It got to the point where Jamie discouraged Charles from using the robotic arm installed by Extreme Makeover in his room because it used too much electricity.

The insurance company still wouldn’t pay Christina to be Jamie’s caregiver. The Dolans talked about selling the house, but friends and family helped them out.

A few months ago, after their attorney filed a complaint with the Department of Financial Services, Liberty Mutual paid Christina $163,000 for the four years of care she had given her husband.

She was relieved but still worries about the future. She doesn’t feel comfortable going back to work at this point and leaving him.

“That’s all the money we have,” she said, “and I don’t know how long that has to last.”

– – –

On the sidelines of their 6-year-old son’s flag football game in Seminole, Christina tries to explain to Jamie what’s happening on the field.

“Okay, they’re lining up,” Christina says. “The one kid’s got the ball.”

She struggles to provide play-by-play for a sport she doesn’t really understand, and promises to get it down by the time the 6-year-old goes to high school. They laugh at the joke.

They met at Seminole High. She tripped over a rock at the county fair and he caught her. Theirs is one of those rare relationships, she says. “He completes me.” She misses the way he looks at her when she comes into the room but still gets to experience his sarcastic sense of humor.

Minutes later, J.T. runs down the field with the football. He scores. In the excitement, she forgets to tell her husband.

This is the daily reality of Jamie’s life.

He can’t follow his kid’s football game. His entire family gets up from the dinner table and he doesn’t realize it. He worries that one day he’ll wake up and forget what his kids look like.

He has mental images from four years ago so he often feels their faces to see how they’ve changed. Then he tries to alter the image in his head.

He doesn’t think about the future, which seems “very far away.”

“I’m a very proud man and I’ve always been able to take care of what needed to be done,” he said, “and now that I can’t, I don’t know what to do with myself. I can’t make it better. I don’t know how to fix it.”

Times researcher Shirl Kennedy contributed to this report. Times reporter Leonora LaPeter Anton can be reached at lapeter@sptimes.com or (727) 893-8640.

FAST FACTS Workers’ comp 2004: 79,338 workers out more than seven days received $1.72-billion in workers’ compensation claims.

2007: 62,023 workers out more than seven days received $712-million in claims. Source: state of Florida

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