$6.5 Million Settlement: Roof Fall, Catastrophic Traumatic Brain Injury 

What Happened 

Our client was working at height on a residential roofing project when the roofing surface gave way beneath him. He fell through the roof and struck his head, sustaining a catastrophic traumatic brain injury. He was transported by ambulance to a Level I trauma center, where the extent of his neurological damage became clear over the following days and weeks: he would not recover the cognitive or physical function he had before the accident, and he would never return to work. 

In the months that followed, his medical needs were not the kind that resolve; they were the kind that compound. Our client required inpatient rehabilitation, around-the-clock supervision, specialists, medications, and adaptive equipment. The kind of care that, without the right legal structure, can bankrupt a family inside of a year and leave the injured worker dependent on Medicaid for the rest of their life. 

What the Carrier Argued 

In catastrophic injury claims, the carrier’s playbook is rarely to deny the accident outright as the accident is documented and the hospital records are unambiguous. The fight is over the scope and duration of care. Carriers move to limit the cost of long-term rehabilitation, push back on the level of attendant care required, dispute the need for specialized cognitive therapy, and resist the classification of permanent and total disability. 

Every day that those issues stay unresolved is a day the injured worker’s recovery is compromised by uncertainty about whether the next round of treatment will be authorized. We treat that timeline as adversarial: every delay benefits the carrier financially, and our job is to close it. 

What We Proved 

Stephen Berlin built the case around the statutory entitlement to permanent total disability benefits under Florida Statute § 440.15(1), which apply when a catastrophic injury renders a worker unable to engage in at least sedentary employment within a 50-mile radius of their home. With detailed neuropsychological evidence and the right medical experts, we established that our client’s TBI met that threshold and would for the rest of his life. 

Separately, we documented the ongoing scope of medical and rehabilitation care required under § 440.13, which entitles an injured worker to all medically necessary treatment causally related to the accident. That meant securing authorization for 24-hour professional rehabilitation, not intermittent therapy or outpatient visits. The medical record had to support that level of care, and we built it. 

Stephen’s 17 years on the carrier side mattered here. He sat at the conference room table where these decisions are made. He knows which arguments carriers will fold on, which they will dig in on, and which IME doctors will return reports favorable to which positions. That perspective shaped the case strategy from the first week. 

When the case moved toward settlement, the structure mattered as much as the headline number. A catastrophic TBI claim with lifetime medical exposure raises Medicare Secondary Payer issues that, mishandled, can later cost the injured worker their Medicare coverage for the very condition that made them disabled. We coordinated a Medicare Set-Aside arrangement consistent with CMS thresholds and worked the structured settlement so that the funds would actually last. 

What This Result Meant 

For our client, the $6.5 million figure was necessary to help cover the cost of care for the rest of his life. The settlement, combined with the PTD benefits secured before settlement, was designed to cover lifetime medical and rehabilitative care, residential care services, equipment replacement, and supplemental income to his family for the decades during which he will be unable to work. 

For his family, it meant they could continue to be his family rather than becoming, by financial necessity, his only caregivers. 

The Takeaway for Other Injured Workers 

Catastrophic injury claims are not won by holding out for a number. They are won by building a record, statute by statute, that forces the carrier to acknowledge the full scope of what the law actually requires it to provide. The number follows. 

If you or a family member has suffered a serious head injury, spinal cord injury, or other catastrophic workplace injury in Florida, talk to us before you talk to the carrier. 

Hurt at Work? Talk to Berlin Law Firm

If you have suffered a serious injury on the job in Florida, the steps you take in the first weeks of your claim can shape what your case is worth for the rest of your life. Berlin Law Firm focuses only on Florida workers’ compensation, and our team includes attorneys with deep experience on both sides of the system. 

Consultations are free, and under Florida law there is no fee unless we recover benefits for you. 

Past results do not guarantee a similar outcome. Each workers’ compensation case is evaluated on its own facts, including the type and severity of injury, the worker’s age and pre-injury wages, the carrier’s defenses, and the medical evidence available. The settlement described above reflects circumstances unique to this case. 

Your Attorney

Stephen Berlin, Esq.

Managing Attorney & Founder · Workers’ Compensation

Stephen Berlin has more than 30 years of experience in Florida workers’ compensation, including 17 years managing the in-house legal operation for one of Florida’s largest workers’ compensation carriers. He founded Berlin Law Firm to use that insider knowledge on the side of the injured workers the system was built to protect. Licensed in both Florida and Georgia, Stephen has spoken at over 100 workers’ compensation seminars across the state and represents clients in catastrophic and complex claims from the firm’s Sarasota and Tampa offices.

Education & Recognition

• J.D. and M.B.A., University of Florida · B.A., Vanderbilt University
• Martindale-Hubbell AV Preeminent® Rated
• Avvo Client’s Choice Award – Workers’ Compensation
• Speaker at 100+ Florida workers’ compensation seminars

Call Stephen — (941) 777-7000 [email protected] View Full Bio →