Attorney Sonia Das, based out of I&F’s Indiana office, recently secured two favorable decisions on behalf of Indiana employers. In the first, a memorandum decision (not for publication), the Indiana Court of Appeals upheld the decision of the Full denying a claim that the insurance carrier acted with a lack of diligence in the handling or adjusting of the injured worker’s claim for benefits. In that case, the injured worker began treating on her own for an ankle injury. After the injury was reported as a worker’s compensation claim, the injured worker complained that the insurance company did not diligently accept compensability of the injury. The evidence showed that Plaintiff did not initially report her injury to her doctor as work related. The insurance company requested a causation opinion from that doctor, the doctor responded that he could not form an opinion as to whether the injury was work related. The insurance company subsequently arranged for the injured worker to be evaluated by another physician, who concluded the injury was work-related. After obtaining that opinion, compensability was accepted. The Court of Appeals held that the injured worker failed to meet her burden of proofing that the periods of time that passed between each action taken by the insurance carrier amounted to a lack of diligence. On appeal, the injured worker amounted to a request for the court to reweigh the evidence, which the court refused to do.
In the second, the Full Indiana Worker’s Compensation Board upheld the decision of a Single Hearing Member that Plaintiff had not met her burden of proving that she suffered from Reflex Sympathetic Dystrophy (RSD) or Complex Regional Pain Syndrome (CRPS). Plaintiff sustained a compensable injury to her left ankle when she slipped and fell on ice. She underwent extensive authorized medical treatment, including physical therapy, injections, and two surgeries, but continued to complain of pain even at the time of discharge. After being placed at maximum medical improvement by the employer’s attending physician, Plaintiff treated on her own and was allegedly diagnosed with RSD or CRPS. A Board-appointed independent medical examiner found that Plaintiff did not meet the diagnostic criteria for CRPS. The Hearing Member found that none of medical records for the Plaintiff’s authorized medical treatment reflected subjective or objective evidence to support a diagnosis of RSD or CRPS. The Hearing Member further found that although Plaintiff received a significant amount of treatment on her own for RSD, the evidence failed to reveal that Plaintiff had, in fact, been diagnosed with that condition. Therefore, the Hearing Member denied Plaintiff’s claim for worker’s compensation benefits related to RSD or CRPS, including additional lost time, reimbursement of unauthorized medical treatment, and palliative measures.
Sonia can be reached at our Indiana office:
9165 OTIS AVE
INDIANAPOLIS, IN 46216