I&F secures favorable decisions in 3 consolidated cases

In these cases, the claimant, a 14-year custodian for the Respondent, filed 3 claims for alleged injuries to her right shoulder on February 7, 2013, October 13, 2013 and March 17, 2014. She testified that her job duties included cleaning bathrooms and hallways, utilizing a vacuum sweeper and a heavy mop with a bucket. In the earliest claim, the claimant alleged an injury to her right shoulder when she tried to wring out her mop at work and felt a crack. She reported the injury later that day, was seen in the emergency room, underwent x-rays that were normal and was diagnosed with a right shoulder strain. She underwent conservative treatment and on March 28, 2013, she was released to full duty by her treating physician and advised to return as needed.

She returned to work on March 28, 2013 until October 13, 2013, at which time she complained of right shoulder pain to her supervisor. In her subsequent medical visit on October 18, 2013, she didn’t specify any specific accident or event. She was referred back to her treating physician and on October 28, 2013, she reported recurrent pain, but no specific trauma or incident that would have triggered or aggravated the right shoulder problem. She was given a steroid injection, taken off work and an MRI scan was ordered. The claimant also completed FMLA paperwork on October 18, 2013, but didn’t specify an injury, but rather, she cited her “own serious health condition.” On November 18, 2013, the treating physician interpreted the MRI scan to reveal minimal tendinitis of the supraspinatus without other significant findings and recommended. She underwent physical therapy and her treating physician returned her to work on January 2, 2014. In a February 17, 2014 visit, the claimant testified that she told her doctor that her shoulder pain was getting worse, but that records reflect that she was feeling significantly better and that the doctor released the claimant from treatment. The claimant alleged a third work accident on March 17, 2014. The treating physician recommended right shoulder surgery, but did not provide a specific causation opinion.

Both parties obtained IME opinions from respective physicians and both physicians were deposed prior to Trial. At Trial, the claimant testified that she sustained a work accident on March 17, 2014. Following a cross-examination, in which she was confronted with payroll records that reflected that she was not working on March 17, 2014, the claimant’s accident date was amended to March 23, 2014. However, in the claimant’s March 24, 2014 medical record, she provided a history of right shoulder pain for one week. The claimant even testified that she was a poor historian with admittedly poor memory.

In the Arbitrator’s decision, it was noted that the claimant failed to describe a specific event or work-related activity that approximated an accident in March 2014. In addition, the Arbitrator found that the claimant failed to provide a history of a specific work accident in October 2013.

The Arbitrator found our IME physician to be more credible that than the Claimant’s IME physician in that our physician reviewed a complete set of medical records, the actual right shoulder MRI scan, a job description and a job analysis video of the claimant’s job duties prior to rendering his opinion that the claimant’s condition was a natural progression of underlying degenerative changes. The Arbitrator noted that the cross-examination of the claimant’s IME physician confirmed that the doctor did not review a job description or job analysis, did not know how much time the claimant spent mopping as part of her job duties or how many times she squeezed a mop or pushed a handle of a bucket with her right arm on her first alleged accident date. On further cross-examination, the Arbitrator found that the claimant’s IME physician did not actually review the MRI scan, but rather the radiologist’s report. The Arbitrator noted that the Respondent’s IME physician was a practicing surgeon, while the claimant’s IME physician last performed surgery four years prior.

The Arbitrator found that the claimant reached MMI on March 28, 2013 in regard to the first accident and denied prospective medical treatment. The Arbitrator found in favor of the Respondent in the 2nd and 3rd cases on the issues of accident, medical causation, medical bills and prospective medical and denied all benefits.

We prevailed by showing that our IME opinion was significantly more informed than the claimant’s IME opinion. In addition, we were able to highlight the claimant’s failure to describe specific events or work-related activities in regard to the 2nd and 3rd accidents. Finally, we were able to provide evidence that the claimant was not working on her 3rd alleged accident date and the Arbitrator found that the changing of the alleged accident date and the claimant’s failure to describe a specific event or work-related activity lessened her credibility.

Congratulations to I&F Partner Mark Carter for another outstanding result.

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