What’s Hot in Workers’ Comp - News and Results*
NEWS
Frank Wickersham (King of Prussia) presented at the 19th Annual Workers’ Compensation ExecuSummit on January 24th. The event focused on delivering strategic insights on emerging issues and trends in workers’ compensation and providing opportunities to exchange ideas with industry leaders. During his presentation, “State of the Union - Medical Marijuana,” Frank highlighted the ongoing efforts around the nation, via lawsuits and legislation, to help attendees obtain clarity on medical marijuana coverage for injured workers.
On March 30, 2023, Michele Punturi (Philadelphia) will participate in a panel discussion at the CLM Annual Conference. The panel will focus on increasing diversity and sustaining organizational change in the claims industry. In “Building a Better Business, Achieving a More Diverse Future,” the panelists will talk about how diversity, equity, and inclusion efforts have taken center stage in the workplace and will identify emerging recruitment and retention strategies that employers can utilize to achieve a more diverse future. The session will also include an analysis of effective ways to maintain diverse vendor teams while building stronger partnerships in claims handling in the legal industry. For more information about the CLM Annual Conference, click here.
RESULTS*
Michele Punturi (Philadelphia) successfully defended a Petition for Review of a Utilization Review Determination on behalf of a local hospital filed by the medical provider, a chiropractor. Michele’s evidence included the Utilization Reviewer’s report and CV, two IME examinations of a board certified orthopedic, and a records review. Michele also submitted into evidence the cross-examination of the claimant, during which she was able to establish only minimal improvement without a specific treatment plan or specific documentation/data to support the reasonableness and necessity of ongoing treatment. Of significance, despite the chiropractor’s and the claimant’s position that such treatment was beneficial, it was emphasized that the chiropractor failed to discuss the case with the reviewer and, also, the claimant never submitted a statement to the reviewer regarding the need for treatment.
Eli Hassinger (Philadelphia) successfully defended a late answer against claimant’s Yellow Freight motion by convincing the judge that the claimant’s Claim Petition was not well-pled and did not meet the claimant’s burden of proof with respect to disability. The Claim Petition alleged that the claimant did not return to work for the employer and sought payment of ongoing disability. In defense of the motion, we submitted evidence showing that the claimant returned to work for the employer within days of the alleged work injury, arguing that the claimant was not disabled as alleged. Accordingly, the judge was convinced that, although the employer’s answer was late, the Claim Petition was not well-pled and the Yellow Freight motion was denied.
John Swartz (Harrisburg) successfully defended modification petitions based upon an impairment rating evaluation and an earning power assessment. The judge accepted the testimony of the employer’s medical and vocational experts and rejected the claimant’s medical and vocational expert testimony. The judge denied claimant counsel’s request for Lorino counsel fees of $11,200 in its entirety. The claimant submitted a request for litigation costs of $4,700. The judge only awarded reimbursement of litigation costs of $1,018. The judge also reversed the Utilization Review Determination in part based on the employer’s expert’s medical testimony, denied the payment of Lidocaine medication, and reduced the claimant’s ongoing use of Oxycodone/OxyContin to 50 mgs from 142.5.
Michael Sebastian (Scranton) successfully defended a termination petition for an accepted lumbar strain injury. Mike established that the claimant had an identical, pre-existing condition that she lied about during her original testimony. The judge found the claimant not credible and her expert not credible because he relied on the claimant’s history and did not review the prior treatment records.
Michael Sebastian (Scranton) successfully defended Claim Petition, finding that the claimant did not suffer a work-related injury. The judge found our witnesses credible, that the claimant did not report his knee condition as work-related. Their testimony was supported by the medical records provided for the six months after the alleged injury, which showed the claimant had nine office visits with five doctors but never indicated that he suffered a work-related injury. In addition, the claimant never told his own expert that he suffered a work-related injury until several months afterwards. Finally, the judge believed our expert that the knee condition was inconsistent with the mechanism of injury.
*Prior Results Do Not Guarantee a Similar Outcome
What’s Hot in Workers’ Comp, Vol. 27, No. 2, February 2023 is prepared by Marshall Dennehey to provide information on recent legal developments of interest to our readers. This publication is not intended to provide legal advice for a specific situation or to create an attorney-client relationship. We would be pleased to provide such legal assistance as you require on these and other subjects when called upon. ATTORNEY ADVERTISING pursuant to New York RPC 7.1 Copyright © 2023 Marshall Dennehey Warner Coleman & Goggin, all rights reserved. No part of this publication may be reprinted without the express written permission of our firm. For reprints or inquiries, or if you wish to be removed from this mailing list, contact tamontemuro@mdwcg.com.