What's Hot in Workers' Comp
What's Hot in Workers' Comp - News and Results*
Kelly M. Scifres (Jacksonville, FL) will present a webinar on the “Five Hour-Law & Ethics CEU for Adjusters” on June 4, 2020, from Noon-5 p.m. Enrollment is free. Please email KMScifres@mdwcg.com to sign up. Space is limited to the first 100 entrants.
Ashley Eldridge (Philadelphia, PA) obtained a defense verdict on a claim petition that alleged significant cognitive, spine and orthopedic injuries following a fall at work. The claimant fell from the second level of a mushroom house. There was no dispute as to the fall, nor that the claimant required hospitalization for multiple transverse process fractures in the lumbar spine. However, after approximately three months of treatment, the claimant was released to full-duty work, at which point, the claim was denied. A claim petition was filed, alleging total disability and a multitude of additional cognitive, spine and orthopedic injuries. Ashley presented the testimony of the claimant's treating physician (a neurosurgeon), an orthopedic surgeon, fact witness testimony from the insured, and an SIU investigator. Ultimately, although granting the claim petition for the time claimant was in the hospital, the judge suspended benefits from a few weeks after the injury and granted a termination based upon the medical evidence presented by the employer. The decision was the best possible outcome and an outright win for the employer.
Michele Punturi (Philadelphia, PA) successfully defeated the claimant’s appeal on behalf of a worldwide youth adult development organization in a case involving claim, penalty, and termination petitions. A Medical Only Notice of Compensation Payable acknowledged liability for a skull contusion and denied any associated disability. The claimant alleged injuries to the cervical spine, head, eyes, and post concussive syndrome, resulting in total disability. It was the claimant’s position that the judge failed to render a well-reasoned decision because he should not have credited the opinions of the three defense experts—a board certified orthopedic surgeon, a board certified neurologist and a board certified neuro-ophthalmologist—or the seven fact witnesses, who challenged the mechanism of injury and disability. The Appeal Board emphasized that determinations of credibility may only be overturned where they are arbitrary or capricious which was not found here. Further, the Board noted that, although a judge may give a treating provider more credence than a physician who examines a claimant solely for litigation, it does not require the judge to do so provided the judge’s analysis is well-reasoned. The Appeal Board concluded that the judge summarized the relevant evidence, rendered credibility determinations, and provided objective explanations for those credibility determinations. The judge’s decision was well-reasoned and supported by substantial competent evidence. The judge did not err in denying and dismissing the claimant’s claim petition, in not awarding a penalty, and in granting the termination petition. This case demonstrates the impact of a thorough investigation and the importance of strong factual and medical witnesses.
*Prior Results Do Not Guarantee A Similar Outcome
What’s Hot in Workers’ Comp is prepared by Marshall Dennehey Warner Coleman & Goggin 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 © 2020 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 email@example.com.