LOIS attorney, Steve McLinden, recently obtained a disallowance of three additional sites in an established claim, which should drastically curtail exposure on a claim that may resolve on a schedule loss of use award comparable to prior payments. This is a claim in which the claimant reportedly tripped in a living space in May 2020 and injured her right shoulder. Our client requested we open a file shortly before a January 2022 hearing, at which the claimant raised the head, neck, and back. Our client then obtained a neurology IME as well as a records review, which each found no causal relation to the additional sites. A total of five doctors were deposed at the law judge’s direction on the additional sites.
When the matter returned, we maintained that the burden of proof for the additional sites were not met, especially as there were at least four reports from May-October 2020 in which the claimant did not complain of the other sites and demonstrated full range of motion. The claimant made a long list of complaints on the C-3 filed several months after the accident, at which point the mechanism of injury described to her doctors began to evolve.
The Law Judge agreed with our argument that the contemporaneous medical evidence did not provide substantial evidence to additional sites of injury. The claimant had made a sizable demand based on an expectation that the sites would be established, and we are presently working to settle the claim for a fraction of the initial demand.
