LOIS Associate Natalia Verde secured a disallowance in a New York Workers’ Compensation claim. The Claimant alleged that she injured her back when bending down to lift packages of salad. An Independent Medical Examination did not find a causal relationship between the alleged symptoms and the mechanism of injury. During medical testimony, the Claimant’s doctor conceded that he did not personally examine the Claimant. At the trial, the Claimant was confronted with numerous medical reports which mention different mechanisms of injury, but she maintained that she did not recall reporting back pain due to lifting a tray at work or stepping into her husband’s truck. The Claimant testified as to her recent cancer diagnoses and testing which confirmed the presence of lesions in her spine. Verde argued that the claim should be disallowed on several bases: that the Claimant waived cross-examination of the IME, that the Claimant did not meet the burden as to prove that there was an accident, and that the Claimant did not meet the burden of proof to prove that there was medical causal relationship to the back.
The Law Judge issued a Reserved Decision, disallowing the claim in its entirety. The Law Judge first acknowledged the IME findings and found that the Claimant waived cross-examination. The Law Judge then disallowed the claim based on the conflict of medical opinions and the Claimant’s testimony as to mechanism of injury. The decision held that the Employee Claim Form C-3 affirmed that she lifted packages of salad, which comported with the Claimant’s testimony. However, the medical report of one provider did not provide a mechanism of injury, another provider’s report indicated that the Claimant was lifting a tray at work, and another report indicated that the pain started when the Claimant was stepping down from her husband’s truck. Therefore, the Law Judge held that the Claimant did not meet her burden of proof of a causally related accident or causal relationship, closing the case.
