LOIS Associate Natalia Verde obtained disallowances for alleged consequential psychological and neurological injuries in a New York Workers’ Compensation case. The Claimant alleged injuries to the neck, back, bilateral shoulders, bilateral knees, bilateral hands, bilateral wrists, and right hip as a result of tripping on an unlevel elevator; the neck, back, bilateral shoulders, bilateral hands, bilateral wrists, and right hip were all disallowed, and the claim was accepted for the bilateral knees only. At a subsequent hearing, the Claimant alleged injuries of concussion, post-concussion syndrome (PCS), and post-traumatic stress disorder (PTSD). Depositions were granted. At the deposition of the Claimant’s doctor, the doctor conceded that the Claimant was not diagnosed with PTSD, but rather that the Claimant merely exhibited signs and symptoms of PTSD. The Claimant’s doctor was also questioned on the mechanism of injury to support the finding of a concussion and PCS. The Independent Medical Examination, on the other hand, performed a cognitive examination on the Claimant and found no evidence of PCS or concussion.
Verde filed a summation brief requesting a disallowance of the alleged concussion, PCS, and PTSD. She argued that the opinion of the IME was more reliable than the Claimant’s doctor based on accreditation, the Claimant’s doctor’s lack of competent understanding of the mechanism of injury, and the lack of the Claimant’s complete medical history to support the Claimant’s self-reported history of symptoms. With respect to the alleged PTSD, Verde argued for a disallowance as there is no medical diagnosis for PTSD. The Law Judge then disallowed the claim for all the alleges sites. The Law Judge agreed with Verde’s position that there was no diagnosis for PTSD per the deposition testimony of the Claimant’s doctor. With respect to the concussion and PCS, the Law Judge did not find the Claimant’s doctor credible and noted the simple mechanism of injury in supporting a disallowance for the concussion and PCS. This high-exposure claim was significantly reduced because of Verde’s tireless advocacy.
