LOIS Associate Erica M. Fersch successfully defeated a Motion for Medical and Temporary Benefits in a New Jersey Workers’ Compensation case, where the Petitioner’s supporting medical evidence was an authorized treating record. The claim resulted from a slip-and-fall, and authorized treatment and indemnity benefits were provided. While investigating, Attorney Fersch noted that there was extensive treatment being provided and recommended for the Petitioner’s underlying and unrelated conditions. Moreover, during the course of authorized treatment, the Petitioner had various unrelated falls and was admitted to hospital on several occasions.
Attorney Fersch objected to the Carrier’s liability for all unauthorized treatment under the seminal case, Benson. She then took the opportunity to recommend that no additional care be authorized, and that an IME should be scheduled to address causal relationship of the alleged injuries and recommended treatment, any additional medically necessary and causally related treatment, and the Petitioner’s ability to work as a result of the work accident. The IME found the Petitioner to have achieved maximum medical improvement, and benefits were stopped. The Petitioner’s attorney filed a Motion for benefits using the authorized treating doctor’s last report, wherein additional treatment was recommended and wherein the Petitioner was kept out of work. Prior to testimony, Attorney Fersch collated fifteen (15) exhibits in support of her opposition.
During testimony, she elicited the following admissions from Petitioner: (1) the treatment she was seeking was actually hurting her and causing her more pain; (2) all treatment she was seeking was related to her underlying and unrelated condition and had nothing to do with the work accident; and (3) the Respondent had no liability for any of Petitioner’s subsequent issues (neurology, cardiology, rheumatology, and/or pain management). Although the Judge directed the parties proceed to medical testimony, the Petitioner instead decided to take Respondent’s Section 20 offer. The matter will resolve for a full-and-final dismissal under NJSA 34:15-20 for within the granted authority.
