LOIS Senior Associate Kristine Rosales and Paralegal James Calabro successfully secured disallowance of an additional injury site in a New York Workers’ Compensation claim. The claim involved a claimant chauffeur, who raised ocular conditions based on medical treatment received over a year from the accident of record.
During oral arguments, Attorney Rosales stressed the fact that the claimant failed to demonstrate causality based on the absence of complaints of ocular conditions at the ER on the date of the accident, and that the initial treatment for the ocular conditions was performed over a year from the accident of record. Further, Attorney Rosales argued that the PFME doctor did not review the initial medical records showing unrelated pre-existing medical conditions that could have caused the ocular conditions. As the doctor’s opinion was not based on the complete record, Attorney Rosales argued that the report should not be given merit and she moved for disallowance. The Law Judge upheld the position espoused by Attorney Rosales and disallowed the ocular conditions based on the treating doctor’s lack of credibility. As a result of this disallowance, the Carrier is relieved of all medical liability involving the ocular conditions.
