Earlier this year, the firm was retained on a claim where the claimant was adjudicated with a permanent total disability in 2016. The claim’s costs were escalating in dramatic fashion due to nine (9) different brand name medications being prescribed by a treating physician. This treating physician was previously successful in being deemed credible on the very same issue in 2018.
After a comprehensive review of the file, LOIS Partner Attorney Christian Sison recommended an IME physician whose medication weaning opinions had been upheld in previous cases. That IME physician then recommended immediate discontinuance or regimented weaning of all 9 medications that were still being prescribed by the treating physician. After litigation was initiated due to this report, a hearing was scheduled by the New York Workers’ Compensation Board.
At this hearing, Christian argued that the claimant’s doctor’s rebuttal report did not comply with judicial directives considering the Non-Acute Pain Medical Treatment Guidelines and an assessment of the claimant’s Morphine Equivalent Dose. Christian also argued that the claimant failed to timely request cross-examination the IME physician that recommended weaning. The Law Judge agreed, rejecting the claimant’s arguments and imposing an order in complete coordination with the IME physician’s opinion. The result is sure to be a major cost-savor for the firm’s client!
Case Information
- CASE: RY v. AGC
- CLIENT: A National Insurance Carrier
- DATE OF DECISION: July 30, 2020
- LOIS ATTORNEY: Christian Sison
