Insurance Dispute Lawyer Blog
Medical testimony is an essential part of determining whether an injured worker has a valid claim. What happens if the doctors’ diagnoses conflict and they reach different conclusions about whether an injured worker can return to work?
Maxine Hall worked as a housekeeper for Global Solution Services. While working for Global at a hotel, a door closed on her foot. She went to the emergency room, where a doctor told her she did not have any broken bones. However, another doctor subsequently diagnosed her with a fractured toe.
Despite receiving medical treatment, Hall continue to suffer from pain in her foot. Hall received workers’ compensation benefits, but the benefits terminated approximately two years after the accident occurred. She then filed a Disputed Claim for Compensation against Global and Illinois National Insurance Company, its insurer. Hall sought to get her benefits reinstated. The Workers’ Compensation Judge dismissed Hall’s claims. Hall filed an appeal.
When appellate courts review workers’ compensation cases, if there are two reasonable views of the evidence, then the trial court’s choice between them is not clearly wrong or erroneous. See Chaisson v. Louisiana Rock Monsters, LLC. Here, the appellate court reviewed the various testimony and evidence presented at trial to see whether the trial court erred in dismissing Hall’s workers’ compensation claims.
Hall saw various doctors, who diagnoses her with a variety of issues and had varying views on whether, and to what extent, she could return to work. One doctor who testified at trial, an orthopedic surgeon, initially said Bostick could return to work to do sedentary work, but later stated Hall was unable to return to work. A vascular surgeon diagnosed Hall with Complex Regional Pain Syndrome. A few other doctors agreed with this diagnosis. The vascular surgeon referred Hall to see another doctor in order to receive a nerve block, which helped Hall.
However, Hall did not receive any additional nerve blocks. A neurologist disagreed Hall had Complex Regional Pain Syndrome and believed Hall’s remaining complaints were subjective. The neurologist testified from his perspective, Hall could return to work fully, but deferred to others to whether there were an orthopedic issues.
The Office of Workers’ Compensation appointed a doctor to complete an independent medical exam of Hall. That doctor found Hall was exaggerated her pain as he could distract her and change her pain levels. He also did not think Hall had Complex Regional Pain Syndrome. He believed Hall could return to work without any restrictions.
Under La. R.S. 23:1123, courts should give the conclusions from the independent medical exam significant want because they are from an objective third-party. Here, the independent medical examiner concluded Hall could return to work fully. Therefore, the appellate court held the trial court did not err in dismissing Hall’s Disputed Claim for Compensation based on the independent medical examiner’s conclusion Hall could return to work and conflicting other medical testimony.
If your workers’ compensation case includes conflicting medical testimony, a good attorney can advise you on the best strategy to prove your claim.
Additional Sources: Maxine Hall v. Global Solution LLC and Illinois National Ins. Co.
Article Written By Berniard Law Firm
Additional Berniard Law Firm Article on Workers’ Compensation Claims: Prevailing Against All Odds: Triumphing in a Workers’ Compensation Claim