Compensability

In a claim defended by Brad Miller and Kendra Gartska, the Administrative Law Judge (ALJ) denied and dismissed alleged repetitive trauma claim due to varied histories of injury and lack of causation per the Medical Treatment Guidelines (MTG’s).

The claimant worked as a customer service agent for a short period of time, most of which was spent in training.  She alleged a repetitive trauma injury to her hip as a result of handling luggage during her brief employment.

Claimant alleged she first began experiencing symptoms about three weeks after being hired, did not report the alleged injury for another six weeks, and did not seek medical treatment for another week. The ALJ noted that during her hearing testimony, claimant alleged an occupational disease and she specifically denied a distinct injury. However, the initial medical records document an allegation of an acute injury. The inconsistency was highlighted during cross examination, as part of factual defense to the claim. The ALJ credited the testimony of an employer representative who credibly explained claimant’s various job duties and that during training, claimant’s baggage handling would have been minimal, undercutting the idea that there was extensive activity over time.

The matter was also defended from a medical perspective. Indeed, the ALJ also relied upon respondent’s expert who cited specific sections of the MTG’s and how the mechanism described by the claimant would not qualify from a causation perspective under any theory.

Cheri Freeburg v. Southwest Airlines and Indemnity Insurance Co. of North America, W.C. 5-059-267-001

Claim Handling Tip: It is important to remember that the MGT’s apply to more than just upper extremity claims. Expertise in the use of the MGT’s by counsel well-versed in their language can make the difference between a win at hearing as opposed to significant liability for surgeries and joint replacements down the road.

Would you like to know more? Contact Brad Miller and Kendra Garstka at bmiller@pollartmiller.com or kgarstka@pollartmiller.com or 877-259-5693.

 

From the March 2019 Newsletter 

2019-04-01T10:57:21+00:00