Compensability—The quality of expert opinions outweighs quantity

Claimant was a police officer for the City of Glenwood Springs who claimed he sustained a compensable head injury when he hit his head attempting to arrest a suspect.  On the night of the incident claimant and four other officers wrote incident reports detailing the incident as well as injuries sustained by the officers involved in the altercation.  None of the written reports indicated that claimant sustained any type of head injury.  Claimant collapsed and was taken to the ER two days after the incident where he had a brain MRI, CT scan and EEG all of which were normal and had no external signs of head injury.  Doctors suspected recurrent pseudo-seizures for which claimant had previously treated and been removed from active duty with the GPD.  When claimant followed up with his personal neurologist he was diagnosed with post-concussive syndrome related to the head injury sustained in the work incident and was referred for additional treatment.  Approximately a dozen additional providers adopted the diagnosis of post-concussive syndrome including five IMEs who evaluated claimant for an Fire and Police Pension Association disability claim.  Respondents eventually obtained an IME who reviewed the police reports, claim related medical records, and records related to the previous treatment for pseudo-seizures and PTSD with the VA.  After reviewing all of these records the IME determined that claimant had not sustained a head injury but instead had a psychological reaction to the event.  After reviewing the IME report and additional records of claimant’s pre-existing condition, the psychiatrist who had previously examined claimant as part of the FPPA claim agreed with respondents’ IME and opined that claimant had returned to his psychological baseline with no claim-related impairment.  The ALJ credited the opinions of the two experts who opined that claimant did not have a head injury over all of the other opinions that had relied on claimant’s subjective reports rather than objective evidence.  The ALJ found that the opinions of the respondents’ experts were based on more complete information and were supported by the initial medical reports and police reports which showed no evidence of a head injury.   He further found that to the extent claimant was asserting a mental-mental claim, he had failed to satisfy the statutory criteria set forth in 8-41 -301

Robert Wetzel v. City of Glenwood Springs

Practice pointer:  The GIGO (garbage in-garbage out) principle can be applied to medical records.  If the earliest medical and/or employment records establish that treating providers have made or adopted a factually inaccurate diagnosis, be sure to provide your expert with the most comprehensive information possible in order to offer a persuasive opinion.   When based on factually inaccurate information an opinion can be successfully challenged whether it is held by one provider or a dozen.  

Would you like to know more? Contact Michelle L. Prince at mprince@pollartmiller.com or 877-259-5693.

From the June 2020 Newsletter

2020-07-08T15:35:38+00:00