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extent of causally related injury New York

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  • extent of causally related injury New York

    I suffered a back injury on the job in 1999 filed a claim and went back to work. I reeopened my claim in 2006 and have been receiving benefits since April. In July 2007 I was in an unrelated MVA and fractured my right heel. No where did I claim an injury to my back because of this MVA. I was actually put on permanent disability from my job because of my back injury prior to the MVA and have been seeing the same DR. for 5 years. My question is this. After the MVA I was put in a cast and my Dr. stated in his report that I was straining my back due to crutch walking. Workers Comp is now trying to say that my injury has worsened because of the car accident. I have a hearing in 2 weeks and have to go for an IME . My Dr. also prescribed PT 3 x's a week. I had been approved for it approx 1 year ago by the comp judge, but did'nt use it because I wound up in the hospital for an unrelated illness. I requested it now and it seems as though they are trying to use that against me as well. Any advice? Also,at my last hearing last month the rep for the state insurance fund made an offer to my attorney that I was going to accept and he completely withdrew it at the hearing! Previous IME's have stated my disability as mild,moderate and marked each time causally related to my work related accident. Does the state insurance fund have the upper hand on me..this is obviously them reaching for whatever they can in order not to pay benefits.I'm in NYS. By the way I saw my primary physician today and his report states that "my present complaints reference to my lumbar spine are causally related to my initial work injury and not the MVA." I spoke to my neurologist and she stated basically the same thing so did the Dr. that's treating my ankle from the MVA. Now to see what the IME states. Hopefully this works out.

  • #2
    Do you have a question?
    I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

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    • #3
      Originally posted by ElleMD View Post
      Do you have a question?
      If the IME states that there is apportionment between the MVA and my work related accident how will that affect my WC benefits. I have documentation from 3 other DR's stating that the 2 are not related .

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      • #4
        If the work injury is responsible for your need for treatment, then it should be granted. For something like PT that was authorized a year ago and not sought until now, after documented difficulty due to an unrelated circumstance (using the crutches), flipping a coin is as accurate as a guess as to whether or not it will found to be related. Unlike something like a surgery, PT is very much a time sensitive treatment. It may be granted though if your doctor still claims the PT is needed a year later and after at least 2 unrelated medical events to the initial injury. You can not approprtion medical treatment.

        When you go to settle the claim or file for PPD, the intervening accident will be taken into account. That is where the apportionment issue comes into play.
        I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

        Comment


        • #5
          Originally posted by ElleMD View Post
          If the work injury is responsible for your need for treatment, then it should be granted. For something like PT that was authorized a year ago and not sought until now, after documented difficulty due to an unrelated circumstance (using the crutches), flipping a coin is as accurate as a guess as to whether or not it will found to be related. Unlike something like a surgery, PT is very much a time sensitive treatment. It may be granted though if your doctor still claims the PT is needed a year later and after at least 2 unrelated medical events to the initial injury. You can not approprtion medical treatment.

          When you go to settle the claim or file for PPD, the intervening accident will be taken into account. That is where the apportionment issue comes into play.
          Thanks. I have a hearing set for next week for ppd. I have'nt had any other incidents which have intervened and actually have Dr's notes stating this. I'm off the crutches and Dr's state my condition is baseline now and was unaffected by the MVA. How do you think it will go ?

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          • #6
            If you are still seeking PT, why are you filing for PPD? I can't begin to guess how your hearing will turn out. I attend literally hundreds of hearings per year and can only guess at how mine will turn out. I simply can not predict what a third party will decide.
            I post with the full knowledge and support of my employer, though the opinions rendered are my own and not necessarily representative of their position. In other words, I'm a free agent.

            Comment

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