Here’s how conflicting medical opinions could impact your workers’ compensation claim and what you can do to deal with this situation if it arises.
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Jim Hoffmann
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314 361 4300
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Fighting for the injured.
James Hoffmann
Your Missouri car accident and workers comp lawyer
314 361 4300
[email protected]
Proud to fight for the injured.
Law Office of James M Hoffmann
2001 S. Hanley suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
James Hoffmann
St. Louis, Mo work comp and car accident lawyer
314 361 4300
Law Office of James M Hoffmann
314 361 4300
[email protected]
Law Office of James M Hoffmann
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
Your Missouri car accident and workers compensation attorney
The LIRC in Nouraie v. MO. Baptist Medical Center et al, Injury No.: 10-111746, March 13, 2013, sanctioned the employer for refusing medical care in connection with a repetitive use claim. The Employer obtained an expert long after the wrongful denial of benefits. This did not justify the prior wrongful denial. The LIRC explained:
“In any event, whether an employer has sent a worker for a medical examination prior to denying a claim is a factor for our consideration in determining whether an employer had reasonable grounds for denying a claim.”
The LIRC in Nouraie also explained:
“The courts have instructed us we are only to award such costs “where the issue is clear and the offense egregious.” Landman v. Ice Cream Specialties, Inc., 107 S.W.3d 240, 250-251 (Mo. 2003). We think it is clear that employers have an obligation to investigate the circumstances giving rise to alleged work injuries before denying benefits. And where the worker is available to discuss the injury, we think any reasonable employer conducting an investigation designed to determine whether an injury is work-related would discuss the alleged injury with the worker. In the instant case, Ms. Bequette, as employer's agent, denied evaluation, treatment and benefits to employee without even discussing employee's alleged back condition with employee. We think employer's act of denying workers' compensation benefits to employee before even discussing the alleged injury with employee constituted an egregious offense. Based upon the forgoing, we find employer defended this claim at the outset without reasonable ground.”
Merry Christmas.
James Hoffmann, Missouri work comp and auto accident attorney
314 361 4300
[email protected]
Claimant, a full-time carpenter for Employer, developed low back pain in September of 2017 making cabinets and displays for the Employer. Claimant’s job is physically demanding. Cabinets and displays can range from 60 to 500 lbs. Claimant job duties include lifting displays weighing up to 500 hundred pounds during the assembly process. Carts, each with 100 lbs of materials, are brought to Claimant who must lift the materials from each cart and assemble same. In October 2017, Claimant’s job duties caused his low back soreness to become severe pain with numbness down his right leg. At the final hearing, the Employer/Insurer produced no evidence of non-work activities that could have caused, or did cause, Claimant’s low back pain.
When Claimant’s low back pain became severe in Oct. 2017, he sought treatment with a chiropractor, Dr. Lynch, on 10/17/20217. Claimant then, on 10/23/2017, reported to Employer a repetitive use work injury to his low back. He went sent to Concentra by the Employer but left due to delays in providing immediate treatment as he had severe pain and radiculopathy. He went immediately to an urgent care and returned to work with a light duty slip for 6 weeks for which the Employer complied.
Despite asking the Employer for additional treatment during the next few months, none was offered. He kept the Employer informed of the treatment he was receiving on his own. IN December 2017, Claimant contacted attorney James Hoffmann who instructed Claimant to hand deliver a letter to the Employer making a written demand for treatment. Claimant delivered the letter in December 2017. At the hearing, Employer presented no evidence that it disputed the contents of the letter.
Immediately after receiving the letter, the Employer contacted the Insurer which then sent medical authorizations to Claimant who signed and immediately returned same to the Insurer. The Insurer then obtained a statement from Claimant in Dec. 2017 where Claimant informed the adjuster of a repetitive use low back injury at work and need for treatment.
After 6 weeks of light duty, Employer requested another light duty slip which Claimant provided.
Claimant continued to work light duty until Feb. 15, 2018, when Employer informed Claimant there was no more light duty and sent Claimant home. In the meantime, neither the Employer nor the Insurer offered treatment. The Employer’s attorney was aware of Claimant’s treatment as he was sending copies of Claimant’s medical records to Claimant’s attorney received via the authorizations signed by Claimant.
In Feb. 2018, Claimant’s attorney obtained a medical report from Dr. Armond Levy who related lumbar disc herniations and the necessity of surgery to Claimant’s work for Employer. Several demands were sent IN Feb. 2018 to the Employer for the surgery recommended by Dr. Levy and for TTD. At the hearing, Employer presented no evidence of any response to the demands for treatment and TTD made by Claimant’s attorney in February 2018.
Claimant then underwent 2 surgeries on his own for his low back, the first being in March 2018 and the second in August 2018. During that time, no TTD or treatment was offered. When Claimant returned to work in November 2018, after recovering from the second surgery, he was informed by the Employer that he was fired.
The Employer eventually sent Claimant to a physician, Dr. Bernardi, in November 2018, who is of the opinion that a person cannot suffer a repetitive use herniated disc. It is his opinion that herniated discs can only acute, and that any degenerative changes in the low back are genetic and cannot be caused by repetitive use occupations. In other words, Employer sent Claimant to a doctor who disagrees with Missouri law which specifically recognizes and accepts repetitive use injuries. Claimant had zero chance of a favorable opinion from Dr. Bernardi
This is the lawyer you want to hire! Just read the reviews. It is all true. Incredible! He will get you every dollar of lost wages, get you every ounce of medical treatment, and get you the highest possible award from the Division of Workers Compensation.
Law Office of James M. Hoffmann
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
Your Missouri workers comp and car accident attorney.
James Hoffmann
314 361 4300
[email protected]
Law Office of James Hoffmann
314 361 4300
[email protected]
James Hoffmann
attorney
St. Louis workers comp and car accident lawyer
314 361 4300
[email protected]
Law Office of James Hoffmann
St. Louis personal injury and work comp lawyer.
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Per Tillotson v. St. Joseph Med. Ctr., 347 S.W. 3d 511 (Mo. App. W.D. 2011) to determine need for treatment, surgery, and treatment after surgery. Treatment need only be reasonably required to cure and relieve the effects of the injury. Id. Section 287.140.1 RSMo states in pertinent part that the Employer shall provide such medical as may “reasonably be required.
To be entitled to future medical care the employee must establish that there is a reasonable probability that he will need future medical care. Forshee v. Landmark Exc. & Equip., 165 S.W. 3d 533 (Mo.App. E.D. 2005) An [Employee] does not have to provide evidence of specific medical treatments or procedures which will be necessary in the future in order to receive an award of future medical care. See Chatmon v. St. Charles County Ambulance, 55 S.W.3d 451, 459 (Mo.App. E.D. 2001).
Employee has already satisfied the burden of proving a compensable injury. Here, defense's authorized Dr. Spears on 4/26/2010 opined "if she doesn't get improvement in her radicular pain, then the next step is going to be a microscopic transforaminal lumbar interbody fusion to remove the foraminal stenosis." He went on to state the January 2010 incident was a "fall (that) aggravated significantly a pre-existing condition". This is enough under Tillotson, Forshee, and, Chatmon (supra) to award further treatment.
Please also see Maness v. City of De Soto, 421 S.W.3d 532 (Mo. App. 2014). The court rejects Employer's contention that the mere existence of degenerative disc disease in the cervical spine and neck symptoms prior to the work accident requires a determination that Claimant's injury is not compensable.
See also the following in support:
If the evidence establishes that an accident caused a
disability or aggravated a preexisting condition or infirmity of an employee,
which produces a condition that would not have resulted in a normal, healthy
individual, an award is authorized. Fogelsong v. Banquet Foods Corp. 526
S.W.2d 886 (Mo. App., K.C.D. 1975)
An aggravation of an existing infirmity caused by an accident or occupational
exposure arising out of and in the course of employment is compensable under
Chapter 287, RSMo, even if the particular accident (occupational injury) would
not have produced such result in a normal and healthy individual. Mashburn v.
Chevrolet-Kansas City Division, General Motors Corp., 397 S.W.2d 23 (Mo.
App., K.C.D. 1965)
Law Office of James M. Hoffmann
2001 S. Hanley
St. Louis, MO 63144
314 361 4300
[email protected]
James M Hoffmann, attorney
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
I see this all the time with neck injuries, low back injuries, disc herniations, rotator cuff tears, meniscus tears: doctors do surgery under workmans comp and then blame ongoing pain on a made up pre-existing condition.
James Hoffmann
Your Missouri workers comp and car accident attorney
314 361 4300
[email protected]
Law Office of James M. Hoffmann
St. Louis, MO car accident and workers compensation lawyer
314 361 4300
Glad to fight for the injured worker in Missouri.
Law Office of James M. Hoffmann
St. Louis, Missouri workers comp, car accident, injury attorney.
314 361 4300
[email protected]
These reviews are correct. This attorney is incredible. He knows workmans compensation, fights for denied treatment and wages, and gets your on the job injury rated by the best doctors. I will be using him from here on our great experience.
It does not take a large law firm to fight an insurance company. It takes a good lawyer. There's a reason why injured insurance adjusters and injured insurance doctors call me to represent them. They know I fight and will not back down.
Law Office of James M. Hoffmann
St. Louis, MO workers comp and auto accident attorney
314 361 4300
[email protected]
The Law Office of James M Hoffmann was referred to me from a previous client, that was extremely impressed, with his service and outcome.
I met with Jim Hoffmann to discuss a car accident. Three cars were involved, my car was totaled, and I was seriously injured. After meeting with Jim the very first time, I immediately felt comfortable, and knew that he would have my back, and would fight for me.
Throughout my journey, I dealt with a lot of pain and several issues that lasted for years. During this time I had to contact Jim and Jamie (Jim’s wonderful assistant) many times. Every time I sent an email with questions, I received feedback extremely quickly!
I feel Jim negotiated a great settlement for me!
The Law Office of James Hoffman will be the first place I contact if I ever need his help again!
Suzanne Charles
James Hoffmann
St. Louis, MO auto accident and workers compensation lawyer
314 361 4300
Glad to fight for the injured Missouri worker and those injured on car accidents.
James Hoffmann
Missouri personal injury attorney
314 361 4300
[email protected],
Jim Hoffmann
Missouri workers compensation and car accident attorney
314 361 4300
St. Louis, MO
Compensation? Get this lawyer. Simply better than all the rest.
James Hoffmann
314 361 4300
[email protected]
James Hoffmann
Missouri workers compensation and auto accident lawyer
314 361 4300
[email protected]
Law Office of James M. Hoffmann
314 361 4300
James Hoffmann, attorney
314 361 4300
[email protected]
Gold bless
James Hoffmann, attorney
314 361 4300
Law Office of James M Hoffmann
St. louis, MO injury attorney
314 361 4300
James Hoffmann
Missouri personal injury and workers comp lawyer.
314 361 4300
Jim Hoffmann
St. Louis injury attorney
314 361 4300
Thanks
Law Office of James M Hoffmann
314 361 4300
Workers’ comp cases are often complicated. However, things can get really confusing when you add conflicting medical opinions into the mix. What does this mean for your case? How will it affect the outcome? In this article, we’ll discuss conflicting medical opinions and how they can impact your workers’ compensation claim. We’ll also provide some advice on dealing with this situation if it arises during your case.
How Are Medical Opinions Used in Workers Comp Cases?
In Missouri, injured workers are generally entitled to have their medical bills paid by their employer’s workers’ compensation insurance carrier. In order to determine whether an injured worker is eligible for this benefit, the insurance company will typically request a medical opinion, which is basically a report from a doctor that says whether or not the worker’s injuries are related to their job.
What Is a Conflicting Medical Opinion?
A conflicting medical opinion occurs when two different doctors give contradictory reports about whether or not an injured worker’s injuries are work-related. For example, one doctor may say that the worker’s injuries are due to a pre-existing condition, while another doctor may say that the injuries are due to an accident that happened at work.
Reasons for Conflicting Medical Opinions
There are a few different reasons why two doctors may give conflicting medical opinions. One reason is that they may be looking at different sets of evidence. For example, one doctor may have access to the worker’s complete medical history, while the other doctor may only have access to the worker’s records after the accident.
Another reason for this discrepancy is that the two doctors saw the injured worker at different times and may have been given different information.
What Does This Mean for Your Case?
If your workers’ compensation case involves conflicting medical opinions, it doesn’t necessarily mean that your claim will be denied. However, it will likely impact your case in some way.
One way that conflicting medical opinions can affect your case is by delaying the approval of your benefits. The insurance company will need additional time to review the conflicting opinions and may even need to get a third opinion. This can drag out your case and make it take longer to get the benefits you need.
Another way conflicting medical opinions can impact your case is by making it more difficult to prove that your injuries are work-related. The insurance company will generally lean towards the conflicting opinions and use them to argue that your injuries are not work-related.
Speak With an Attorney
If you have been injured on the job, we recommend speaking with an experienced workers’ compensation attorney as soon as possible. They can help you navigate the claims process and help protect your legal rights. An attorney can help you understand how the conflicting opinions may impact your case and can develop a strategy for dealing with them.
St. Louis Workers Compensation Attorney
At The Law Offices of James M. Hoffman, we have over 30 years of experience helping injured Missouri workers get the benefits they’re legally entitled to. Contact us today for a free consultation to learn more about your rights as an injured worker.