Inconsistencies Doom Petitioner’s Claim for Benefits

In this case, the claimant, a 50 year old laborer, was struck in the head by a hydraulic lift upon returning to his work station. His sole job was to shovel chicken from a bin onto an assembly line. Prior to the accident, and in violation of the respondent’s policy, the petitioner left his work area to find a forklift driver for more chicken.

The claimant sustained a scalp laceration which required six staples. In addition, the petitioner alleged that the accident caused injuries to his left hip, left shoulder, lumbar spine, and cervical spine. One of the petitioner’s treating physicians recommended left shoulder surgery to repair a full thickness rotator cuff tear discovered thorough an MRI scan. Another one of the petitioner’s treating physicians recommended a lumbar fusion. The respondent’s examining physician opined that, based upon a review of the initial treating records, the accident did not cause injuries to the left hip, left shoulder, lumbar spine, or cervical spine.

The case proceeded to 19b/8a trial with the petitioner seeking $16,471.46 in temporary total disability benefits, $59,846.49 in accrued medical bills, and prospective medical care in the form of left rotator cuff surgery and a lumbar fusion. The Arbitrator found that the accident arose out of and in the course of the petitioner’ employment, rejecting the respondent’s argument the petitioner had voluntarily and in an unexpected manner exposed himself to a risk outside of any reasonable exercise of his duties. However, the Arbitrator ruled in favor of the respondent on all other issues, adopting the opinion of the respondent’s examining physician and finding that the only condition of ill being related to the accident was a scalp laceration. Neither temporary total disability nor prospective medical benefits were awarded. The Arbitrator awarded only $3,115.81 in medical expenses, representing charges associated with the initial emergency room treatment.

In reaching her findings, the Arbitrator noted that the initial treating records were entirely devoid of complaints referable to neck pain, back pain, or left shoulder pain. In fact, the petitioner had expressly denied neck and back pain to the emergency personnel and at the hospital emergency room department. Moreover, the Arbitrator noted that the petitioner only complained of left shoulder pain after being released to full duty work.

The Arbitrator also noted that the petitioner’s testimony on accident was inconsistent with that of the testimony of two eyewitnesses to the accident and, therefore, not credible. At trial, the petitioner testified that he had attempted to defend himself with his left arm before the lift hit him, and that he was knocked unconscious falling to the ground when the left hit him. Two eyewitnesses testified that the petitioner did not raise his left arm up to defend himself, that he was not knocked unconscious, and that he did not fall to the ground. Rather, the witnesses testified that the petitioner walked away from the scene of the accident. The petitioner had also denied loss of consciousness to emergency personnel that had arrived on the scene.

Congratulations to Scott McCain for the excellent outcome. This case clearly illustrates how thoroughly investigating eyewitness accounts and impugning credibility of petitioner based upon inconsistent histories in medical records is crucial to achieving success at trial. We welcome the opportunity to pursue similar results for all of our clients.

If you are an employer, insurer, or third-party administrator and have any questions about the services we provide, please contact us.

Related Post