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  1. #1
    Join Date
    Apr 2012

    Question IME Doctor Disputes Injury's Relation to Fall

    Good Evening Everyone,

    Obviously I am new an anxious to hear everyone's advice.

    Here's my background...

    Fell off loading dock at work in Sept 2011...torn my left ACL which was covered by comp. Had knee surgery Jan 2012.

    Also hurt my lower back and neck in fall. Had previous neck injury (fused C4-C6) which was not a comp case in 2010.
    My doctor has determined I have a herniated c3 which is directly related to fall in Sept 2011 (his exact words) and recommends surgery. Insurance company is denying authorization for surgery and sent me for an IME exam. Had IME exam and received IME report back also saying injury was work (fall) related.

    I'm Scheduled for NYS Comp hearing in early May...Now in today's mail receive addendum to IME report and now IME doctor says after further review this injury may not be related to fall and more than likely old age and stress weaknesses from previous non work related surgery. BTW I'm only 40.


    Should I be concerned with addendum IME report or is this just a dr working with ins company?
    What should I expect at hearing? How long will it last? And will I hear the results of the judges findings that day or later on?

    When can I expect a surgery date if judges rules in my favor? I.e. can date be scheduled right away or is everything on hold pending an appeal?

    Yes, I do have an attorney, but he's not very forthcoming with my questions.

    Thanks for any and all comments,

  2. #2
    Join Date
    Oct 2006

    Default Re: My First Comp Case.pls

    yes, evidence that there is no industrial injury will not support your claim.
    generally judges issue written opinions within 30 of hearing the evidence.
    if the judge rules in your favor, there could be an appeal; there is no predicting a time for your surgery.

  3. #3
    Join Date
    Feb 2007
    Charlotte, NC

    Default Re: My First Comp Case.pls

    It would be interesting to know why the doc changed his opinion. My guess is that someone from the insurance company or employer spoke to him.
    The North Carolina Court of Appeals has held that "In contested Workers' Compensation cases today, access to competent legal counsel is a virtual necessity." Church v. Baxter Travenol Labs, Inc., and American Motorists Insurance Company, 104 N.C. App. 411, 416 (1991).

    Bob Bollinger, Attorney at Law

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