A Dispute over the Best Kind of Medical Treatment for a Job Injury Goes to Court
After agreeing with the insurance company to change orthopedic surgeons for my client's low back injuries, we moved forward with a Dr. Velez as the new doctor, a spine specialist with Resurgens.
After a period of treatment, Dr. Velez proposed a single level partial disc removal. My client did his due diligence research, we spoke on a number of occasions, and he consulted his family doctor and thereafter concluded that this partial disc removal was not the right operation for him.
My client had a face to face meeting with Dr. Velez about the type of operation the doctor proposed. As my client later testified in court, the doctor said: “it is my way or the highway.” This was shameful and completely egocentric behavior on the doctor's part.
To add insult to injury, Dr. Velez then released my client to full duty work with a 5% whole body impairment rating after initially stating my client was totally disabled! The insurance company then stopped completely my client's weekly disability benefits.
I wrote a very strongly worded letter to Dr. Velez asking him for the reason why he gave my client a full duty work release (Dr. Velez had not seen my client for over 60 days). I paid him a fee for answering my letter and I waited for a response. After numerous attempts to contact his office, the office manager sent my money back stating the “doctor refused to answer my letter.” I could have subpoenaed him but instead, I asked my client to submit to an independent doctor's examination and evaluation.
I chose Dr. Douglas Linville, an independent, fair minded and well-experienced orthopedic spine surgeon. Dr. Linville essentially stated two things:
- Further testing was needed to see how my client's injury affected his entire lumbar spine.
- The Dr. Velez proposed surgery would not help my client-he needed a more extensive surgery.
The insurer countered by sending my client to Max Steuer, a reputable Neurosurgeon for a one time examination to counter Dr. Linville's opinion.
The insurer's goal was to offer my client the one level partial disc removal, stating this is all they are responsible for in his workers' compensation injury claim.
I obtained additional medical diagnosis and another narrative report from Dr. Linville, asking him to pull together all the medical evidence.
Once this was accomplished, we were ready to submit everything to a Workers' Compensation Administrative Law Judge for a decision.
Our position was that more than a small, partial disc surgery was necessary to treat the entire effect to my client's lumbar spine job injuries. The insurer argued they should still be in control of the medical treatment, Dr. Linville should not be authorized, and only my client's lumbar spine at the point of the partial disc removal was their responsibility.
We recently received a great Award written by the ALJ giving my client Dr. Linville as his new treating physician. The Judge's opinion was that Dr. Linville essentially gave my client hope of a comprehensive treatment and a better hope of recovery.
This was a very satisfying victory. Now there are no limitations on my client's treatment and my client will not ever have to return to Dr. Velez. Also, my client's weekly benefits were restored since Dr. Linville believes my client is not capable of any work at this time.
From the time of our first request for a hearing until we received the Award of the Judge six (6) months went by. Depositions, interrogatories, new medical doctor's examinations, follow up on medical treatment and interpretation of diagnostic testing, preparation of the case for a hearing and two postponements, brief writing and review all are part of this formidable Award. Lots of work but we have given our client a new opportunity to get better. This is what I like to do.
Practice area(s): Workers Compensation