Case Studies

Utilization Review Curbs Excessive Treatment

Facts   

Petitioner was a food worker who sustained injuries to her chin and left shoulder when struck by a forklift on May 24, 2006. Petitioner later alleged neck and right elbow problems related to the original incident. Petitioner began treatment in summer of 2004. She received extensive chiropractic manipulation for the next two years. Our IME physician found no causation after initial company clinic released

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Cafeteria Worker Denied Benefits for Later Manifested Knee Condition

Facts

Petitioner sustained a fractured right fibula in slip and fall May 20, 2005, treated for eight weeks with non weight bearing, followed by therapy, and received full duty   release July 25, 2005. Claimed right knee aggravated by work incident. Petitioner received chiropractic care for next two years for both knees and other conditions. She then sought a surgeon for continued right knee pain and underwent

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General Manager Denied Benefits for Low Back Treatment, Extensive Treatment, Permanent Restrictions

Facts

Petitioner sustained a fracture to her L1 vertebrae following a slip and fall on May 12, 2004. Petitioner underwent conservative care through the fall of 2004. She continued to complain of low back complaints with sporadic treatment for next two years. She then pursued aggressive care beginning in the fall of 2006. This treatment was related by Petitioner’s physician to her original work injury. Our

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CNA Seeks Treatment and Temporary Total Disability Benefits

FACTS:

Petitioner suffered a low back injury while assisting a patient. Following her injury, Petitioner was taken off of work and started undergoing physical therapy and injections. Despite her prolonged treatment, Petitioner continued to complain of 10/10 pain and sought authorization for a spinal cord stimulator, which was disputed by our IME doctor. The matter proceeded to trial on Petitioner’s 19(b)/8(a) petition.

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