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Judge remands disability case, finds no credibility in medical exams

Posted On: Dec. 6, 2019 11:24 AM CST

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A judge with the Appellate Division of the Supreme Court of New York on Thursday remanded a workers compensation disability case back to lower court, finding all the medical evidence to be “not supported.”

In March 2009, Luis Rodriguez fell while working for a subsidiary of Coca-Cola Consolidated Inc. and injured his left leg. At a later date his workers compensation claim was amended to include injuries to his neck, back, right shoulder, right wrist and right hip, according to documents in In the Matter of the Claim of Luis Rodriguez v. Coca Cola et al., Workers' Compensation Board, filed in the Appellate Division of the Supreme Court of New York, Third Department in Albany.

Starting in 2016, two doctors — the claimant's treating physician and an independent medical examiner hired by Coca Cola — provided opinions of varying degrees of disability to separate body parts, as severe as a 35% loss of use of right arm in one instance, all related to the workplace fall.

A Workers Compensation Law Judge subsequently classified Mr. Rodriguez with “a permanent partial disability of the cervical, thoracic and lumbar spine at a severity A rating but found a 0% loss of wage-earning capacity.”

Upon later review, the state Workers' Compensation Board found “neither medical expert's opinion to be credible” on the grounds that Mr. Rodriquez’s doctor “admittedly did not examine claimant's neck or back” and that the follow-up medical examiner “did not review claimant's medical records from prior to the 2009 accident,” according to documents, which highlight that the worker had suffered a workplace injury in 2005 and has then injured his neck, back, shoulders, and his left wrist.

The board found that "no accurate determination can be made on permanency on the record currently developed." As a result, the board rescinded the workers compensation judge’s classification for disability.

On appeal, the appellate division with the state’s highest court remanded the entire decision — with costs — back to the Workers’ Compensation Board, finding that the board’s decision was “inadequate” since it failed to credit either of the expert’s medical opinions. “Under these circumstances, the Board's decision is not supported by substantial evidence and must be reversed,” Thursday’s ruling states.