Medical Records and Witness Testimony Led to Denied Benefits and $50K Savings

Noah P. Hamann

Petitioner was a 49-year-old handyman for a property management company. He alleged a left knee injury on November 26, 2019. Specifically, he claimed that while descending a ladder, he missed a rung and fell approximately three feet to the ground. He was recommended for left knee arthroscopy with a possible meniscectomy. Accident was disputed. On September 16, 2021, the case was tried before Arbitrator Linda Cantrell.

Respondent was able to use the medical records to contradict the petitioner’s allegations. In detail, on the alleged date of accident, the petitioner was seen at a local emergency room with complaints of left leg pain for one week. The timeline did not correlate with an acute accident earlier that day. Likewise, there was no mention of a work-related fall in this initial record. The same was true for a second emergency room visit on November 29, 2019. The first mention of a work-related accident did not appear until the petitioner’s initial orthopedic evaluation on December 5, 2019. At trial, the petitioner testified that he did not describe the work accident in the first two medical records because he was focused on his pain and he did not think his injury was serious.

A coworker of the petitioner’s testified in support of the petitioner at trial. The coworker testified that he was working with the petitioner on the date of accident. The petitioner was descending the ladder and the coworker was on the roof. The coworker heard a “ruckus.” He looked down from the roof and saw the petitioner lying on the ground. During cross-examination, the respondent was able to get the coworker to testify that he did not actually see the petitioner fall and that the petitioner did not appear to be in any pain.

The arbitrator ruled in the favor of the respondent. She assigned weight to the first two medical records, which failed to describe a work accident and also pointed to an onset prior to the alleged date of accident. The arbitrator also found it significant that the petitioner’s witness did not actually see the accident. All benefits were denied. The petitioner reviewed the case and on May 26, 2022, the Commission unanimously affirmed the decision.

At trial, the petitioner was seeking three months of TTD, the cost of a meniscus surgery and permanency was forecasted to be around 20% of a leg. The total savings achieved for the client was around $50,000.00.