Rozalyn L. Childs v. Renaissance of South Shore

Steven L. Miller successfully defended a nursing home on the issue of medical causal connection at both arbitration on a 19(b)/8(a) trial and on review at the commission level.

A Certified Nurse Assistant alleged that she slipped and fell on a pool of water falling onto her left side, though testified that she sustained a “jarring” injury to her right side on her way down. The petitioner’s treating physician ultimately opined that the petitioner required surgical intervention to address impingement syndrome in the right shoulder. The respondent successfully relied on an independent medical examiner’s opinion that the petitioner’s physical exam findings were inconsistent with a diagnosis of impingement.

During cross-examination of the treating physician, the doctor admitted that he did not know if the petitioner fell backward or forward, did not know what distance she fell to the floor, did not know what kind of surface she fell on, and did not know what she was doing when she fell. He admitted that he would be in a better, more informed position regarding medical causation if he had known some of those factors. He also admitted that he was “speculating” that the petitioner had a jarring injury to her right side, as he never asked the petitioner this question.

Ultimately, the Arbitrator found that the independent medical examiner’s opinions were more credible in that the petitioner had diffuse pain complaints which were non-anatomical and inconsistent with a diagnosis of impingement syndrome. While the petitioner was 28-years-old without any alternative etiology to point to, the Arbitrator nonetheless agreed with the independent medical examiner that the diffuse nature of her pain complaints and the inconsistencies on clinical presentation with a diagnosis of impingement were persuasive.

This ultimately resulted in a net savings well in excess of $150,000.00 in cumulative costs in terms of 70 weeks of alleged temporary total disability benefits, outstanding medical treatment charges that had accrued prior to trial, future costs associated with the proposed surgical intervention, future medical costs associated with physical therapy as well as ongoing conservative care following the proposed surgical intervention, anticipated temporary total disability benefits for all lost time incurred following the proposed surgical intervention, and the increased permanency value of the case based on an operated shoulder.

The Commission affirmed on appeal.