Successful Defense: BCM Law, P.C. Secures Favorable Ruling in Knee Injury Case

Matthew P. Sheriff

This case involved a 65-year-old physical education teacher who claims an injury to her left knee when she was struck from behind by two students running for a loose basketball. The accident was accepted, and the petitioner suffered a torn meniscus as a result. Following surgery and a course of post-operative physical therapy, the petitioner returned to work.

Following her return, she began experiencing continuing knee pain. The treating physician recommended a course of Supartz injections. These were initially found to be causally related by the Section 12 IME physician, Dr. David Raab however as time passed and the injections continued, Dr. Raab opined that the need for injections was no longer due to the traumatic injury, but rather due to the natural progression of the osteoarthritis.

The matter proceeded to trial before Arbitrator Granada who awarded the petitioner the disputed Supartz injection bills and the petitioner obtained future medical rights under Section 8(a) by virtue of the petitioner prevailing on this issue at trial.

The petitioner subsequently filed a Section 8(a) Petition requesting coverage for Supartz injections. The matter was presented for trial before Commissioner Tyrell and testimony was held, however the evidence was not submitted, and proofs were not closed. Commissioner Tyrell retired thereafter, and the matter was transferred to Commissioner Simonovich. The new commissioner requested the parties review the trial testimony previously provided and present exhibits at a hearing held in November of 2024. The petitioner stood on the prior decision and the records incurred by the petitioner several years prior, with no recent medical submitted. The Respondent presented the prior IME report of Dr. Raab and a subsequent report detailing his opinions in light of the lack of additional records, the argument being the petitioner had neither supported the claim for additional injections with recent medical records, nor were the opinions of Dr. Raab countered by a recent report.

Commissioner Simonovich found that the petitioner had not met her burden of proving a causal connection between the original accident and the continuing need for Supartz injections and found for the Respondent. The order was not appealed.