Traci Teer (Atlanta, GA) (Workers’ Compensation) The claimant, Wesley Arnold, sustained a compensable injury on June 23, 2018 when he was working as a food runner at Taki Japanese Steakhouse. A co-worker slammed a freezer door and it struck the claimant on his right elbow. The accident itself was not disputed, and the claimant went to the hospital for immediate treatment. He also hired legal counsel quickly. Since the restaurant did not have a panel of physicians list in place at the time of accident the other attorney arranged for her client to see several “claimant-friendly” doctors. They disabled the claimant from working, which necessitated the commencement of weekly TTD benefits.
Shortly after the claimant began treatment he was diagnosed with RSD and CRPS. A spinal cord stimulator was recommended soon thereafter. After discussion with Farmers and their insured, it was decided to start arranging IMEs with various physicians of different disciplines. First, Dr. John Porter (physical medicine/rehabilitation specialist) pointed out the claimant’s “dramatic hypersensitivity to light touch” in the arm and concluded that there was no definable medical diagnosis. He also stated how the claimant only met 2 of the 10 objective criteria for CRPS, and that the “most likely diagnosis is self-mutilation”. A second physician, Dr. Barry McCasland (neurologist) concurred that there was no neurologic syndrome or diagnosis and that the claimant did not have CRPS. Like Dr. Porter, he felt that the claimant could work regular duty insofar as the work injury was concerned. A third physician, Dr. Michael Hilton (psychiatrist) evaluated the claimant and noted a history of extensive issues prior to the work injury. He also diagnosed somatoform disorder and felt that there was a strong possibility of malingering or factitious disorder. He believed the claimant’s anxiety and depression were both pre-existing and unrelated to the on-the-job accident.
The issues for hearing were (1) the claimant’s request for treatment CRPS, psychological care, and a spinal cord stimulator and (2) the employer/insurer’s request for a ‘change-in-condition’ finding, which would allow a suspension of weekly TTD benefits. After considering all the testimony and medical evidence, the ALJ concluded that the IME doctors’ opinions were collectively more persuasive than the claimant’s treating doctors. In denying the claimant’s request for treatment of CRPS he found that the injury was isolated to a right elbow contusion, only. Additionally, he determined that the claimant had undergone a change in condition for the better with respect to his right elbow injury, and that there was no associated or ongoing disability. Therefore, the ALJ granted the employer/insurer’s request to suspend TTD retroactively to January 19, 2019 – with a credit for overpayment of such benefits against any future income benefits which might be found due and owing.