In this case the employee appeals from the compensation judge’s determination that her right hip complaints are not related to her work injury of December 30, 2016, and from the compensation judge’s denial of her claim for benefits. The issue before the court was whether the Employer/Insurer’s IME doctor based his opinions on adequate foundation.
The employee sustained an injury on December 30, 2016, in the course of her employment when she was walking from her house to the mailbox and she slipped on ice. She fell, landing on her right side. She sought care, with complaints of right shoulder, back, and right hip pain.
The employee’s right shoulder pain was subsequently diagnosed as being the result of a rotator cuff tear. The employer and insurer admitted liability for the employee’s right shoulder injury and paid for the surgery.
The employee also sought medical care for her right hip and low back. The employer and insurer denied that the employee’s low back and right hip complaints were related to the work injury and refused to pay for such treatment. The employee filed a claim petition.
In a hearing, compensation judge Kathleen Behounek denied the employee’s claim, determining that the employee had failed to establish by a preponderance of the evidence that she had sustained injuries to her back and right hip. The employee appealed. The issue on appeal was whether the evidence presented by the employee established a causal relationship between the employee’s work injury and her ongoing right hip complaints.
The employer and insurer relied on the opinion of their independent medical examiner, Dr. Edward Szalapski. He considered her right hip pain to be referred pain from her low back condition, which he diagnosed as degenerative disc disease at L4-5. He also concluded that the employee had osteoarthritis of the hip that was not related to the work injury and which had not been aggravated by the work injury.
The employee argues in her brief that the opinion of Dr. Szalapski should not have been accepted by the compensation judge because he failed to mention that the employee responded favorably to multiple bursal injections, which she contends is evidence that she suffered from bursitis as opposed to referred low back pain. However, that argument does not indicate a defect in the foundation for Dr. Szalapski’s opinion, but instead simply reflects an opposing view as to the significance of the employee’s pre-existing hip complaints and the treatment she received for her right hip. Dr. Szalapski had adequate foundation for his opinion based on his physical examination of the employee and his review of the employee’s voluminous medical records.
The take away on this case is that an IME doctor does not need to address every condition or treatment to lay adequate foundation for his or her report.