Recent Take Nothing Award
The Applicant, a 44-year-old male, was working as a baker at a large grocery chain on the date of the alleged injury. The Applicant claimed to have suffered a cumulative trauma injury to his eye, back, psyche, respiratory system, sleep disorder, & skin in the course & scope of employment with the grocery chain (December 30, 2011 – November 14, 2012). This claim was timely denied based on a lack of medical evidence to support a claim of injury and a lack of timely reporting to the employer.
The Applicant’s only evidence in support of the injury AOE/COE was the medical reporting of his primary physician, Chiropractor Caligiuri. Caligiuri’s reliance on the Applicant’s inadequate & inaccurate medical history, as well as his failure to review the Applicant’s prior medical history represented two big flaws in his evaluation of the Applicant. The Applicant had failed to disclose to Chiropractor Caligiuri his prior industrial back injury & his prior motor vehicle accidents. Three separate & independent Panel Qualified Medical Examiners (PQMEs) conducted exhaustive reviews of the Applicant’s prior medical history & found the Applicant’s alleged injuries non-industrial in nature & unrelated to his employment at the grocery chain, based on several, irrefutable factors.
At trial, the Applicant outright misstated that he did not have a prior back injury. He stated that his previous workers’ compensation claim with another firm was for an injury to his right shoulder, despite medical & legal evidence disproving his statements. None of this information was mentioned to any of the PQMEs that met previously with the Applicant. The Applicant admitted he did not tell anyone that he worked with that his injuries were work related.
Further, it is found that Chiropractor Caligiuri’s reports were inadmissible for failure to rise to the level of substantial medical evidence. Due to absent medical evidence to support his claim of industrial injury, the applicant is incapable of meeting the burden of proving the injury AOE/ COE.
The Applicant was found to be less than credible. His testimony at times was inconsistent with the information contained in the medical record & his deposition testimony. He denied knowing any of his injuries were work related before he stopped working.
As injury was found to be not industrially related, the Applicant is not entitled to compensation on the basis of temporary disability, permanent disability, apportionment, need for further medical care, or coverage of attorney’s fees.
The Applicant was ordered by the ALJ to take nothing on his claim.