Claimant Successful on Utilization Review, Reinstatement and Review Petitions

Case Study

June 16, 2011

The injured worker, a resident of Middletown, Dauphin County, PA, suffered a work injury on May 23, 2008, while employed by Colonial Park Care Center as a Staff Development Coordinator and Nurse Aid Instructor while helping a student move a patient into bed.  Claimant felt a “give” in the center of her back and pain radiating down to her lower back. Claimant was diagnosed with a low back strain. Claimant was prescribed medications and underwent physical therapy for her lower back but still experienced significant pain. Claimant began treating with Dr. Albert Skocik, DC, for low back manipulation, electrical stimulation, therapeutic exercises and massage therapy, until the end of March 2009.

Then on March 30, 2009, while employed by Colonial Park Care Center as a Staff Development Coordinator and Nurse Aid Instructor, she tripped and fell, hitting her right shoulder, elbow and knee. Claimant experienced bruising, back, neck and lower back pain. The Claimant began treatment again with Dr. Albert Skocik, DC for the March 30, 2009 injury.

Claimant filed a Petition for Review of Utilization Review Determination on May 18, 2009, for modalities, office visits, prescriptions, chiropractic manipulation, massage therapy and physical therapy provided by Dr. Skocik, which went before Judge Charles Clark in Harrisburg, Dauphin County, Pennsylvania. On July 28, 2009, Claimant filed a Petition to Reinstate Compensation Benefits as of July 15, 2009, due to the March 30, 2009 injury, which went before Judge Charles Clark in Harrisburg. The Claimant further requested costs, interest and attorney fees for unreasonable contest. The Defendant filed an Answer to the Claimant’s Reinstatement Petition on August 17, 2009, denying all allegations.

The Judge found the Claimant’s treating provider, Dr. Albert Skocik, DC, credible that the Claimant suffered a cervical radiculitis C6 to the right, a cervical segmental dysfunction; right knee contusion and segmental dysfunction; a cervical sprain/strain and aggravation of a pre-existing arthritic cervical condition. The Judge rejects the testimony of Dr. David Bosacco, MD as incredible and unpersuasive because he was not aware of the light-duty job and ignored pertinent findings of his examinations. Claimant’s Petitions for Review of a Utilization Review, Review of Compensation Benefits and Petition for Reinstatement of Benefits were granted, awarding litigation costs and interest on all due and payable compensation in the amount of $836.00 for the time period of July 15, 2009, to present and continuing and attorney fees. The Defendant and Chartis Claims, Inc. was ordered to be responsible for the Claimant’s medical expenses.