November 01, 2016

Treating Physician's Medical Reports Basis for Denial of Claim Petition

In Myers v. Geisinger, the claimant filed a claim petition alleging that he sustained an injury on October 28, 2015.  Specifically, the petition alleged that the claimant sustained an aggravation of a previous lumbar spine injury from 2002, due to repetitive trauma, lifting, carrying, and bending associated with his job duties.  The claimant sought temporary total disability benefits from November 24, 2015, until his return to work on March 1, 2016, without a loss of earnings and ongoing medical benefits.

This was a claim for a closed period of less than 52 weeks.  The medical evidence was submitted via report.

The claimant and the defense relied on two medical reports from the claimant's treating physician.  The judge, in reviewing the two medical records of the treating physician, found that the opinions failed to establish that the claimant sustained an aggravation of a pre-existing condition and disability.  The judge specifically noted that the treating physician stated that there was material aggravation; however, the details of the office notes failed to support any such aggravation. In fact, the office notes did contain the magic words "material aggravation;" but, the content of the reports did not support that conclusion.

What It Means to You

This case highlights the importance of the content and findings in the records, and not just the fact that records contain these magic two words.