Thurston v. CW Hayden

Name

Insurance Company

Date Decided

December 28, 2015

Panel Members

Elizabeth Elwin

Sue Jerome

Mike Stovall

File Size

146 KB

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Summary from the Troubh Heisler Attorneys

Richard Thurston appeals Judge Goodnough’s decision granting his Petition for Award in part, denying his Petitions for Payment of Medical and Related Services, for Restoration, and for a Provisional Order. The judge based his decision on Dr. Donovan’s medical findings. The panel considered two issues on appeal:

(1) whether the ALJ abused his discretion by not considering untimely medical records as evidence contrary to the IME’s opinion, and

(2) whether there was, nevertheless, clear and convincing evidence contrary to the IME’s findings. The panel rejected both issues on appeal and affirmed Judge Goodnough’s decision.

In so holding, the panel found that Mr. Thurston was provided ample time and explicit instructions in an Order that explained how to provide Dr. Donovan with the medical records Mr. Thurston wanted him to review. Mr. Thurston failed to provide the records in accordance with the Order, and it was within Judge Goodnough’s discretion to decline to consider them.

Second, when considering whether clear and convincing medical evidence contrary to the IME’s findings permits a rejection of those findings by the ALJ, courts “determine whether the [ALJ] could reasonably have been persuaded by the contrary medical evidence that it was highly probable that the record did not support the IME’s medical findings.” Dubois v. Madison Paper Co., 2002 ME 1, ¶ 14, 795 A.2d 696 (quotation marks omitted) When, as in this case, the hearing officer adopts the IME’s findings, the panel will reverse only if those findings are not supported by any competent evidence, or the record discloses no reasonable basis to support the decision. Because the Judge Goodnough’s findings were supported by competent evidence, and the record provides a reasonable basis to support his decision, the panel affirmed.

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