Baral v. Alliance Health Documentation

Insurance Company

Twin City Fire Insurance

Date Decided

July 14, 2020

Panel Members

Timothy Collier

Evelyn Knopf


Medical Examination


Thumbs Fingers §312 IME Arthritis Tenosynovitis Carpal Tunnel

File Size

117 KB


Summary from the Troubh Heisler Attorneys

Baral developed pain in her thumbs in 2014 and in her right ring finger in 2015, and she attributed both to her work as a medical transcriptionist. She filed petitions alleging those injuries, and Dr. Mazzei conducted a §312 IME. He diagnosed CMC arthritis, right flexor tenosynovitis, and also carpal tunnel syndrome, all caused by her work activities. No medical evidence contradicted his findings, nor did any other medical evidence support the CTS claim.

Judge Hirtle granted Baral’s petitions on the arthritis and tenosynovitis, but he declined to include the carpal tunnel syndrome in the work injuries. He stated that Baral had not established a date of the CTS injury, Dr. Mazzei’s CTS analysis was “cursory [and] without explanation,” and Dr. Mazzei did not link her CTS to her other injuries. Ms. Baral appealed, but the Appellate division panel affirmed Judge Hirtle’s decision.

The panel agreed that §312 required Judge Hirtle to adopt the IME findings “absent a clear and convincing evidence to the contrary in the record,” and that the lack of corroborating evidence alone does not meet that standard. In this case, however, Judge Hirtle gave other reasons for rejecting the IME findings on the carpal tunnel syndrome: the IME report did not explain the basis of that opinion, it did not indicate when the injury occurred, and it did not connect the CTS to Baral’s other injuries. The panel found that the IME opinion was insufficient to carry the employee’s burden of proof on the CTS condition.

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