Joseph Masselli v. Yellow Transportation, Inc.
October 31, 2022
Katherine Gatti Rooks
CategoriesMedical Expenses Board IME Findings of Fact Board IME Findings of Fact Medical Expenses
Summary from the Troubh Heisler Attorneys
. Because the ALJ failed to make sufficient findings and conclusion regarding the 312 IME’s relative qualifications and expertise, the Appellate Division vacated the denial of Masselli’s Petition for Payment of Medical Services. In Masselli v. Yellow Transportation, Inc. Dec. No. 22-35, when attempting to open a stuck door Masselli suffered a work-related back injury on August 7, 2007. A L4-5 disc herniation was diagnosed. Masselli returned to work after a 10 month absence and continued to receive chiropractic care from Dr. McLean to the date of hearing. Masselli testified that the chiropractic care allowed him to remain at work and avoid surgery. Dr. McLean opined that the chiropractic treatment was reasonable and proper. In his 312 IME report Dr. Bradford stated he would not condone the extent or frequency of the chiropractic treatment over such period of time. At deposition he challenged the reasonableness of the treatment. The ALJ denied the Petition for Payment of Medical Services, concluding that Dr. McLean’s opinion did not meet the clear and convincing standard required by sec. 312(7). Masselli’s motion for further findings of fact and conclusions of law was denied.
Masselli appealed, arguing it was error for the ALJ to rely on the opinion of Dr. Bradford who lacked expertise in the relevant specialty- chiropractic services. The Appellate Division agreed, relying on Hood v. Me. Dep’t of Corrections, Me. W.C.B. No. 18-5 (App. Div. 2018). In Hood the 312 IME opined that the employee’s respiratory injury had resolved. The IME testified that he had never treated a similar injury and lacked experience in occupational and pulmonary medicine. The appellate panel concluded it could not make a meaningful review of whether there was clear and convincing evidence to the contrary of the IME where the ALJ failed to make findings of the medical experts’ relative qualifications or expertise. In this case, because the ALJ failed to make findings as to Dr. Bradford’s expertise in chiropractic care as compared to the competing medical expert in the case, the decision did not provide an adequate basis for appellate review of the issues raised by Masselli. The decision was remanded for the ALJ to make findings on this question.