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Case No. ADJ3408326

Regular

Jan 07, 2013

MOISES MENDOZA vs. WORLD SUPER SERVICES, INC., TRAVELERS INSURANCE COMPANY

The Workers' Compensation Appeals Board granted reconsideration and rescinded a prior award. The Board found that the lien claimant, Precision Occupational Medical Group, failed to meet its burden of proof. Specifically, the claimant did not demonstrate that the EMG/NCV study of the applicant's lower extremities was reasonable and necessary to treat the admitted left ankle injury. The matter was returned to the trial level with the lien claim disallowed.

Workers' Compensation Appeals BoardPetition for ReconsiderationFindings and AwardLien ClaimantReasonable and Necessary TreatmentBurden of ProofStipulations with Request for AwardMaximum Medical ImprovementEMG/NCV StudyLower Extremities

References

Case No. MISSING

Regular Panel Decision

Brown v. Achy

This personal injury lawsuit arose from an automobile accident, addressing the 'serious injury' threshold under Insurance Law § 5102 (d). Defendants moved for summary judgment, presenting reports from independent medical examinations that found no objective confirmation of disc herniation, despite an initial MRI. Plaintiff countered with objective evidence, including MRI and EMG/NCV results showing abnormal findings, and a doctor's affirmation detailing significant range of motion limitations and a permanent partial disability. The court ruled that this evidence, alongside an adequate explanation for a treatment gap, created a triable issue of fact as to serious injury. Consequently, the Supreme Court's order granting summary judgment was reversed, and the complaint was reinstated, with a purported appeal from an earlier decision dismissed.

Personal InjuryAutomobile AccidentSerious Injury ThresholdSummary JudgmentInsurance Law § 5102(d)Disc HerniationMRI FindingsEMG/NCV StudyRange of Motion LimitationsStraight-Leg Raising Test

References

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MOISES MENDOZA vs. WORLD SUPER SERVICES, INC., TRAVELERS INSURANCE COMPANY

Brown v. Achy

Personal InjuryAutomobile AccidentSerious Injury ThresholdSummary JudgmentInsurance Law § 5102(d)Disc HerniationMRI FindingsEMG/NCV StudyRange of Motion LimitationsStraight-Leg Raising Test