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Claim Disallowance With Unanimous Medical Opinion Giving Causal Relationship

May 17, 2021 | MAD News, NYS Workers Compensation

This was a controverted claim for chemical exposure for an accident which occurred in 2019. The claimant was working as a bus driver and alleged that she was exposed to fuel additives somehow coming out of the heating vents, and that she has been subject to repeat exposures. The history of the accident provided to each of the claimant’s providers, as well as the independent medical examiner, what that she was exposed to chemicals repeatedly while working and developed certain symptoms each time she was exposed. Given the history provided, it was unanimous among medical providers, including the independent medical examiner, that causal relationship existed. Upon taking testimony of the medical providers, the providers conceded the claimant suffered other medical conditions which may be causing her to be symptomatic but are not necessarily related to work. Then, upon taking lay witness testimony, the various witnesses testified that it was impossible for the claimant to have been exposed to the fuel additive, as she never came in contact with it and the vents are not connected to the gas tank, so it would be impossible for it to have come out of the vents. They also testified the additive was only added once, and would have dissipated the same day, which is inconsistent with the history the claimant was giving which claimed that the additive was added on multiple occasions subjecting her to repeat exposures.

The Carrier relied heavily on a recent Third Department decision which have very similar facts and found that “the lack of objective findings to support claimant’s complaints, coupled with the employer’s contrary testimony regarding claimant’s working conditions and the inconsistencies in claimant’s disclosures to [the medical providers], raise issues with claimant’s credibility that the Board was free to resolve against her. For all of these reasons, the Board’s decision finding that claimant failed to meet her burden of establishing a causal relationship between her employment and her claimed disability [was] supported by substantial evidence.” Matter of Collen Hanely v. Trustees of Columbia University, 189 A.D.3d 1847 (3rd Dept. 2020).

The WCLJ ultimately found that the lay witnesses had direct knowledge of when the fuel additive was added and that the evidence established that there were no additional exposures to explain the claimant’s symptoms. The WCLJ also found that the claimant’s medical providers admitted the claimant had unrelated conditions which could have accounted for claimant’s symptoms. The claim was disallowed as a result.

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