Medical Evidence Supports Termination of Benefits

Claimant was injured in a motor vehicle accident in the course and scope of his employment while a passenger in one of Employer’s garbage trucks.  Employer paid Claimant benefits for a related lower back injury over the course of two years.  Employer terminated benefits on the basis that Claimant had reached maximum medical improvement and could return to full-time employment.  Employer based this decision on medical reports from a pain management doctor, neuropsychologist, and psychiatrist.  There were other medical reports from other medical providers that conflicted with those cited by Employer.  Claimant filed a claim disputing the termination of his benefits and requesting continuation of his temporary total disability (TTD) benefits as well as interest, penalties, and attorney’s fees.  The WCJ found that Employer’s decision to terminate benefits was not arbitrary or capricious and that Claimant did not carry his burden proving that he was disabled at the time Employer terminated his benefits.  The WCJ denied Claimant’s claim for continuing benefits, penalties, and fees.

Claimant appealed to the First Circuit, arguing that the WCJ erred in denying him TTD and upholding Employer’s termination of benefits.  Employer filed an answer and requested attorney’s fees for what it alleged was a frivolous appeal.  The crux of Claimant’s argument on appeal was that the WCJ relied only on the opinion of the pain management doctor, specifically the statement that he is “[n]ot sure why this claim has gone on for over 2 years with no objective findings.”  The Court rejected this argument, citing extensive testimony and medical evidence relied on by the WCJ showing that Claimant either did not have an associated psychological injury, demonstrated symptom magnification, or was malingering.  Accordingly, the First Circuit held that the WCJ’s findings were reasonable based on the entire record and should not be reversed.  Further, in addressing Employer’s request for attorney’s fees based on a claim of frivolous appeal, the Court found that Claimant submitted a well-written brief supported by facts and law.  Claimant’s appeal, therefore, was not taken solely for delay.  The judgement of the WCJ AFFIRMED and Employer’s request for attorney’s fees on appeal was denied.

Rogers v. Waste Management of Louisiana, LLC