General Internist’s Vague Recommendations Result in Denial of Motion for Medical and/or Temporary Disability Benefits

In Amedeo v. UPS, the Appellate Division focuses on the Petitioner’s reliance upon a report authored by a general internist in denying the Motion for Medical and/or Temporary Disability Benefits. By way of background, the Petitioner had a work-related injury which ultimately settled in 2012 for injuries to his right hip and lower back. Four months after settling the case, the Petitioner filed an application for review or modification of the prior award and requested treatment to his right hip. In response, the Respondent scheduled the Petitioner for an evaluation with Dr. Corona, who determined that the Petitioner was at maximum medical improvement. 

As a result of the Petitioner’s ongoing failure to appear in Court, the Respondent filed a Motion to Dismiss in July, 2013. An answer to that Motion was filed by the Petitioner along with a Motion for Medical and/or Temporary Disability Benefits based upon Dr. Brustein’s report recommending that the Petitioner seek out other specialists for his hip condition.

On October 4, 2013, the matter was listed and the Petitioner’s attorney did not attend, but instead sent another attorney to cover the matter. The Petitioner was not present. At the hearing, the Judge of Compensation dismissed the Petitioner’s Motion for Medical and/or Temporary Disability Benefits due to insufficient medical proofs. More specifically, the Judge found that the Petitioner’s Motion and supporting documentation did not meet the requirements of N.J.A.C. 12:235-3.2(b)2. In particular, Dr. Brustein’s report failed to specifically identify the type of treatment being sought. The Judge of Compensation emphasized that Dr. Brustein was not an orthopedic surgeon; rather, he practiced internal medicine and the proposed areas of treatment were outside his area of expertise. Ultimately, the Judge of Compensation dismissed the Motion for Medical and/or Temporary Disability Benefits in order to give the Petitioner the opportunity to submit sufficient support for his Motion.

The Petitioner then appealed asserting that the judge abused her discretion in dismissing the Motion for Medical and/or Temporary Disability Benefits. In affirming the Judge of Compensation’s holding, the Appellate Court determined that the Petitioner failed to provide adequate evidence to support a prima facie case in support of his Motion. In particular, the Appellate Court determined that Dr. Brustein’s report did not give rise to the specificity required for the Judge of Compensation to evaluate the Motion. 

Date Published: February 7, 2017


Written by: Cooper Levenson, P.A.

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