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In 2017, Claimant slipped and fell, injuring her knee. In 2020, Claimant filed a Petition alleging 6% permanency to her left lower extremity, specifically the knee, based upon Dr. Bandera’s opinion, relying on the 5th Edition of the AMA Guidelines for Rating Permanent Impairment.
The Board denied the Petition, relying on the opinion of the defense medical expert, Dr. Piccioni. The Board noted that unlike Dr. Bandera, Dr. Piccioni is a Board certified orthopedic surgeon. Dr. Piccioni’s review of the records of claimant’s treating orthopedic surgeon, Dr. Leitman, showed that claimant recovered fully from her injuries within 2-3 months, when she was released to full duty and to be seen as needed. Dr. Piccioni agreed with Dr. Leitman’s assessment that following the 2-3 month point, claimant’s knee was “benign.” No treating provider ever recommended claimant use any sort of ambulatory aid, proceed with injections, or discussed surgical options. Claimant only followed up with Dr. Leitman once after the 2-3 month mark, where he again referred to the knee as “benign.” The Board questioned Dr. Bandera (not a surgeon) going against the opinions of two orthopedic surgeons, especially as Dr. Bandera did not evaluate the claimant until over 2 years had elapsed following the work accident.
The Board was also very critical of Dr. Bandera’s attempts to analogize claimant’s knee bruise diagnosis with patella subluxation and fracture diagnoses in the 5th Edition of the AMA Guides, as Dr. Piccioni testified credibly that these were not appropriate comparisons. The Board agreed with Dr. Piccioni that the 6th Edition of the Guides, which allowed for a zero rating for claimant’s specific diagnosis, even with continued credible subjective complaints, provided a much more fair and accurate representation of claimant’s true functional abilities in the knee.
Should you have any questions concerning this Decision, please contactGreg Skolnik, or any other attorney in Heckler & Frabizzio's Workers’ Compensation Department.
Darlene Cole v. State, IAB Hrg. No. 1463877 (Oct. 13, 2020).