Triangle R Inc. v New York Cent. Mut. Fire Ins. Co., 2011 NY Slip Op 51663(U)(App. Term 1st Dept. 2011)
“In this action by plaintiff to recover assigned first-party no-fault benefits, defendant’s submissions sufficed to establish prima facie that the medical supplies provided by plaintiff to its assignor were not medically necessary (see Enko Enters. Intl., Inc. v Clarendon Natl. Ins. Co., 30 Misc 3d 127[A], 2010 NY Slip Op 52267[U] [2010]; Innovative Chiropractic, P.C. v Travelers Ins. Co., 25 Misc 3d 140[A], 2009 NY Slip Op 52447[U] [2009]). In opposition, plaintiff failed to raise a triable issue of fact. The undated medical report relied upon by plaintiff was not properly sworn (see CPLR 2106, 2109), and should not have been considered (see CPT Med. Servs., P.C. v New York Cent. Mut. Fire Ins. Co., 18 Misc 3d 87, 88 [2007]). Moreover, even if considered, the report was insufficient to defeat summary judgment (id.).”
It looks to me like the Appellate Term, First Department, is not too fond of durable medical equipment. Enko v. Clarendon and Triangle v. NYCM (Defendant is entitled to summary judgment based upon submissions) and A-plus v. Mercury and Pomona v. Geico (Defendants submissions fail to conclusively establish its prima facie entitlement to summary judgment)
3 Responses
Some doctors love DME.
I hurt myself in Ju Jit Su the other night and went to a Chiro. I have a neck brace. Two wrist braces. A custom fitted back brace — although I don’t think that I ever was fitted. Although my chiro told me someone fitted me during my MUA session.
I have a jaw brace. Two knee braces and two ankle braces.
When I asked if all these braces might encumber my love life he gave me a brace for that too. Thats an awkward one but he told me that it actually helps fight STD transmission so — well the circles I run in; hey its cool.
This doctor, Leonid Shapiro, has never seen DME that was medically inappropriate. Even the infrared lamps that probably can cultivate oregano better than heal a sore neck gets a two thumbs up in his affidavits. I would like to meet this man.
I know this from D-1 College ball; boxing and martial arts. Never treat an injury with heat because heat only inflames. The one exception is contrast treatment to break up swelling. I had to put my ankle in water with crushed ice and keep it there “for as long as I could stand it” and then switch to hot water — back and forth. The trainer kept adding hot water because my foot made it cold.
Then you apply to ultra sound to help break it up. That restores mobility and reduces healing time. Of course you need to wrap it and start the strength exercise within 3 days of even the worse sprain.