Key Takeaway
Court rules IME doctor's contradictory causation statements and failure to review key medical records insufficient to establish lack of causation in no-fault case.
Shur v Unitrin Advantage Ins. Co., 2017 NY Slip Op 51011(U)(App. Term 2d Dept. 2017)
“Here, the affirmed report of the doctor who had performed an independent medical examination (IME) of the assignor contained contradictory statements (see e.g. Black v County of Dutchess, 87 AD3d 1097; Coscia v 938 Trading Corp., 283 AD2d 538 ) as to whether the injury to plaintiff’s assignor’s right knee was “partially causally related to” the accident at issue or caused by “preexisting degenerative changes.” Furthermore, an MRI report that was reviewed by the IME doctor did not set forth an impression of degenerative changes. Nor did the IME doctor indicate that he had examined an operative report on the arthroscopy at issue. Thus, contrary to the determination of the District Court, defendant failed to make a prima facie showing of lack of causation. Consequently, defendant’s motion should have been denied.”
The above raise two issues: examination of operative report and examination of the MRI report play. Both of these documents play a critical role in whether a peer doctor’s causation analysis (who opines that surgery is not related to the accident) is valid. I sense a lot of causation peer reviews will not survive the Vladamir Shur test.
*** It was a Thomas Nipper peer review **
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