The claimant sought a catastrophic impairment as a result of chronic pain and psychological impairment following an accident. Because the accident was after June 1, 2016, the claimant was required to prove that she suffered three Class 4 Marked Impairments. The insurer argued that the claimant’s chronic pain pre-existed the accident, and was not worsened by the accident. Adjudicator Hines accepted the opinion of the claimant’s expert psychologist, Dr. Levitt, and found that the claimant suffered Class 4 Marked Impairments in all four spheres of function. Adjudicator Hines also found that the accident was a necessary cause of the claimant’s worsening psychological impairments. Since the accident, the claimant had been unable to return to work, her relationship with her partner had deteriorated, she rarely socialized due to anxiety, she experienced outbursts with family members and strangers, and she struggled to maintain a daily routine. The claimant’s reporting was credible, and the inconsistencies were minor. Adjudicator Hines rejected the conclusion of the IE psychiatrist, Dr. Ali, because the assessment was less than one hour and used no testing or collateral interviews; she relied on an occupational therapy assessment that was geared towards people with Alzheimer’s; she did not find the claimant’s self-reporting valid yet did not comment on the claimant’s credibility; and her conclusions were inconsistent with her post-104 IRB conclusions. A special award was claimed by the claimant, but not awarded due to insufficient evidence to support that the insurer’s conduct was unreasonable.
Menu