IME: Knee Replacement
Steven Babitsky, Esq.
Is an incomplete medical history taken by an IME physician “cured” by a subsequent review of the employer’s medical report?
The appeals court of Kentucky, PADUCAH PUBLIC SCHOOLS v. Dumas, Ky: Court of Appeals 2012, hold it in fact was.
The court stated:
PPS further contends that the ALJ erred in relying on Dr. Bilkey’s opinion because it was founded on insufficient knowledge of Dumas’s medical history. Dr. Bilkey was not aware of Dumas’s prior left knee treatment and surgeries when he opined that the knee replacement was attributable to the 2009 injury. PPS argues that the situation is analogous to that found in Cepero v. Fabricated Metals Corp., 132 S.W.3d 839 (Ky. 2004), in which a workers’ compensation claimant attributed his knee injury to a work-related accident, and did not tell his physicians about an earlier injury he had sustained while practicing martial arts. The physicians based their opinions regarding work-related causation on this incomplete history, and their opinions were in turn adopted by the ALJ. The Kentucky Supreme Court held that “where it is irrefutable that a physician’s history regarding work-related causation is corrupt due to it being substantially inaccurate or largely incomplete, any opinion generated by that physician on the issue of causation cannot constitute substantial evidence.” Cepero, 132 S.W.3d at 842. But in this case, Dr. Bilkey did learn of Dumas’s medical history from Dr. Snider’s IME, and submitted another report regarding her level of impairment, yet Dr. Bilkey gave no indication that he had revised his ultimate opinion regarding the work-relatedness of the surgery. Under these circumstances, the Board did not commit flagrant error in affirming that the ALJ’s finding of work-relatedness was supported by substantial evidence.