Practice Area: Workers compensation
Outcome: Prevailed At Division of Workers' Compensation
Description: In this case, I represented a medical provider who treated an injured worker but was not paid by the Texas work comp insurance carrier. The injured worker had a back injury that failed to resolve as quickly as it should have. Because of peristent pain that interfered with his functional abilities, the claimant developed depression, and the medical provider treated this with psychotherapy and counseling, all of which was preauthorized as medically necessary treatment. The insurance carrier denied payment to the medical provider arguing that the claimant's depression was not related to the work injury. The carrier hired an expert witness, Dr. Andrew Brylowski, who wrote a report indicating that while the claimant had a mood disorder, it was related to a prior head injury that happened more than 15 years prior. The problem with this opinion, is that the "expert" didn't even review one single medical record from the prior head injury to know what the injury was, what the symptoms were at the time and thereafter, what treatment was provided, whether any psychological issues were present back then or not, or anything else about the nature of the prior injury. His conclusions were completely unfounded and not based upon any evidence that was reviewed by the doctor or placed into evidence at the hearing in this matter. The judge determined that the claimant's depression arose out of and naturally flowed from his current work injury. Therefore, depression is compensable, and the carrier was ordered to pay benefits in accordance with the judge's decision.