Phillips v. Wal Mart Ins Co of the State PA (the), 061621 VAWC, 2128788

Case DateJune 16, 2021
CourtVirginia
KEVIN PHILLIPS
v.
WAL MART INS CO OF THE STATE PA (THE), Insurance Carrier
AIG Claims, Inc., Claim Administrator
Jurisdiction Claim No. 2128788
Virginia Workers Compensation
Virginia In The Workers' Compensation Commission
June 16, 2021
          Date of Injury: December 26, 2002          Claim Administrator File No. C2296911           Mingkwan Emme Collins, Esquire For the Claimant.           Evans G. Edwards, Esquire For the Defendants.           REVIEW on the record by Commissioner Marshall, Commissioner Newman, and Commissioner Rapaport at Richmond, Virginia.          OPINION           NEWMAN COMMISSIONER          The defendants requested review of the Deputy Commissioner's February 11, 2021 Opinion finding them responsible for the cost of the claimant's evaluation by Dr. Patrick Riggins. The defendants argue the claimant failed to prove the evaluation is necessary medical attention causally related to his compensable injury. We AFFIRM.          I. Material Proceedings          The claimant sustained an injury to his left shoulder while apprehending a suspected shoplifter on December 26, 2002. His claim seeking medical and indemnity benefits was resolved through stipulations set forth in a July 1, 2004 Opinion. The parties also agreed that the claimant's authorized treating physician was Dr. Patrick J. Riggins, orthopedic surgeon. The claimant was subsequently awarded permanent partial disability benefits for a 9% loss of use of his left upper extremity.          On November 6, 2020, the claimant filed an application seeking authorization for an evaluation by Dr. Riggins to determine if a recurrence of left shoulder pain was related to his December 26, 2002 work injury. The defendants argued there was no causal relationship between the requested medical treatment and the workplace accident.          The Deputy Commissioner found it was plausible that the claimant's current left shoulder pain could be related to his compensable injury and reasoned that the requested evaluation was equivalent to a diagnostic procedure used to establish causation. He ordered...

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