How Important is Provider Credibility?

Feb. 2020

Gordon v. Tradesmen Int’l, Inc., decided September 5, 2019.

Facts: Applicant had a prior slip and fall that resulted in a low back injury. He reached an end of healing. Four years later, he brought a permanent total disability claim citing the low back injury and a subsequent fusion surgery. His doctor completed a WKC-16-B and marked “yes” to all three causation boxes (traumatic injury, precipitation/aggravation/acceleration, and occupational exposure) and provided no explanation for his opinion nor the decision to move forward with surgery.

Decision: LIRC did not credit Applicant’s doctor for this reason and further stated his opinions did not explain how a work injury, that Applicant healed from, resulted in the need for a fusion. Instead, LIRC found Respondent’s IME credible because the surgery was directed at a preexisting condition; and therefore, not work-related. Applicant’s doctor’s failure to explain how a work injury that Applicant healed from resulted in a surgery four years later discredited his opinion. Additionally, checking all boxes on the WKC-16-B without explanation was also viewed negatively.