5th Circuit: okay to give treating doctor special weight (unpublished)

by Matthew H. Ammerman on September 14th, 2015

Those defending LHWCA claims in southwest Louisiana will recognize the doctors in this case where the 5th Circuit affirmed an award of spinal fusion surgery.

In February 2007, Ryan Courville hurt his back aboard an inland barge bound for a drilling rig.

On March 19, 2007, spinal surgeon Patrick Juneau, M.D., reviewed an MRI of Courville’s thoracic spine and recommended physical therapy but did not recommend surgery.

Now-deceased John Cobb, M.D., also reviewed the MRI and recommended physical therapy and pain management by Steven Staires, M.D. By January 2009, Dr. Cobb recommended a 3 or 4-level spinal fusion surgery.

Courville’s employer, Petron Industries, sought a second medical opinion from Wayne Lindemann, M.D., who saw Courville in February 2009. Dr. Lindemann concluded that conservative therapy proved unsuccessful and that it was "more likely than not" that surgery would be required. Petron then sought another medical opinion from Stanley Foster, M.D., who reviewed the same records approximately two months later and concluded that Courville did not need surgery and could to medium-duty work.

Due to conflicting opinions, the OWCP ordered a special medical examination of Courville with Paul Fenn, M.D., on February 24, 2010. Dr. Fenn, the “DOL-IME,” did not recommend surgery and concludes that Courville is MMI.

After Dr. Cobb died, Courville selected John Sledge, M.D., as his treating orthopedic surgeon. In April 2012, Dr. Sledge saw Courville and ordered a second MRI. Dr. Sledge ultimately concludes in February 2013 that fusion surgery was appropriate.

At a formal hearing in July 2013, the administrative law judge acknowledged the conflicting medical opinions but noted that the opinion of a treating physician – here Dr. Sledge -- may be entitled to greater weight than the opinion of a non-treating physician. The ALJ found the medical treatment recommended by his treating physician Dr. Sledge—including the surgery -- were reasonable and necessary.

The 5th Circuit affirmed the award of surgery citing the 7 years that had passed since his injury. In doing so, the appellate court states that “…the ALJ was within his discretion to lend greater weight to the opinions of Courville's treating physicians—who are familiar with his injuries, treatment, and responses—than the opinions of his non-treating physicians.” Petron Indus. v. Dir., OWCP, 2015 U.S. App. LEXIS 16230, *2-6 (5th Cir. Sept. 9, 2015).

That statement was probably unnecessary because both Courville’s treating surgeon, Dr. Sledge, and a doctor picked by Petron Industries, Dr. Lindemann, concluded that surgery was needed. Nevertheless, the 5th Circuit states affording special weight to treaters is not reversible error. Petron Indus. v. Dir., OWCP [Courville], 2015 U.S. App. LEXIS 16230, *10 (5th Cir. Sept. 9, 2015).

Posted in LHWCA: Section 7    Tagged with Section 7 Medical, Longshore, LHWCA, 5th Circuit, special weight



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