QMERejected · physical medicine and rehabilitation
The left shoulder injury from April 16, 2023 was non-industrial and not a compensable consequence of the June 11, 2017 injury.
The QME concluded the left shoulder condition was non-industrial as it resulted from the fall on April 16, 2023, but the opinion was found conclusory and lacking substantial medical evidence due to ignoring the applicant's continuous treatment history.
From the decision · page 2(Joint Exhibit A1; Exhibit 3; Joint Exhibit A3.)
In the May 23, 2024 supplemental report, the QME noted that "applicant sustained injuries
to the left shoulder, one on April 17, 2023, when he was riding a motorbike with his left hand on
the clutch, downshifting when the clutch froze up and the hand seized. He lost control of the bike
and fell, striking the handlebars with his left shoulder, rolling six to eight times with eight." (Joint
Exhibit A3, QME Report by Mark Bernhard, D.O., dated May 23, 2024, at p. 3.) Dr. Bernhard did
not find the left shoulder injury from April 16, 2023 to be industrial. (Id. at p. 19.)
PTPRelied upon
Applicant continued to have left wrist pain and numbness, with the wrist seizing up, prior to the April 16, 2023 injury.
The PTP's medical history contradicted the QME's opinion and supported further development of the record.
From the decision · page 619.) However, the QME appears to ignore the medical history and the records that show
applicant had been continuously obtaining treatment for his left wrist and left hand prior to the
injury in April 2023. Applicant saw his primary treating physician (PTP), Richard D. Scheinberg,
M.D., on February 27, 2023, which was less than two months before the April 16, 2023 injury. (Id.
at pp. 11-12.) In the progress report, the PTP notes that "[t]the patient continues to have primarily
radial sided left wrist pain. He is functioning adequately at work, but continues to have pain. He
indicates his left wrist seizes up on him. He also says he gets left hand severe numbness at night."
(Id. at pp. 11-12.) An examination demonstrated tenderness primarily over the first dorsal