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Workers Compensation claims
Workers Compensation Claims

The insurance companies are bringing up Dr. Scot Youngblood for “independent” medical evaluations again.

How “Independent” is Dr. Youngblood?

Dr. Scot Youngblood has become one of the new go-to doctors so called "independent" medical evaluations.  There is a reason for that. He can be relied upon to issue an opinion that there was no work injury, or work injury is not the cause of the ongoing need for treatment or disability, or that any problems are caused by “age and genetics.” As of 2017, Also, Dr. Youngblood was performing 15 to 20 "independent" medical evaluations per month which would earn him approximately $85,000 per month. Because of his incentive to curry his opinion to please his insurance employers, his opinion was given less weight. Piasini-Branchflower v Anchorage School District, AWCB Dec. No. 17-0041 (April 11, 2017)

Dr. Youngblood: Pain behavior and symptom magnification

Tobar v Liberty Insurance Co, 447 P 3rd 747 (Alaska 2019). In July 2013, a hotel housekeeper injured her back while lifting a pile of linens. She was taken by ambulance from her workplace to the hospital because she had difficulty walking. An MRI showed a bulging disc in her lumbar spine. She was given an epidural and prescribed physical therapy. In March of 2014, the insurer sent her to see Dr. Scot Youngblood for an "independent" medical evaluation who opined  that she had a low back strain in July 2013, had “pain behavior and symptom magnification” and that the work injury was not the substantial cause of her degenerative disc disease. The case went to hearing before the Board in June 2017 where the claimant was not represented by counsel. She lost. She lost again in front of the Commission. The Employee Won.

Dr. Youngblood: Pre-existing degenerative disc disease

Reuer v New Hampshire Ins Co., AWCB Dec. 16-0033 (April 22, 2016). On October 26, 2010, the Employee was injured in a motor vehicle accident as a school bus driver. He reported injury to the neck, back, shoulders, and arms. On July 1, 2015, the Employer sent him to Dr. Scot Youngblood for an an "independent" medical evaluation who opined that he had suffered cervical sprain/strain in the work injury, now resolved and medically stable, and that he had “multilevel degenerative disc disease, pre-existing, age and genetics related” and not caused by the industrial injury. The Board ordered a Second Independent Medical Evaluation (SIME). 

For more information on SIME procedure: https://www.keenanpowell.com/blog/2017/08/28/negotiating-the-maze-iii-second-independent-medical-evaluations-sime/

The Board's website is a good resource: https://labor.alaska.gov/wc/wc-and-you.htm

Dr. Youngblood: Age, genetics, gender, and obesity

Corona v State of Alaska, AWCB Dec. 20-0032 (May 21, 2020). On June 30, 2017, the Employee reported carpal tunnel syndrome symptoms in both wrists. She was seen by a number of doctors who were uncertain about the diagnosis and treatment. On September 15, 2017, the State sent her to Dr. Scot Youngblood for an an "independent" medical evaluation who opined that her carpal tunnel syndrome symptoms were related to her “age, genetics, gender, and obesity” and not substantially caused by industrial activities on June 3, 2017. In its decision, the Board pointed out that there was no family history of carpal tunnel syndrome and that Dr. Youngblood’s risk-factors did not conform to the statute and case law. The Employee won.

Dr. Youngblood: Age and genetics

Campoamor v Berkshire Hathaway, AWCB Dec. 19-0014 (November 8, 2019). The Employee slipped on melted ice on stairs at work and stopped his fall by grabbing a handrail. He ended up having five shoulder surgeries. His treating physicians also believed that he had injured his neck. The insurer sent him to Dr. Youngblood for an "independent" medical evaluation who opined that “age and genetics” were the cause of cervical disc disease and that there was no further need for shoulder treatment. He also opined that there was no explanation for the continued pain symptoms. The SIME doctor diagnoses a brachial plexus injury. Th Board found that Dr. Youngblood’s opinions were not supported by the evidence and that it did not conform to legal requirements. The Employee won.

Dr. Youngblood: Cannot explain her pain

Longway-Marotta v Liberty Insurance Co., AWCB Dec. No. 17-0137 (December 8, 2017). On August 18, 2016, the Employee was working as a flagger when a bus drove through a construction zone striking her sign paddle, causing right arm and shoulder to hyperextend. She was diagnosed with shoulder impingement and rotator cuff tendinopathy. On November 16, 2016, she was sent to Dr. Youngblood for an an "independent" medical evaluation who opined that she had suffered a sprain which was resolved and required no further treatment. At his deposition, he testified that her subjective complaints of pain were in excess of objective findings (i.e. she is lying) and that her shoulder was not injured at all. He also testified that she had age-related arthritis in her neck and mild rotator cuff tendinopathy “which just means that, you know, like the rest of us, she’s getting older.” He could not explain her pain so the Board gave his opinion less weight and was against the weight of the evidence. The Employee won.

Dr. Youngblood: Age and genetics, psychological issues

Piasini-Branchflower v Anchorage School District, AWCB Dec. No. 17-0041 (April 11, 2017). The Employee, a teacher, slipped on the ice and fell twisting her back neck to hips, also injuring her right knee and right hand on January 2, 2009. The Employer sent her to Dr. Scot Youngblood for an an "independent" medical evaluation who opined that her right knee meniscus tear was preexisting, related to age and genetics, and not related to the fall. He stated that she had multilevel degenerative disc disease, not caused or aggravated by work, and that her ankle sprain and thumb injury were not related. He also found significant psychological issues and there were no objective findings to support her ongoing pain complaints. The Board found that her hand injury and right knee injuries were work-related and specifically discounted Dr. Youngblood’s “age and genetics” causation opinion because it was conclusory, he didn’t understand the mechanics of the fall, and he behaved more like an advocate for the Employer than as an objective medical evaluator. The Employee won.

Dr. Youngblood: Strain resolved, no need for further medical treatment

Contreras-Mendoza v Alaska National Insurance Co, AWCB Dec. No. 18-0023 (March 6, 2018). On January 21, 2016, the Employee twisted her left ankle during a work basketball game. She was diagnosed with a peroneus brevis tear and surgery was recommended. On October 21, 2016, the Employee sent her to see Dr. Scot Youngblood for an an "independent" medical evaluation who opined that her ankle strain was resolved and medically stable, that her subjective complaints were in excess of objective findings, and she did not need treatment. The Board ordered a Second Independent Medical Evaluation (SIME).

Dr. Youngblood: Pre-existing knee problems

Blakeslee-Edwards v State of Alaska, AWCB Dec. No 16-0097 (October 27, 2016). The Employee, who suffered from cerebral palsy, tripped at work on April 28, 2008, December 14, 2011, and February 10, 2012. On March 20, 2014, her Employer sent her to see Dr. Eugene Wong and Dr. Scot Youngblood for an an "independent" medical evaluation. They concluded her knee problems were pre-existing. The Board ordered a Second Independent Medical Evaluation (SIME).

Dr. Youngblood: Age, genetics, and inherent foot anatomy

In Lena v Fred Meyer Stores, AWCB Dec. No 16-0135 (December 30, 2016), Dr. Younblood's an "independent" medical evaluation report stated that the Employee’s shoes could not have caused her condition (without examining the shoes) and the potential causes were “age, genetics, and inherent foot anatomy”. He opined she was medically stable, and needed no further treatment. His opinion was given less weight because of the inadequate basis.

Moral of the Story

There are two morals of this story:

  1. Dr. Youngblood’s opinion will be used against Employees,
  2. The Alaska Workers Compensation Board, more often than not, does not agree with his opinions.

If the insurance company in your case is sending you to see Dr. Youngblood for an an "independent" medical evaluation, it is because it plans to controvert your benefits. You should collect all your medical records and find an attorney now.

Keenan Powell has practiced Workers Compensation law in the State of Alaska for nearly 40 years and has dedicated her practice to Workers Compensation representing injured Alaskans handling hundreds of cases. http://www.keenanpowell.com/past-verdicts-settlements

All consultations are free. 

To make an appointment, email keenan@keenanpowell.com or call:  907 258 7663.

"Independent" Medical Evaluations: The Boys Are Back in Town!
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independent medical examination
Insurance Doctor

Word has it that so called "independent medical evaluations" are taking place again in Alaska. One of the doctors being flown up to evaluate injured workers is Dr. David Bauer. Odds are if the insurance company has scheduled an appointment for you to see Dr. Bauer, he is going to deny your claim.

Dr. Bauer's History of "Independent Medical Evaluations"

Doctor Bauer has been evaluating injured Alaskans for several years and a number of cases involving him have gone to hearing before the Workers Compensation Board. Take a look and see if any of these cases sound like yours. In each case, Dr. Bauer denied the employee was entitled to benefits. And in each of these cases, the Employee won.

Lifting injury, herniated disc.

In Serafin v Denali AK Fed Credit Union and Liberty Mutual AWCB 17-0032 (3/21/17), the Employee injured her back lifting and moving a small refrigerator at work. She was diagnosed with a herniated disc and annular tear. Dr. Flanum performed a microdisctomy.

The Second Independent Medical Evaluator (SIME), Dr. Coulter, found the injury was work-related and treatment reasonable and necessary.

She continued to have pain and had a second surgery.

The insurance company sent her to see Dr. Bauer who concluded the February 24, 2010 work injury was not the substantial cause of any then-current disability or need for medical treatment, including surgery. Dr. Flanum disagreed with Bauer’s opinion. The SIME doctor, too, disagreed with Dr. Bauer. After the SIME doctor’s deposition, Bauer wrote a rebuttal letter stating: I do not believe the work injury from February 24, 2010, is the substantial cause of the need for medical treatment from January 19, 2012, through January 31, 2014. In my medical opinion, Ms. Serafin's occasional back symptoms between 2012 and 2013 were due to the progression of degenerative disease consistent with age. The symptoms from mid-2013, when she had the disk herniation, through 2014 are due to a sudden and unrelated event. Therefore, the 2010 work injury is not the substantial cause of her disability or need for medical treatment.

At his deposition, Dr. Bauer testified the 2010 MRI study as revealing a disc “bulge” rather than herniation. He believed the February 24, 2010 work injury was not the substantial cause of Employee's need for treatment, but only an aggravation of a pre-existing degenerative condition which resolved. Because disk bulges can be caused by aging, Dr. Bauer believes the disc bulge was present prior to and not caused by the 2010 work injury.  Employee had an “age appropriate” spine on the imaging ….Referencing academic literature, 70-80 percent of studied individuals with one-level disc herniation had no identifiable, known cause. The majority of these injuries are caused by a “wrong move” or even turning over in bed.

The case went to hearing. The Board found Employee credible and her physicians credible. Further, it found that the lack of treatment prior to injury, employee’s credible testimony, the medical records, her doctors’ credible testimony outweighed Holly and Bauer. It held that the disability and need for treatment was work-related. Ordered Liberty Mutual to reimburse for past medicals.

The Employee won!

Dr. Bauer had "no explanation"

In Henson v Apicda Joint Ventures, Liberty Mutual AWCB 18-0044 (5/11/18), the Employee tripped in a freezer container in the course of his employment and injured his leg and back.

The Employee was examined by Dr. Kirkham, who recommended Employee find sedentary work, based on the April 20, 2016 FCE. Dr. Kirkham states “... chef is a light duty position and not a sedentary duty position, so he would not be able to return to work as a chef.” 

The Employee attended an EME with R. David Bauer, M.D. Dr. Bauer found no objective or physiological basis for Employee's pain complaints, no objective or physiological reason Employee could not return to his job at the time of the injury, or other heavy-duty work.

The Employee won a remand to the RBA for modification of her previous denial. While the Board did not address the credibility of Dr. Bauer’s report specifically, it found instead that the Employee and her treating physician were credible.

The Employee won!

Dr. Bauer a "no show" at the hearing!

In Cavitt v D&D Services and Ohio Casualty Company AWCB 18-0060 (6/25/18), the employee fell from scaffolding at work and fractured his elbow.  He had partial elbow replacement surgery. He had a second surgery because hardware came loose due to osteomyletis (infection.) His treating physician recommended continuing follow-ups every year or two because of infection and stated that in future there would be additional surgeries and that he could not go back to the job he was doing at time of injury or subsequently.

On January 25, 2018, Employee was seen by Dr. Bauer for a second EME. In addition to examining Employee, Dr. Bauer reviewed medical records dated after his April 26, 2017 EME. Dr. Bauer's diagnosis was unchanged since his April 2017 EME report, and he continued to find the work injury was the substantial cause of Employee's disability and need for medical treatment, and treatment to date had been reasonable and necessary. However, Dr. Bauer found Employee had reached medical stability as of the date of his examination and the only further treatment needed was a home exercise program and continued use of his elbow brace, although a functional capacity evaluation would aid in determining appropriate restrictions for future employment. Dr. Bauer rated Employee with an eight percent permanent partial impairment. 

When the Employee filed a claim and took the case to hearing, the insurance company, Ohio Casualty (a Liberty Mutual company) withdrew its controverson and refused to produce Dr. Bauer for testimony.

The Employee won!

Dr. Bauer said back injury was not work-related, only degeneration.

In LaBlanc v Alaska Inga’s Gallery Dec. No 20-0098 (10/23/20), Dr. Bauer opined that the back injury was not work-related and instead the result of degeneration. The Board found Dr. Bauer’s testimony deserved less weight in this analysis:   

Dr. Bauer opined Employee's pain complaints were not consistent with the L3-4 herniation because it required pain radiating into her thigh and she did not report it to him during his examination. His opinion is given less weight than Drs. Bursell's and Pohlman's because the medical record is clear that Employee has experienced anterior thigh pain. AS 23.30.122; Smith; Moore. The preponderance of the lay and medical evidence is the work injury was the substantial cause of Employee's past and current need for low back medical treatment. Saxton.

And again, in regards to his opinion on acupuncture:

Dr. Bauer's opinion is given less weight than Dr. Hess's because he testified he did not discuss the effect of acupuncture with Employee. AS 23.30.122; Smith; Moore.

The Employee won!

Dr. Bauer diagnosed a pre-existing condition.

In Wise v Wolverine Dec. 20-0095 (10/13/20), Dr. Bauer opined the cervical condition was pre-existing. As in Cavitt, the Employer failed to produce him for testimony. His opinion was excluded. The Employee won!

Dr. Bauer said there was no need for treatment.

In Elardo v Walmart Dec. 19-0057 (5/8/19), Dr. Bauer opined the condition was not-worked related degeneration, there was no need for medical treatment and the Employee was medically stable. The Board held his opinion would be given less weight:

Dr. Bauer testified “all the findings on this MRI were due to aging”; they were related to the progression of the degenerative condition that would have occurred regardless of the work injury. He explained that a person constantly degenerates so his steady state is not a straight line across the bottom, but rather, a line of steadily increasing impairments and disabilities as he gets older. A 2015 study showed someone in his fourth decade of life would be 40 to 50 percent likely, even if asymptomatic, to have all the findings of Employee's MRI. Thus, just because Employee had an injury, it does not mean that everything that followed was caused by that injury. However, Dr. Bauer's opinions are given little weight and credibility as he neither addressed why degeneration would only show at one disc, and not in others, nor provided the basis for his conclusion degeneration pre-existed the work injury. AS 23.30.122; Smith. He did not consider other potential causes of degeneration; he did not explain why Employee would belong to the 40 to 50 percent group, rather than the 50 to 60 percent group, absent the work injury. Id. Emphasis added.

The Employee won!

For More Information on Dr. Bauer

A more detailed list of cases in which Dr. Bauer has issued reports can be found here: Gang of Seven: Insurance “Independent” Experts

Call an Experience Workers Compensation Attorney!

If the insurance company set up an appointment for you to see Dr. Bauer or someone like him, chances are they are preparing to cut off your benefits. Call an experienced Workers Compensation attorney.

Check out my past verdicts & settlements page here: http://www.keenanpowell.com/past-verdicts-settlements

And for updated verdicts and settlements, check out these posts: Never Give Up, Never Surrender – 2019 Victories, Never Give Up, Never Surrender 2020!

Keenan Powell has practiced Workers Compensation law in the State of Alaska for over 35 years and has dedicated her practice to Workers Compensation representing injured Alaskans handling hundreds of cases. www.keenanpowell.com.

All consultations are free.  To make an appointment, email: keenan@keenanpowell.com or call:  907 258 7663.

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“Preexisting conditions” is an excuse that the insurance companies like to use to deny benefits. Frequently they will hire their own doctor ("IME") to say that an Employee’s need for medical treatment or his disability is not because the Employee was injured at work, but instead due to preexisting conditions, usually degenerative disc disease.

The law is clear: work-related injuries which aggravate, accelerate or combine with pre-existing conditions to cause a disability or need for medical treatment is still a Workers Compensation injury.

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In 2011, 3,550 employee injuries were controverted but only one-third of those, 1,224, filed claims with the Alaska Workers Compensation Board and employers paid their attorneys $9.4 million in 2011 to defeat employee's claims.   Source: Alaska Workers Compensation 2011 Annual Report.

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All Employers are required by law to carry Workers Compensation insurance, yet many do not.  When that happens, the Employees think they have no right to benefits but that is not true.

All Alaska employees are insured in case they are injured at work.  The State of Alaska has a Guarantee Fund which pays the same benefits to injured workers which they would get if their Employer carried insurance.  In order to collect these benefits, the Employee must file a Claim with the Alaska Workers Compensation Board.