Opinion ID: 1930702
Heading Depth: 2
Heading Rank: 2

Heading: The Jury Box Accident (January 17, 1992)

Text: Landesberg claims that she aggravated her prior lower back injury when she misstepped while alighting from a Superior Court jury box. As a result of the accident, Landesberg sought and received significant amounts of medical treatment from a variety of providers for injuries she sustained to her lower back. WMATA did not challenge whether the injury she suffered was work related; instead it argued before the hearing examiner that some of the treatment received by Landesberg was unnecessary and excessive. Although Landesberg introduced evidence in the form of medical opinion that she was still partially disabled as a result of the accident, the hearing examiner found that some of the treatment received by Landesberg for her injury was beyond excessive. After culling together all of Landesberg's treatment history for her aggravated lower back injury that resulted from her jury box misstep, the hearing examiner found that the injury sustained by Landesberg had been resolved as of April 29, 1992, and thus, any claims for disability benefits after that date were excessive. In making that finding, the hearing examiner was persuaded by the Utilization Review Report (URR) dated April 1, 1996 that was prepared by WMATA's doctors after examining Landesberg. The URR concluded that Landesberg's medical care was mismanaged and improperly supervised by Dr. Dennis. According to the hearing examiner, the URR also concluded that Landesberg's injury had been resolved as of April 29, 1992. Our review of the URR, however, does not reveal such a conclusion. In fact, we are unable to determine from a review of the URR the significance, if any, of the April 29, 1992 date. Because the URR does not contain a representation that the injury Landesberg sustained to her lower back on January 17, 1992 was resolved by April 29, 1992, the hearing examiner's decision that further treatment after that date was excessive, is not supported by substantial evidence in the record. Therefore, we find the Director's decision affirming the denial of medical benefits after April 29, 1992, to be in error. [5]