Philadelphia, PA (January 29, 2025) – Philadelphia partner Zachary Rubinich obtained a successful decision from a Pennsylvania Workers’ Compensation Judge (WCJ) terminating an employee’s workers’ compensation benefits based upon a determination that Mr. Rubinich’s expert was more credible than the claimant’s treating physician.

The employee sustained a shoulder injury in a work-related motor vehicle accident. The injury was accepted as compensable. The employee began treating with an orthopedic surgeon, a pain medicine physician and a chiropractor. Mr. Rubinich had the employee examined by a Board Certified orthopedic surgeon specializing in shoulder injuries. Mr. Rubinich provided this independent medical examination (IME) physician with complete medical records, shoulder MRI and shoulder arthrogram films for review.

Based upon review of the medical records, diagnostic studies and an objectively normal physical examination, the IME physician determined that the employee was fully recovered from the work injury, did not require any further treatment and was capable of returning to work without restrictions.

Mr. Rubinich filed a Petition to Terminate compensation benefits. Utilization Review Requests were filed to challenge the reasonableness and necessity of ongoing medical treatment. The employer also issued a job offer letter to the employee, requesting a return to work.

When the employee failed to respond or return to work as requested, Mr. Rubinich also filed a Petition to Suspend/Modify compensation benefits. The petitions were assigned to a WCJ, hearings were held and evidence was submitted by both parties.

The WCJ granted the Termination Petition, finding that the IME physician was more credible and more persuasive than the treating orthopedic physician. The Judge reasoned that the IME physician was Board Certified, while the treating physician was only Board Eligible. The Judge also relied upon the shoulder MRI and shoulder arthrogram which revealed degenerative changes and arthritis in the employee’s shoulder.

The Judge found no evidence of any aggravation, so the ongoing subjective complaints were inconsistent with the objectively normal physical exam. The Judge determined that the employee was fully recovered from the work injury and terminated the employee’s entitlement to both wage loss benefits and medical benefits, including treatment from the pain management physician and the chiropractor.

This favorable decision allows Mr. Rubinich to seek a reimbursement from the Supersedeas Fund in Pennsylvania for all overpayment of wage loss and medical benefits paid during the relevant time period, on behalf of his client. For more information about Zachary Rubinich, visit https://rawle.com/attorneys/zachary-m-rubinich/

About Rawle & Henderson LLP:  Founded in 1783, Rawle & Henderson has been recognized by the American Bar Association as the oldest law firm in continuous practice in the United States. With 10 offices in Delaware, New Jersey, New York, Pennsylvania and West Virginia, its lawyers represent the interests of corporations, businesses, individuals and their insurers.  For more information, visit http://www.rawle.com