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Placido v. District of Columbia Department of Employment Services

Court of Appeals of Columbia District

June 5, 2014

MIRNA PLACIDO, PETITIONER,
v.
DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, RESPONDENT, and COMPASS GROUP USA, INC. and GALLAGHER BASSETT SERVICES, INTERVENORS

Submitted December 13, 2013.

Page 324

Petition for Review of an Order of the District of Columbia Department of Employment Services Compensation Review Board. (CRB-121-12).

David J. Kapson was on the brief for petitioner.

Irvin B. Nathan, Attorney General for the District of Columbia, Todd S. Kim, Solicitor General, and Donna M. Murasky, Deputy Solicitor General, filed a statement in lieu of brief.

Barry D. Bernstein was on the brief for intervenors.

Before BLACKBURNE-RIGSBY and McLEESE, Associate Judges, and NEBEKER, Senior Judge.

OPINION

Page 325

McLeese, Associate Judge :

Petitioner Mirna Placido challenges a decision of the Compensation Review Board (" CRB" ) denying her claim for workers' compensation benefits. We affirm.

I.

In August 2010, Ms. Placido injured her left shoulder and back while working as a food preparer for intervenor Compass Group USA, Inc. Dr. Joel D. Fechter, an orthopedic specialist, treated Ms. Placido's injuries. Dr. Fechter initially administered injections for the pain, restricted Ms. Placido to light duty, and recommended home exercise and physical therapy. Although her back pain improved, Ms. Placido continued to experience intermittent pain in her left shoulder. After an MRI scan, Dr. Fechter reported that Ms. Placido had two choices: She could " live with the symptoms, manage[] them symptomatically as best she can, or . . . undergo arthroscopic evaluation and treatment of the left shoulder."

Ms. Placido sought authorization for arthroscopic shoulder surgery, which Compass Group denied. In support of the denial, Compass Group relied on independent medical evaluations (" IMEs" ) conducted by Dr. Robert O. Gordon, an orthopedic specialist, and a utilization review (" UR" ) report prepared by Dr. Reese Polesky, an orthopedic surgeon. The parties then proceeded to an evidentiary hearing before an administrative law judge (" ALJ" ).

The ALJ denied Ms. Placido's claim for workers' compensation benefits, concluding that the surgery was not medically reasonable or necessary. First, the ALJ found that Dr. Fechter had " not strongly recommend[ed] the left shoulder surgery." The ALJ ...


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