Author Archives: Admin4

http://www.canlii.org/en/on/onhparb/doc/2013/2013canlii46994/2013canlii46994.html?searchUrlHash=AAAAAQAFSFBBUkIAAAAAAQ

11.              The Committee investigated the complaint.

12.              The Committee determined that, on a technical level, it was satisfied that the Applicant`s assessment of the Respondent, his clinical findings and opinion, and his ensuing report (which fully set out the information he based his opinion on) were reasonable and in keeping with the expectations set out in the College’s policy on Third Party Reports. The Committee accepted that the Applicant’s reference to the Respondent’s weight as 225 pounds was an inadvertent error, which he has acknowledged.

13.              The Committee noted, however, that it had previously received other complaints from patients regarding the Applicant’s unprofessional communication, many in the IME context. In addition, it noted two concurrent complaints about communications concerns before it at the same time as this complaint. It stated that this information had served to heighten the Committee’s concern in this case.

14.              It concluded that it was very troubled by the Applicant’s communication and what appeared to be a sustained pattern of issues related to unprofessional behaviour. Therefore, the Committee decided to caution the Applicant and to require the Applicant to complete a specified continuing education or remediation program, as set out in paragraph two above.

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The requirement to consider prior decisions is couched in mandatory terms under section 26(2) of the Code.

Prior decisions

 (2)   A panel of the Inquiries, Complaints and Reports Committee shall, when investigating a complaint or considering a report currently before it, consider all of its available prior decisions involving the member, including decisions made when that committee was known as the Complaints Committee, and all available prior decisions involving the member of the Discipline Committee, the Fitness to Practise Committee and the Executive Committee, unless the decision was to take no further action under subsection (5). [Emphasis added]

23.              The Committee has not complied with this legislative provision as it has considered only summaries of the matters detailed in the “CPSO Physician Profile” rather than the entire decisions.

24.              Further, the Committee has not complied with the section 25 (6) (c) which provides as follows:

 Notice to member

 (6)   The Registrar shall give the member, within 14 days of receipt of the complaint or the report,

(a)      notice of the complaint, together with a copy of the provisions of sections 28 to 29, or notice of the receipt of the report;

(b)     a copy of the provisions of section 25.2; and

(c)   a copy of all available prior decisions involving the member unless the decision was to take no further action under subsection 26 (5).

25.              The Committee did not comply with section 25 (6) (c) because it provided the Applicant with the summary of the matters contained in the “CPSO Physician Profile” but did not provide the Applicant with the actual available prior decisions.

26.              The Board finds the Committee’s investigation to be inadequate as a result of its failure to comply with section 25(6) (c) and 26(2) of the Code.

27.              The Board, therefore, returns this matter to the Committee and requires it comply with sections 25(6) (c) and 26 (2).

______________________________________________

http://canlii.ca/t/fzsxg

4.                  The Respondent, an orthopaedic surgeon, conducted an independent medical assessment (IME) of the Applicant on June 29, 2011 as part of a multi-disciplinary assessment.

……•        he did not recall telling the Applicant to “suck it up” or “toughen up” and noted that he does not use such language;

•        he may have said something about insurance companies being taken advantage of as part of a general discussion with the Applicant but he did not suggest that the Applicant was making a false claim as evidenced by his report which confirmed that the Applicant suffered serious and extensive injuries; and

•        he has given serious consideration to the Applicant’s complaint and acknowledged that he has had previous complaints about his demeanour and ability to communicate well with patients; he has taken a communications course with Dr. Dawn Martin.

14.              The Committee noted that there had been previous complaints about the Respondent’s communications. The Committee accepted that the Respondent’s contrition in this case was sincere and stated that it was pleased that he had entered into a communications course with Dr. Martin. Nevertheless, the Committee felt that the Respondent would benefit from reflection and education in the area of communications and decided to issue a written caution to the Respondent to be aware that patients with post-traumatic chronic pain and disability who attend for an IME may not appreciate the Respondent’s efforts at small talk and that the Respondent should refrain from discussing systemic issues or details of his personal life.

24.              The Applicant submitted that the Committee’s decision was unreasonable because the caution issued to the Respondent did not reflect the serious impact that the Respondent’s conduct during the IME had on the Applicant and would not ensure that other patients would not experience the same trauma. The Applicant submitted that the Committee should have imposed a requirement that the Respondent should not be permitted to conduct an IME without someone else being present.

VI.       DECISION

37.              Pursuant to section 35(1) of the Code, the Board confirms the Committee’s decision to caution the Respondent to be aware that patients with post-traumatic chronic pain and disability who attend for an IME, such as [the Applicant], may feel vulnerable, may not appreciate his efforts at “small talk,” and that he should refrain from discussing systemic issues or details of his personal life.

http://www.canlii.org/en/on/onscdc/doc/2013/2013onsc4261/2013onsc4261.html?searchUrlHash=AAAAAQAGSFBBUkIgAAAAAAE

[1]               This is an application for judicial review to quash the May 3, 2012 decision of the Health Professions Appeal and Review Board, which upheld the decision of the Inquiries Complaints and Reports Committee of the College of Physicians and Surgeons of Ontario to verbally caution the applicant.  The applicant was alleged to have acted unprofessionally and with bias in administering an independent medical examination to a patient.

[2]               The applicant seeks to have the decision set aside and to have the matter remitted to a differently reconstituted panel.

[3]               The applicant is an orthopaedic surgeon.  On December 20, 2006, Ms. Nancoo sustained several injuries when she was struck by a motor vehicle while crossing the road.  On May 4, 2010, Ms. Nancoo submitted an application to the insurer for catastrophic benefits in accordance with theInsurance Act.

[4]               The applicant was retained by the insurer to conduct an orthopaedic Independent Medical Examination (IME) of Ms. Nancoo.  The applicant met with Ms. Nancoo on August 11, 2010 and conducted the IME.  On August 24, 2010, the College received a complaint for Mr. Warren, Ms. Nancoo’s lawyer regarding Dr. Fielden’s behaviour during the course of the IME.

[5]               The Committee found that Dr. Fielden’s behaviour when conducting the IME was inconsiderate and inappropriate.  The Committee decided not to refer the matter to the Discipline Committee but rather to verbally caution Dr. Fielden in person regarding being professional, objective and courteous in performing IME’s.  HPARB dismissed Dr. Fielden’s appeal and determined that the Committee’s investigation was adequate and that its decision to caution Dr. Fielden was reasonable.

[6]               The applicant seeks judicial review.  Assuming that the decision is reviewable at all, it is accepted that the standard of review is reasonableness.[1]

[7]               We do not agree that the Board erred in not finding that the Committee’s Decision was unreasonable by failing to make a credibility finding in the circumstances of this case and particularly the applicant’s submission that these facts required the Committee, in effect, to make a determination with respect to Ms. Nancoo’s credibility.

[8]               First, it is clear that the Committee has no jurisdiction to make credibility findings per se. (See McKee v. Health Professions Appeal and Review Board, [2009] O.J. No. 4112).  The Committee exercises a screening function.  It conducts an investigation and renders a decision as to the existence of sufficient evidence to warrant referral to the Discipline Committee.  It does not hold any hearing to determine with finality what the facts were.  Here, the Committee decided not to refer the matter to the Discipline Committee.  This decision was amply justified on the record and particularly on the basis of the admissions and statements made by Dr. Fielden.

[9]               We also find no error of procedural fairness on the part of the Committee.  The Committee was entitled to take into account all of the information it obtained in its investigation in determining the appropriate course of action.  What the applicant refers to as “add on issues”, in fact came from Dr. Fielden’s responses to the complaint which raised additional concerns.  These did not give rise to any further notice entitlements.

[10]           The decision of the Committee to caution the applicant in person is not a “sanction”.  Cautions are entirely remedial in nature and intended to assist the applicant to improve his practice.  A caution administered by the Committee is not a penalty and must be contrasted with the range of penalties that can be imposed by the Discipline Committee of the College consequent to a finding of professional misconduct.  The Discipline Committee of a College can impose a variety of sanctions, which may be recorded on the permanent and public record of a member.  By contrast, a caution is remedial only, cannot involve any finding of professional misconduct (a finding which is outside the jurisdiction of the ICRC and the Board), and does not appear on the register or in any public document of the College.

[11]           The Committee required that Dr. Fielden be cautioned on being objective, professional and courteous in performing independent medical exams.  One of the basis upon which the Committee expressed concern was factual errors which it stated Dr. Fielden had made in his report.  For example, stating that he had incorrectly asserted that Ms. Nancoo had been treated in a private rehab facility when the record indicates that she had been.  Given the absence of support for the finding that Dr. Fielden made factual errors in this case, there is no reasonable basis for cautioning him on this point.  With this one exception, we find the Committee’s decision to caution Dr. Fielden was reasonable as was the HPARB decision.

[12]           The application is therefore dismissed.   The Board does not seek costs.

http://canlii.ca/t/flplv

HUMAN RIGHTS TRIBUNAL OF ONTARIO

[2]               The Application alleges discrimination in goods, services, and facilities because of disability, marital status and age regarding erroneous information the respondent relayed in the context of an independent medical evaluation for an insurance company. The applicant was involved in motor vehicle accident in December 2005 and his insurance company required him to undergo an independent medical evaluation, which was performed by the respondent. The respondent provided his initial evaluation on May 23, 2006. The insurance company provided further medical records for the respondent to review and he responded by letter to the insurance company on July 11, 2006. In this second letter, the respondent provided erroneous information regarding the applicant, based on a misreading of the notes provided by the applicant’s family physician. This erroneous information had negative consequences for the applicant regarding his insurance claim.

[8]…Neither the CPS or HPARB have expertise in the human rights law of Ontario; therefore, it was not reasonable for the applicant to rely on any advice he may have received from either body regarding his rights under the Code. As noted above, waiting for other legal proceedings to conclude before pursuing one’s rights under the Code will also generally not constitute a valid explanation for delay in filing an Application.

[9]               In the circumstances, I find that applicant has not provided a reasonable explanation for the delay and therefore has not established that the delay was incurred in good faith. Having found the delay was not incurred in good faith, I need not address the issue of prejudice.

[10]           The Application is dismissed.

https://www5.fsco.gov.on.ca/AD/3759

…Dr. R.H.N. Fielden, an orthopaedic surgeon and Dr. Douglas Saunders, a psychologist, conducted the first assessments for Old Republic on October 4, 2005. They authored reports dated October 11, 2005 [See note 31 below] and October 19, 2005. [See note 32 below] Dr. Fielden concluded that Mr. Xavier was suffering from no residual impairment as a result of the accident and could return to all pre-accident activities, including work.

Mr. Xavier told Dr. Fielden that he continued to experience shoulder and back pain. Dr. Fielden was aware of the treatment Mr. Xavier was receiving from Dr. Raghunan. Dr. Fielden’s observations on physical examination include restricted range of shoulder and lumbar motion. His report does not contain an explanation of how he arrived at his opinion.

…I do not accept Dr. Fielden’s conclusion in his report of October 11, 2005 [See note 50 below] that Mr. Xavier suffered no ongoing physical impairment. The report contains no explanation of how he arrived at this conclusion and his opinion is at odds with the findings of his own examination which included restricted range of shoulder and lumbar motion.

https://www5.fsco.gov.on.ca/AD/3534

…This examination was done by Dr. Robert Fielden, an orthopaedist…..State Farm knew of the diagnosis and of Mr. Turner’s history of treatment in this regard, when it chose to have Dr. Fielden examine him in 2002.

He concluded that Mr. Turner “does not suffer a complete inability to engage in any employment.” A Functional Abilities Evaluation done by Jodi Levstein on the same day resulted in the same conclusion. Based on the conclusions of Dr. Fielden and Jodi Levstein, State Farm terminated weekly income replacement benefits on July 9, 2002 .

…as far back as 1999, long before Mr. Turner was examined by Dr. Fielden in April 2002. It made its adjusting decision on the basis of the opinion it obtained from Dr. Fielden’s report. Nothing has changed. There is no ongoing adjusting of a changing or evolving claim. State Farm has maintained its position.

Indeed, when I asked counsel for State Farm how the requested examination would contribute to an adjusting decision, she could offer no insight at all in this regard. Her reply was that the decision was up to the adjuster. She submitted that the Insurer had stated the purpose of the examination in the notice sent to Mr. Turner, and it was not open to an arbitrator to “second- guess” ; that decision. As I pointed out above, the cases do not support this approach.

In the circumstances of this case, where some six months after mediation failed and four months after Mr. Turner applied for arbitration, the Insurer seeks to clarify information it has been aware of for years, the Insurer must provide a better explanation lest the inference be drawn that what the Insurer really seeks is ammunition for the arbitration proceeding. I conclude that this is the likely reason for the request.

http://canlii.ca/t/fvkrt

1.                  It is the decision of the Health Professions Appeal and Review Board to confirm the decision of the Inquiries, Complaints and Reports Committee of theCollege of Physicians and Surgeons of Ontario to issue a caution to Dr. K.I. regarding her inadequate and inaccurate report and to further recommend that the Applicant review the College policy, “Third Party Reports”.

5.                  The Respondent complained that the Applicant failed to provide an accurate opinion of her claim for psychological services to the Respondent’s insurer; for example, the Applicant provided an opinion that may be outside of her expertise, since she opined regarding psychological services but is an occupational medicine specialist.

8.                  The Committee, however, noted that the Applicant’s report contained inaccuracies with respect to the details of what happened at the time of the collision. The report indicates that the Respondent was backing out of her driveway and was hit by an oncoming car, while the information before the Committee indicated that the Respondent was hit by a car backing out of a driveway. The report omitted the fact that the police were called, the car was damaged to the extent that it had to be towed away and was written off, which the Committee wrote, “speaks to the extent of the motor vehicle accident”.

9.                  Further, the Committee found that the Applicant failed to address important information that supported a claim for psychological services. It wrote that the Applicant “commented that the physiotherapist did not mention psychological issues, but she failed to mention that [the Respondent’s] family physician felt that a referral for psychological services was indicated” and that it appeared she had “completely disregarded this referral from the family physician.” The Committee stated that the Applicant “completely disregarded the results of the Beck Depression Inventory and Beck Anxiety Inventory, which showed severe depression and anxiety, respectively. Without performing a psychological assessment of [the Respondent], it would be difficult to assess whether or not these conditions pre-existed the accident.”

10.              The Committee determined the appropriate disposition was to caution the Applicant regarding “her inadequate and inaccurate report” and to recommend that the Applicant review the College policy, Third Party Reports.

24.              Counsel submitted that the Respondent should have raised her concerns with the report under the mediation and arbitration processes provided under theInsurance Act and that the College is the wrong forum for the determination of her concerns. He submitted that having determined the Applicant was properly qualified, the Committee should defer to her expertise:  if the College engages in the review of third party assessment undertaken by qualified health professionals, it will deter physicians from conducting assessments.

34.              The Board has reviewed the Policy and finds the Committee’s assessment that the Applicant failed to comply with it is reasonable. The Committee concluded its analysis as follows:

Accordingly, it appears to the Committee that [the Respondent’s] report was both inaccurate and inadequate. It seems that she failed to comply with the College policy, “Third Party Reports,” which notes that when providing a third party report physicians must “take reasonable steps to ensure that they have obtained and reviewed all available clinical notes, records and opinions relating to the patient or examinee that could impact the findings of the report …” Moreover, the policy also states that physicians “should ensure to the best of their abilities that the information contained in the third party report is accurate.”

 35.              In her May 5, 2011 report, the Applicant referred only to a physiotherapy report written shortly after the accident and did not discuss any of the other 37 documents in the file, including the opinions of the Respondent’s physician and other health professionals that an assessment was required. She then wrote:  “based on the documentation available for review, there was no evidence that [the Respondent] requires a psychological assessment …” (Board’s emphasis). The Board concludes that in light of this, the Committee’s conclusion that the Applicant failed to comply with the obligation “to take reasonable steps to ensure that they have obtained and reviewed all available clinical notes records and opinions” was reasonable.

 36.              Likewise, the Board finds that the Committee’s view regarding accuracy is reasonable as the Applicant made no effort to clarify the inconsistency regarding how the accident occurred. The Board does not find that the Committee’s reference to missing details regarding the apparent severity of the accident is misplaced as it is indicative of the absence of almost any factual content in the report.

37.              The Board finds that that the Committee’s decision to issue a caution is reasonable. The Board notes that a caution is not a sanction. It is remedial in nature.

 VI.       DECISION

38.      Pursuant to section 35(1) of the Health Professions Procedural Code, Schedule 2 to the Regulated Health Professions Act, 1991, the Board confirms the Committee’s decision to issue a caution to the Applicant regarding her inadequate and inaccurate report and to further recommend that the Applicant review the College policy, Third Party Reports.

Read:

http://www.torontosun.com/2013/01/25/protecting-docs-reputations

http://www.canadianunderwriter.ca/news/ontario-appeal-board-upholds-caution-issued-to-ime-in-auto-claim/1001993394/

http://www.fairassociation.ca/wp-content/uploads/2013/02/Ms.-M.G.-and-Economical-+-Arbitration-2012-11-23-FSCO-A09-002443.pdf

I disagree with this assessment for a number of reasons. I find Dr. Gnam based his conclusion on limited and inaccurate information. Limited, because neither he nor Ms. Krushed interviewed any family members for insight into what she could, or would, actually do on her own on a daily basis, without cueing, unlike Dr. Levitt, who interviewed Ms. M.G.’s mother for collateral information. I also find it inaccurate because I find Ms. Krushed’s report failed to consider the effect of pain, diminished capacity and lack of motivation on the effectiveness and sustainability of Ms. M.G.’s ADLs.

In relying on Ms. Krushed’s inaccurate report, I find Dr. Gnam’s opinion was based on misleading information.

Secondly, Dr. Gnam failed to consider, compare and differentiate the criteria for moderate, marked and severe impairment before arriving at his conclusion. His statement, that mental impairment that appears to “preclude some but not all useful functioning” [emphasis added] is consistent with Moderate impairment, is not accurate.

I do not believe Dr. Gnam’s opinion to be either correct or reasonable for two reasons. The first is that Ms. M.G.  testified, and I find, that even simple volunteer efforts such as calling out bingo numbers or helping visiting family members at the hospital were overwhelming for her, and she quickly became fatigued, confused, irritable and unable to cope. I find the facts indicate Ms. M.G. has not been able to “maintain some restricted work-like stresses or activities” as Dr. Gnam claims.

The second reason I reject Dr. Gnam’s opinion is that, even if he were not wrong on the facts,  his application of the impairment rating system set out in theGuides is not correct in this case. His conclusion, that Ms. M.G.’s impairment is Moderate because she is “not completely unable to engage and maintain some restricted work-like stresses and activities,” applies the wrong test. The test for Moderate impairment, or even Marked impairment, is not, as he suggests, “complete inability.”

I find Dr. Gnam failed to consider and compare all of the relevant impairment levels and correctly apply them to the facts and his conclusion was flawed as a result.

As can be seen from the chart above, the only assessment of physical impairments that falls short in this case is that of the Custom Rehab team. I did not find their assessment and rating to be as reasonable or as persuasive as those of Dr. Garner or the Drs. Becker for a number of reasons. The first reason is that I do not find the Custom Rehab team had a realistic or accurate grasp of Ms. M.G.’s actual functional abilities for her activities of daily living. As discussed above, I did not find Ms. Krushed’s extrapolations from her observations of Ms. M.G.’s abilities to complete daily living tasks and engage in social activities to be realistic or reasonable.  Consequently, to the extent Dr. Mathoo and Dr. Dost relied on Ms. Krushed’s faulty statements and conclusions, their reports are similarly inadequate.

The second reason I prefer the evidence of Kaplan and Kaplan and Omega over that of Custom Rehab, is that I find the Custom Rehab team’s approach resulted in their under-rating of Ms. M.G.’s physical impairments.  There appear to be a number of reasons for this. One is that the team members did not consult with each other, or even exchange their reports; each simply conducted his or her own assessment and prepared a report, and the team leader, Dr. Mathoo, included their findings in his Executive Summary. I find this lack of communication impeded the exercise of clinical judgment or interpretive analysis by team members – essential components of assessing the impact of impairments on daily functioning.

The effect of this compartmentalized approach can be seen in how the Custom Rehab team members accounted, or rather, failed to account, for the effects of pain on daily functioning. …

Although Ms. M.G. complied with her obligations, and despite requests from her counsel, Economical did not reinstate Ms. M.G.’s IRBs until just before the start of this hearing, two and a half years after stopping them.  Economical did not provide any explanation for the delay. I find both the delay and the lack of any explanation to be completely unacceptable. As it is well-established that an insurer cannot avoid a special award simply by paying an overdue benefit just before the issue is to be adjudicated, I find Economical’s conduct merits a special award in this case.

Read: http://www.torontosun.com/2013/01/18/catastrophic-impairment-cases-continue-to-vex-insurers

http://www.fairassociation.ca/wp-content/uploads/2013/02/M.M.-and-Guarantee-+-Arbitration-2012-09-19-FSCO-A10-000338.pdf

http://www.fairassociation.ca/wp-content/uploads/2013/02/Mr.-C.-and-Coachman-2-+-Arbitration-2011-10-21-FSCO-A09-000167.pdf

Although she did not provide a diagnosis in her report, Dr. Wilkins testified that she based her conclusion that Mr. C. was not catastrophically impaired because in her view Mr. C. was a malingerer. Dr. Wilkins, however, did not provide any objective, credible evidence to support this conclusion. Her conclusion that Mr. C. is a malingerer stands alone in the face of an abundance of consistent and objective evidence that Mr. C.’s behaviour and complaints are credible. I, therefore, give very little weight to her opinion that Mr. C. is a malingerer.

Accordingly, for all these reasons I give little weight to Dr. Wilkins’ report and testimony that Mr. C. is not catastrophically impaired.

Dr. Lawson, a psychologist, conducted a catastrophic impairment assessment on behalf of Coachman on August 4, 2009.

Like Dr. Wilkins, I find that Dr. Lawson was a poor example of an expert witness. I agree with Mr. C.’s submissions where he states: Dr. Lawson’s demeanour when testifying, was argumentative, evasive, confusing and demonstrated a lack of understanding of his role as an expert to assist the Tribunal in reaching its decision on the complex issue of whether Mr. C. is catastrophically impaired.

In a short report, Dr. Lawson, without providing much information, rationale or analysis, concluded that Mr. C. was not catastrophically impaired. I give little weight to his conclusion.

I find that in failing to follow the Guides to observe and record a description of Mr. C.’s “concentration, persistence and pacing” during the testing, I cannot give much weight to Dr. Lawson’s conclusions regarding Mr. C.’s functionality when they are solely based on the test results.

Like Dr. Wilkins’ report, I find Dr. Lawson’s report to be superficial and biased in favour of Coachman. For example, in his report, Dr. Lawson notes: “Mr. C. stated he was hospitalized within the past two weeks as a result of depression and suicidal ideation.”… “He reiterated he has experienced suicidal ideation at times and has threatened to hurt himself and family members.” (It should be noted at the time of his assessment with Dr. Lawson, Mr. C. had not yet been hospitalized for overdosing on his medication.) [Emphasis added]

In light of this information, Dr. Lawson ignored the significance of Mr. C.’s very recent suicidal/homicidal mental state in relation to Mr. C.’s ability to function in any of the four domains noted in theGuides. I find this to be an important omission, especially since in his conclusion Dr. Lawson states that “Mr. C.’s accident occurred two years prior to his evaluation. As such, his psychological status is considered stable at this time.”

Another significant omission in Dr. Lawson’s report is his failure to comment on or consider the occupational assessment by Ms. Perreras. Dr. Lawson was on the same team as Ms. Perreras, who were carrying out a catastrophic impairment assessment on behalf of Coachman. Nevertheless, Dr. Lawson, without any explanation, ignored this very relevant assessment regarding Mr. C.’s capacity to function.

Although Dr. Lawson found that Mr. C. was not catastrophically impaired, he completely failed to substantiate his conclusions regarding the four areas of function pursuant to the Guides. He did not provide any supporting evidence or rationale for his conclusions. He merely stated that in his view Mr. C.’s impairment in the domains of concentration, persistence and pace and activities of daily living was “mild.” In the domains of social functioning and adaptation, hefound Mr. C. to be “moderately” impaired.

Like Dr. Wilkins, I find that Dr. Lawson ignored consistent, credible medical evidence, which could lead to a finding that Mr. C. suffered a “marked” impairment in one or more domains and accordingly was catastrophically impaired. Accordingly, I give very little weight to Dr. Lawson’s conclusion that Mr. C. is not catastrophically impaired.

I give little weight to Coachman’s submissions. In its written submissions, I find that Coachman engaged in a self-serving summary, “cherry-picking” its way through the evidence, in minute detail, to present a completely distorted, out of context picture of the reality of the objective evidence.

In reviewing the submissions, one easily sees that there are numerous significant distorted assertions of the evidence. [See note 6 below] In his reply submissions, Mr. C. submitted a number of examples which he characterized as “gross mischaracterization of the evidence by Coachman.” [See note 7 below] I note below several additional relevant examples.

Note 6: While parties presenting their submissions will try to put the best spin they can on the evidence, I find that Coachman went beyond what is considered reasonable advocacy and engaged in a pattern of distortions that did not reflect the evidence in a credible manner.

For the reasons stated above, I gave little or no weight to the catastrophic impairment assessments by Drs. Wilkins and Lawson. Both assessors ignored relevant, credible information when coming to their conclusions. Not only did Dr. Wilkins not assess Mr. C. for a catastrophic impairment, nor did she provide any diagnosis in her short three-page report, [See note 15 below] but she completely failed to comment on obvious, relevant and material information in Dr. Rosenblat’s catastrophic impairment assessment report, although she purported to have reviewed his report.

Note 15: At the hearing, Dr. Wilkins stated that her diagnosis of Mr. C. was that he was a malingerer. As noted above, I gave very little weight if any to this diagnosis.

In the case of Dr. Lawson, he not only narrowly relied on his test results in a manner that was contrary to the Guides, but provided no rationale, whatsoever, as to how he arrived at his ratings. His ratings were completely arbitrary and provided no foundation for his conclusions.