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The Rogak Report: 24 Mar 2009 (Part 2) ** No Fault - Medical Necessity - MRIs **

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  • insurancelawyer
    MRIs ARE NOT NECESSARY FOR SPRAINS, COURT RULES Doshi Diagnostic Imaging Services a/a/o Rosie Angrand v. State Farm Ins. Co., (unreported) District Court,
    Message 1 of 1 , Mar 24 3:14 PM
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      MRIs ARE NOT NECESSARY FOR SPRAINS, COURT RULES

      Doshi Diagnostic Imaging Services a/a/o Rosie Angrand v. State Farm Ins. Co., (unreported) District Court, Nassau, First District, Index no. 29240/2006 (Hirsh, j.)

      This was a no-fault suit we took to trial on 10 January 2009.  At issue was an MRI of the shoulder.  After the prima facie case was stipped out, Dr. Harold Schecter testified for the defense as a "re-peer" in the place of Dr. John Ashfeld, who was not available for trial.

      After reviewing the original peer report and the medical records on which it was based, Dr. Schechter testified that he concurred with the original opinion that the MRI was not medically necessary.

      The Court held, "While the peer review report does not establish what is generally accepted medical practice for order[ing] an MRI, Dr. Schechter testifies that generally accepted practices indicate that an MRI not be ordered before the injured area is X-rayed.  Dr. Schechter also testified that an MRI is an advanced diagnostic test.  He testified that an MRI is not medically necessary where the diagnosis is a sprain.  Therefore, the court finds that the MRI of the upper extremity was not medically necessary.  The complaint is dismissed."

      Larry Rogak

       

       

       

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