{"id":980,"date":"2019-04-29T17:07:27","date_gmt":"2019-04-29T17:07:27","guid":{"rendered":"http:\/\/www.keenanpowell.com\/blog\/?p=980"},"modified":"2019-04-29T17:07:38","modified_gmt":"2019-04-29T17:07:38","slug":"gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor","status":"publish","type":"post","link":"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/","title":{"rendered":"Gang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor"},"content":{"rendered":"\n
\"\"<\/figure>\n\n\n\n

<\/p>\n\n\n\n

Last week, I featured Dr.\nLynne Bell in \u201cThe Gang of Seven\u201d, a blog series devoted to identifying some of\nthe insurance industry\u2019s most frequently-used \u201cindependent\u201d medical examiners.\n\u201cThe Gang of Seven\u201d include: Dr. David Bauer, Dr. Lynne Bell, Dr. Dennis Chong,\nDr. Keith Holley, Dr. Stephen Marble, Dr. Patrick Radecki, and Dr. Marilyn\nYodlowski. <\/p>\n\n\n\n

If your insurance\ncompany sends you to any of these doctors, beware!<\/strong><\/p>\n\n\n\n

Today\u2019s installment\nfeatures Dr. Dennis Chong, a physiatrist (physical medicine and rehabilitation)\nwho has been practicing for 26 years. He currently has no disciplinary actions\nnor reported medical malpractice cases. https:\/\/fortress.wa.gov\/doh\/providercredentialsearch\/<\/a><\/p>\n\n\n\n

His\nHealthgrades review is 3 stars. One of the comments was: \u201cIf you have an IME scheduled with this\nguy watch out.\u201d<\/p>\n\n\n\n

Interestingly, the Alaska Workers Compensation\nBoard as stated that Dr. Chong is less credible due to his extensive contact\nwith the insurance industry. His first job was a ten-year stint as a medical\ndirector of a Cigna. His second job was as a medical director for Blue Cross. It\nwas his job to tell the doctors what they could and could not do in treatment\nof patients. He has only been in private practice since 2009. <\/p>\n\n\n\n

Alaska Cases<\/strong><\/p>\n\n\n\n

<\/p>\n\n\n\n

The following are a selection of cases in which he testified in Alaska. The overall trend of these decisions is that the Board rejected Dr. Chong\u2019s opinions because he didn\u2019t rely on the legal standard for causation in his opinions. <\/p>\n\n\n\n

Umiker v Bristol Bay Area, Seabright Insurance\nCompany. <\/em> AWCB Decision No.\n15-0006 January 21, 2015<\/em><\/p>\n\n\n\n

The Employee was injured on the job while\nworking for Employer as a registered nurse on November 15, 2011. Employee\ncontends the work injury caused significant time loss from work, medical\nexpenses, and required considerable treatment, including surgery, to address\npain in her back, legs, buttocks, and foot. <\/p>\n\n\n\n

On August 8, 2012, Employee was examined by Dennis Chong, MD, for\nan Employer's Medical Evaluation (EME). Dr. Chong's EME report states, in\nrelevant part: Diagnosis: By historical record in proximate physician and\nchiropractic examination, bilateral knee contusion<\/a>,\nrelated to the industrial event on November 15,2011. Neck strain and thoracic\narea back strain, related to the industrial event of November 15, 2011. Development\nof right buttock pain at the end of January 2012 as reported to her\nchiropractor after chiropractic adjustments at greater than two months\nsubsequent to the industrial event of November 15, 2011. This is most likely\nnot related to the industrial event of November 15, 2011.Pre-existing severe\ndegenerative disk disease, L5-S1, with grade 2 spondylolisthesis<\/a>\nof L5 on S1. This is not related to the industrial event of November 15, 2011\n....<\/p>\n\n\n\n

Regarding causation, Dr. Chong opined: The work injury of\nNovember 15, 2011 is the substantial cause of bilateral knee contusion<\/a> and\nneck strain and thoracic back strain.<\/p>\n\n\n\n

Regarding further medical treatment, he stated: With regard to\nMs. Umiker's spondylolisthesis<\/a>,\nI would recommend that further diagnostic imaging of the lumbar spine ... be\nobtained to assess for stability. .... However, this would not be related to\nthe claim under study. There is no further medical treatment recommended for\nconditions related to the November 15, 2011 injury. Ms. Umiker's work related\nconditions are medically stable at this time. She is currently not stable with\nregard to her pre-existing condition. There is no impairment to rate with\nrespect to her work-related condition<\/p>\n\n\n\n

The Board held that in context of a back injury,\na common industrial injury often difficult to objectively diagnose or describe,\nthe Employee's credible testimony concerning her suddenly deteriorating\nphysical abilities after November 15, 2011, was given significant weight. Her\ntestimony is strongly corroborated by changes in her life following the work\ninjury. Further, Dr. Chong's report opined the medical condition, spondylolisthesis<\/a> combined with pre-existing degenerative disc disease<\/a>, is not related to the work injury.\nHowever, that is not the legal issue. The question is whether the work injury is the\nsubstantial cause for the need for medical treatment or disability. Therefore,\nthe EME and SIME reports of Drs. Chong and Pitzer are given less weight. <\/p>\n\n\n\n

Employee won medical benefits, TTD, PPI and\nreemployment benefits.<\/p>\n\n\n\n

Nielson v Alaska Teamster Local 955, AWCB Decision No. 19-0019, February 15, 2019<\/em><\/p>\n\n\n\n

On April 21, 2008, Employee rammed his head\nonto a truck differential housing while working as a mechanic for Employer.<\/p>\n\n\n\n

On June 25, 2011, Scott Fechtel, D.C., M.D.,\nsaw Employee for an EME. There was no evidence of preexisting neck or head\npain. Dr. Fechtel found \u201crigid paraspinal muscles\u201d and diagnosed among other\nthings severe neck pain with severe guarding, muscle spasm and limited motion,\nwhich appeared to be neurogenic, and a possible posttraumatic cervical dystonia<\/a>. He offered the posttraumatic dystonia<\/a> as why Employee's magnetic resonance imaging<\/a> (MRI) findings were not sufficient to\nexplain all his symptoms, particularly the muscle rigidity. Dr. Fechtel found\nposttraumatic cervical dystonia<\/a> present in the medical literature and associated with past, violent\nneck movements, which could suggest an alternative therapeutic approach to\nEmployee's symptoms. He recommended electromyography<\/a> (EMG) with an evaluator \u201ccomfortable with cervical dystonia<\/a> evaluation.\u201d Dr. Fechtel endorsed recommendations from Thomas Grissom,\nM.D., and added Botox<\/a> injections as an added treatment.<\/p>\n\n\n\n

On January 7, 2013, Dr. Kralick performed an\nanterior discectomy<\/a>, spinal canal nerve root decompression and total disc arthroplasty<\/a> at C6-7.<\/p>\n\n\n\n

On August 18, 2014, Matthew Peterson, M.D., diagnosed Employee\nwith chronic cervical spine pain, cervical spondylosis<\/a>\nand postsurgical pain syndrome with previous disc replacement at C6-7.\n(Operative Report, August 18, 2014). On September 17, 2014, Dr. Peterson opined\nEmployee had exhausted all medical treatment options and was at \u201cmaximum\nmedical improvement.\u201d His ongoing care was for \u201cpalliative pain management.\u201d<\/p>\n\n\n\n

On March 22, 2018, Dennis Chong M.D., examined\nEmployee for an EME. He interviewed Employee and reviewed his medical records,\nincluding those recording his consistent complaints of neck and head pain\nthrough 2017\u2026Based on his \u201cReview of Symptoms,\u201d itself\nbased on the medical documentation and \u201can interview with the examinee,\u201d Dr.\nChong knew Employee had nausea, sleep problems and neck pain. He diagnosed a\ncervical and left shoulder \u201c\u201csprain<\/a>\/strain\u201d\nsubstantially caused by Employee's work injury \u201cand long since resolved\u201d;\nbilateral, curative shoulder surgeries; preexisting cervical spine multilevel\ndegenerative disease and spondylosis<\/a>,\nunrelated to, not caused by and not aggravated by the work injury; and a C6-7\ndisc arthroplasty<\/a>, with\na \u201cpostoperative explosion of subjective pain complaints\u201d including headache,\nworsened left upper extremity symptoms, circumferential neck pain, upper torso\npain and dysequilibrium. Dr. Chong opined Employee's symptoms \u201ccannot be\nexplained by an uncomplicated, technically successful C6-7 disc arthroplasty<\/a>.\u201d\n(Chong report, March 22, 2018).<\/p>\n\n\n\n

The adjuster asked Dr. Chong to \u201cidentify all causes\u201d of Employee's disability or need\nfor medical treatment following his work injury (emphasis in original). He\nlisted no causes and said no \u201canatomical or physiological cause\u201d explained\nEmployee's \u201ccurrent constellation of disparate symptoms to result in\ndisability.\u201d In response to this question, again\nidentifying no \u201ccauses,\u201d Dr. Chong stated the work injury has not been the\nsubstantial cause for any medical treatment since 2013, when Employee underwent\ncervical surgery assuming the disc arthroplasty<\/a> was administratively accepted. He recommended no further\ncare or prescription medication because, in his view, chronic opiate therapy\n\u201chas not resulted in any functional improvement\u201d and there was no evidence of\nsigns or symptoms to support other medications. <\/p>\n\n\n\n

The Board held: Dr. Chong's report and deposition testimony do nothing to\nclarify causation for Employee's continuing\ndisequilibrium, head, left arm and neck symptoms post-surgery. He says there\nis no cause for Employee's pain but he never opines Employee has no pain. His\nopinion makes it impossible to evaluate the relative contribution of different\ncauses of the need for medical treatment, since according to Dr. Chong, there\nis no cause. AS 23.30.010(a)<\/a>.\nSince there is no cause for the symptoms, he offers no cause with which to compare\nthe work injury. Huit<\/em>.<\/p>\n\n\n\n

Dr. Chong admits he is not a surgeon and is unfamiliar with arthroplasty<\/a>\nsurgical techniques and expressly said he has no opinion on whether a cervical arthroplasty<\/a> could\ncause post-surgical pain. Nevertheless, Dr. Chong concludes the work injury has\nnot been the substantial cause of Employee's need for medical treatment since\n2013. He could find no objective explanation for Employee's continued\ndisequilibrium, cervical, left arm and head symptoms, because the arthroplasty<\/a>\nwas \u201ctechnically successful.\u201d But the Alaska\nSupreme Court has held the lack of objective signs of an injury does not\npreclude its existence because there are many injuries which are not readily\ndisclosed by objective tests. Kessick<\/em>. As Dr. Chong conceded, \u201cany surgery ... can possibly\nresult in any complications.\u201d But he opines this surgery did not cause pain or\nother symptoms as a post-surgery complication apparently only because he cannot\npinpoint the cause. Dr. Chong admitted there \u201cis no machine that tells the\ntruth about pain\u201d and no way to objectively measure Employee's subjective pain.\n\u201cSo pain cannot be seen or shown.\u201d Given this testimony, it is difficult to\naccept Dr. Chong's causation opinions as credible because they are simply\nconclusory and he offers no alternative explanation for Employee's undisputed\nsymptoms. Further, though Dr. Chong applied, albeit incorrectly, CDC\n\u201cdomains\u201d to derive his continued medical treatment opinion, his report never\nmentions activities of daily living upon which the CDC domains are reportedly\nbased and cannot recall discussing them with Employee. Given this analysis, Dr.\nChong's opinion is not credible and is given no weight. AS 23.30.122<\/a>.\nEmployee prevails on the entire presumption analysis as well.<\/p>\n\n\n\n

The Board that Dr. Chong\u2019s report did not rebut the raised\npresumption of compensability, that the Employee was entitled to palliative\nmedical care, and that the Employer frivolously controverted Employee's right\nto benefits and his claims.<\/p>\n\n\n\n

Hays v Arctec Alaska, \n<\/em>AWCB Decision No. 18-0068 July\n11, 2018<\/em><\/p>\n\n\n\n

The Employee injured his right shoulder and\nneck while lifting a heavy bucket at work, and these injuries necessitated his\nparticipation in a work hardening<\/a> program and physical therapy, which resulted in further\ninjuries to his lumbar spine and left shoulder.<\/p>\n\n\n\n

On March 13, 2013, Dennis Chong M.D., performed an employer's\nmedical evaluation (EME). He diagnosed: 1) right shoulder labral tear with\nchronic impingement, status post historical previous rotator cuff repair<\/a>,\nrelated to the March 8, 2012 injury; 2) status post right shoulder\nreconstructive surgery, related to the March 8, 2012 injury; 3) learned\nvoluntary chronic contraction of right shoulder girdle musculature; and 4)\nchronic preexisting multilevel cervical spine degenerative disease with presumptive\ndiagnosis of spinal stenosis<\/a>,\nunrelated to the March 8, 2012 work injury. Dr. Chong did not think Employee's\nright shoulder was medically stable and cautioned against a third arthroscopic shoulder procedure<\/a> since Employee's recovery from his March 22, 2012\nsurgery was unsuccessful. He also opined Employee's work injury aggravated a\npreexisting right shoulder rotator cuff condition and produced a permanent\nchange, which necessitated Employee's need for treatment. The work injury was\nthe substantial cause of Employee's right shoulder \u201ccondition,\u201d according to\nDr. Chong. (Chong report, March 13, 2013).<\/p>\n\n\n\n

The Board held that weightiest causation opinions in the record\ncome from Employer's medical evaluator, Dr. Chong, and the SIME physician, Dr.\nScarpino. In contrast to Drs. Manion and Eule, Dr. Chong's opinions remained\nfairly consistent throughout this case's long pendency, at least with respect\nto right shoulder causation. He thought the March 8, 2012 work injury did\naggravate a preexisting right shoulder rotator cuff tear<\/a>,\nwhich he likened to frayed stitches on an old shirtsleeve, to produce the\n\u201cfinal tear\u201d requiring treatment. However, there is some vacillation in Dr.\nChong's right shoulder medical stability opinion. In his January 22, 2015\nreport, Dr. Chong initially found Employee's right shoulder to have been\nmedically stable by September 2012, but he later revised this date to April\n2013.<\/p>\n\n\n\n

Meanwhile, Dr. Chong did not find work to be the substantial\ncause of Employee's cervical spine, lumbar spine and left shoulder treatment.\nInstead, Dr. Chong thought the Employee required cervical fusion surgery\nbecause of \u201cmany life factors,\u201d such as work activity, leisure activity,\nsmoking, genetic predisposition and congenital factors. Similarly, Dr. Chong\nopines \u201c[a]ll of life's activities,\u201d including work, caused Employee's need for\nleft shoulder medical treatment, and Employee's need for low back surgery was caused\nby decades of work activity, smoking and Employee's other back injuries. It\nis interesting to note, though Dr. Chong provides alternative explanations for\nEmployee's need for treatment, each includes work as a partial, causative\nfactor even though, in his opinion, it alone does not rise to being \u201cthe\nsubstantial factor.\u201d<\/p>\n\n\n\n

Between Dr. Chong and Dr. Scarpino, the Board\nheld that Dr. Scarpino's opinions was afforded the most weight. Dr. Chong's\ncredibility suffers a bit from his unusually close relationships with the\ninsurance industry. Id.<\/em> Even though it is not unusual for independent\nmedical evaluators to perform a majority of their evaluations for the defense, Dr.\nChong's background includes quite a bit more than merely performing these\nevaluations. Dr. Chong underwent training provided by CIGNA insurance company\nand worked as an Insurance Medical Director. He also participated in leadership\ntraining provided by a health insurance company and served as a reviewer for\nthe publication Workplace Disability Guidelines<\/em>, which was written as a guide for workers'\ncompensation case managers to instruct them on the ordinary types and lengths\nof treatment. Therefore, while Dr. Chong is generally credible, his opinions\nare viewed with some skepticism since an inordinate amount of the achievements\non his curriculum vitae have been provided by the insurance industry. Id.<\/em><\/em><\/p>\n\n\n\n

The Employee won his claim for medical benefits, TTD, PTD, and PPI.<\/p>\n\n\n\n

Drago v Scan Home, Liberty Northwest, AWCB Decision No. 12-0083 May 7, 2012<\/em><\/p>\n\n\n\n

On November 6, 2009, Mr. Drago injured his\nlower back picking up a heavy box while working for Scan Home. (Report of\nOccupational Injury or Illness, November 11, 2009).<\/p>\n\n\n\n

Mr. Drago returned to Dr. Kropp on July 20,\n2011. Dr. Kropp noted that \u201c[t]oday we met with the equipment representative\nand discussed a stimulator trial.\u201d<\/p>\n\n\n\n

Dr. Dennis Chong, a specialist in physical\nmedicine and rehabilitation, also examined Mr. Drago at Scan Home's request.\nDr. Chong also concluded that the November 6, 2009,work incident was the substantial\ncause of Mr. Drago's condition and his need for medical treatment. Dr. Chong\nstated, \u201cMr. Drago's current condition does not meet the most common\nindications for spinal cord stimulator<\/a> placement,\u201d and a \u201cspinal cord stimulator<\/a> trial is not recommended.\u201d<\/p>\n\n\n\n

The Employee was granted a second independent\nmedical evaluation.<\/p>\n\n\n\n

Keenan Powell has practiced Workers Compensation law in the State of Alaska for over 35 years and has dedicated her practice to Workers Compensation representing injured Alaskans. <\/strong>www.keenanpowell.com<\/strong><\/a>.<\/strong><\/em><\/p>\n\n\n\n

All consultations are free.<\/em><\/strong>\u00a0 To make an appointment, email: <\/strong>keenan@keenanpowell.com<\/strong><\/a> or call:\u00a0 907 258 7663.<\/strong><\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Last week, I featured Dr. Lynne Bell in \u201cThe Gang of Seven\u201d, a blog series devoted to identifying some of the insurance industry\u2019s most frequently-used \u201cindependent\u201d medical examiners. \u201cThe Gang of Seven\u201d include: Dr. David Bauer, Dr. Lynne Bell, Dr. Dennis Chong, Dr. Keith Holley, Dr. Stephen Marble, Dr. Patrick Radecki, and Dr. Marilyn Yodlowski. ...continue reading \"Gang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor\"<\/span><\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"nf_dc_page":"","jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false},"version":2}},"categories":[1],"tags":[],"class_list":{"0":"post-980","1":"post","2":"type-post","3":"status-publish","4":"format-standard","6":"category-uncategorized","7":"h-entry","8":"hentry","9":"h-as-article"},"jetpack_publicize_connections":[],"yoast_head":"\nGang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor - Keenan Powell, Attorney at Law<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Gang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor - Keenan Powell, Attorney at Law\" \/>\n<meta property=\"og:description\" content=\"Last week, I featured Dr. Lynne Bell in \u201cThe Gang of Seven\u201d, a blog series devoted to identifying some of the insurance industry\u2019s most frequently-used \u201cindependent\u201d medical examiners. \u201cThe Gang of Seven\u201d include: Dr. David Bauer, Dr. Lynne Bell, Dr. Dennis Chong, Dr. Keith Holley, Dr. Stephen Marble, Dr. Patrick Radecki, and Dr. Marilyn Yodlowski. ...continue reading "Gang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor"\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/\" \/>\n<meta property=\"og:site_name\" content=\"Keenan Powell, Attorney at Law\" \/>\n<meta property=\"article:published_time\" content=\"2019-04-29T17:07:27+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2019-04-29T17:07:38+00:00\" \/>\n<meta property=\"og:image\" content=\"http:\/\/www.keenanpowell.com\/blog\/wp-content\/uploads\/2016\/01\/medical-stuff.jpg\" \/>\n<meta name=\"author\" content=\"Keenan Powell\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Keenan Powell\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"12 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/#article\",\"isPartOf\":{\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/\"},\"author\":{\"name\":\"Keenan Powell\",\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/#\/schema\/person\/fef8eaac5ea95f5b7ff4074311b55eda\"},\"headline\":\"Gang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor\",\"datePublished\":\"2019-04-29T17:07:27+00:00\",\"dateModified\":\"2019-04-29T17:07:38+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/\"},\"wordCount\":2422,\"commentCount\":0,\"publisher\":{\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/#organization\"},\"image\":{\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/#primaryimage\"},\"thumbnailUrl\":\"http:\/\/www.keenanpowell.com\/blog\/wp-content\/uploads\/2016\/01\/medical-stuff.jpg\",\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"CommentAction\",\"name\":\"Comment\",\"target\":[\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/#respond\"]}]},{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/\",\"url\":\"https:\/\/www.keenanpowell.com\/blog\/2019\/04\/29\/gang-of-seven-episode-iii-dennis-chong-md-career-insurance-doctor\/\",\"name\":\"Gang of Seven Episode III: Dennis Chong MD, Career Insurance Doctor - 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