{"id":984,"date":"2019-05-22T18:06:03","date_gmt":"2019-05-22T18:06:03","guid":{"rendered":"http:\/\/www.keenanpowell.com\/blog\/?p=984"},"modified":"2019-05-22T18:06:16","modified_gmt":"2019-05-22T18:06:16","slug":"gang-of-seven-episode-iv-keith-holley-md","status":"publish","type":"post","link":"https:\/\/www.keenanpowell.com\/blog\/2019\/05\/22\/gang-of-seven-episode-iv-keith-holley-md\/","title":{"rendered":"Gang of Seven Episode IV: Keith Holley MD"},"content":{"rendered":"\n
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In The Gang of Seven Episode III, I featured Dr. Dennis Chong. The Gang is a blog series devoted to identifying some of the insurance industry\u2019s most frequently-used \u201cindependent\u201d medical examiners. The Gang of Seven include: Dr. David Bauer, Dr. Lynne Bell, Dr. Dennis Chong, Dr. Keith Holley, Dr. Stephen Marble, Dr. Patrick Radecki, and Dr. Marilyn Yodlowski. This episode is devoted to Dr. Keith Holley.<\/p>\n\n\n\n

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

Keith Holley MD is an orthopedic surgeon practicing in Idaho. He was previously\nlicensed to practice in Alaska\nhowever his license is now inactive. Under Alaska Workers Compensation law, he\nmust be licensed in the state in which he performs an Employer Medical\nEvaluation or the so-called \u201cindependent medical evaluation\u201d so at this time he\nshouldn\u2019t be performing EMEs in Alaska.\nBut it is still possible that an insurance company will send an injured worker\nto see him in Idaho\nor some other state where he might be licensed.<\/p>\n\n\n\n

His evaluations have shown up quite a bit in Alaska workers\ncompensation cases but interesting, not many of them go to hearing. The logical\nconclusion is that despite the insurance company going to the expense of\nobtaining Holley\u2019s opinion, if the employee fights the case, the insurance\ncompany is likely to settle.<\/p>\n\n\n\n

The trend of Dr. Holley\u2019s reports is to opine that the employee\u2019s need for treatment and disability are related to a pre-existing condition or some other non-work related event. Despite this opinion, employees have fought their cases and won despite the insurance company\u2019s reliance upon Dr. Holley. Following are a sample of such cases which can be accessed on the Alaska Workers Compensation Board website at: http:\/\/appeals.dol.alaska.gov\/SearchRoot\/workerscomp\/<\/a> <\/p>\n\n\n\n

Innes v Vend and Commerce and Industry Ins Co<\/strong><\/em>., AWCB Decision No. 10-0005 (1\/24\/10)<\/strong><\/p>\n\n\n\n

The employee injured her lower\nback when she fell from the back of a truck, landing on a concrete floor on May\n24, 2005, while working as a driver for the employer.<\/p>\n\n\n\n

Lawrence Stinson, M.D., of the\nAdvanced Medical Centers of Alaska, saw the employee on May 22, 2008, noted the\npersistence of the employee's symptoms from her 2005 work injury and diagnosed\nmultilevel lumbar\nspondylosis<\/a> and degenerative changes\nwith positive slump testing indicative of epidural inflammation, primarily\nright-sided and L5\/S1 disc protrusion. Dr. Stinson referred her to\nphysical therapy for spinal stabilization and prescribed a lumbar\nbrace. Dr. Stinson recommended an epidural steroid injection to palliate\nher symptoms to permit her to pursue physical therapy rehabilitation. Dr.\nStinson administered a caudal epidural steroid injection on May 23, 2008<\/p>\n\n\n\n

At the employer's request,\u00a0Keith<\/strong>\u00a0Holley<\/strong>, M.D., of the Objective Medical Assessments Corporation, Seattle, Washington, performed an EME examination of the employee on August 1, 2008, and opined the employee suffered a work related injury in 2005, but her current condition was degenerative in nature.\u00a0Dr. Holley opined the work injury was not the substantial cause of her symptoms.<\/span><\/p>\n\n\n\n

 At the Board's direction,\nthe employee underwent a second independent medical evaluation\n(\u201cSIME\u201d) with physiatrist Larry Levine, M.D., on August 20, 2009. In his\nAugust 20, 2009, report Dr. Levine stated the employee's 2005 work injury is a\nsubstantial cause of her continuing low back symptoms, her medical care has\nbeen reasonable, and there is no evidence of back problems pre-existing the\nemployee's work injury. Dr. Levine opined the degenerative changes in her\noriginal X-ray were asymptomatic.<\/sup> Dr.\nLevine indicated the facet blocks and rhizotomy<\/a> treatments received by the employee provided good\nrelief to permit her to get good exercise for core stabilization. He\nrecommended she continue to be trained in proper lifting and posture and\ndynamic stabilization, and should be involved in a core exercise program.34<\/a><\/sup> He\nrecommended she stop smoking and control her weight.<\/sup> Dr.\nLevine indicated he \u201c\u2026 would not have ongoing recommendation for interventions\nsuch as injections, rhizotomies<\/a>, etc., for a long period of time. This would be\nrecommended for the pain issues, but not solely for the work injury from\n2005.\u201d Dr. Levine rated the employee with a one percent whole person\npartial impairment (\u201cPPI\u201d), under the American Medical Association Guides\nto the Evaluation of Permanent Impairment<\/em>, 6th<\/sup> Ed.,<\/p>\n\n\n\n

At the beginning of the hearing\non December 17, 2009, the employer accepted liability for the claimed TTD\nbenefits from April 28, 2008 through October 13, 2008, accepted liability for\none percent PPI benefits based on Dr. Levine's rating, and accepted liability\nto hold the employee harmless for all medical benefits through the date of the\nhearing. <\/p>\n\n\n\n

Employee won.<\/p>\n\n\n\n

Serafin v Denali Alaska Federal Credit Union and Liberty Northwest Insurance Co, <\/strong><\/em>AWCB Decision No 17-0332 (3\/21\/17)<\/strong><\/p>\n\n\n\n

On February 24, 2010, Employee\nwas working as a receptionist for Employer when she reported experiencing pain in\nher back, right leg, and foot while she and a co-worker were moving a small\nrefrigerator in the office<\/p>\n\n\n\n

On April 22, 2010, Employee had\nan MRI of her\nlumbar spine<\/a>. The impressions were:<\/p>\n\n\n\n

1. Mild degenerative\ndisc disease<\/a> lower lumbar spine L4-L5 and L5-S1 including 3-4\nmm central disc protrusion L5-S1. Central canal and foramen are adequate.<\/p>\n\n\n\n

2. Dissection-degenerative\nchanges L4-L5 and L5-S1 discs. There may be local internal derangement of the\nsuperior aspect of the L4-L5 disc at the interface with the endplate resulting\nin small fluid collections. (Diagnostic Health Chart Note, April 29, 2010).<\/p>\n\n\n\n

 On May 5, 2012, Employee\nwas seen by orthopedic surgeon Keith<\/strong> Holley<\/strong>,\nM.D., for an employer's medical examination (EME). Dr. Holley diagnosed:<\/p>\n\n\n\n

1. Lumbar strain<\/a> with right lower extremity\nradicular component, related to occupational Injury of February 24, 2010.<\/p>\n\n\n\n

2. Mild lumbar spondylosis<\/a> with degenerative disk\nchanges by MRI. These are age-related degenerative changes, pre-existing, and\nnot occupationally related.<\/p>\n\n\n\n

3. Current symptoms of low back pain and right lower extremity\u00a0<\/span>radiculopathy<\/span><\/a>\u00a0in January 2012 after prolonged computer gaming at home, now improved after epidural steroid injection and physical therapy. This is not occupationally related to the injury of February 24, 2010.<\/span><\/p>\n\n\n\n

Dr. Holley opined the February\n24, 2010 work injury is the substantial cause of the first diagnosis but not\nthe substantial cause of diagnoses 2 and 3. Dr. Holley opined the work\ninjury is not the substantial cause of Employee's then-current need for medical\ntreatment and that all treatment from January 2012 onward is substantially\ncaused by the computer gaming incident at home in combination with the\npre-existing degenerative changes in Employee's lumbar spine. Dr. Holley\ndid not believe did not believe the February 24, 2010 incident permanently\naggravated or accelerated the pre-existing condition. No further treatment was\nrecommended. Dr. Holley opined Employee was medically stable as of July 6,\n2010. <\/p>\n\n\n\n

On September 20, 2013,\northopedic surgeon Mark Flanum, M.D., performed a right side microdiscectomy<\/a> with no complications<\/p>\n\n\n\n

On May 16, 2014, neurosurgeon\nJames Coulter, M.D., performed a second independent medical examination (SIME).\nDr. Coulter concluded the February 24, 2010 work injury aggravated and combined\nwith pre-existing lumbar\nspondylosis<\/a> to cause a permanent change of the right L5-S1\nnerve root radiculopathy<\/a>.\nIn answer to the question concerning the need for the September 20, 2013 microdiscectomy<\/a>,\nDr. Coulter concluded the 2010 MRI showed a disc herniation rather than a\nprotrusion. Dr. Coulter stated:Yes, the work injury of 02\/24\/2010 was the\nsubstantial cause of the need for L5-S1 microdiscectomy<\/a>.\nMs. Serafin's escalation of symptoms, in my opinion, was related to the\nenlarging L5-S1 disc herniation which reached 9 mm in size, occupying about\nthree quarters of AP diameter of the spinal canal on the right side at that\ntime. At surgery the extruded disc fragment was found lying beneath the\ntraversing right S1 nerve root, and there was subtle indications that disc\nextrusion was present at the time of the first MRI in April 2010, compressing\nand minimally dorsally displacing the right S1 nerve root.<\/p>\n\n\n\n

On November 4, 2015, an MRI was\ntaken of Employee's lumbar spine. On reviewing the study, Dr. Flanum\nopined:This shows interval resection of the large disc herniation that was not\npresent previously. Now there is some facet arthropathy<\/a> and\nthickening of the ligamentum flavum, along with recurrent disc extrusion that\nlooks a little more far lateral. This is consistent with a compression of\nthe S1 nerve root.Dr. Flanum's report indicates Employee reported her pain is\n\u201cintermittent at best.\u201d Dr. Flanum recommended revision L5-S1\nmicrodecompression and microdiscectomy<\/a>.<\/p>\n\n\n\n

On January 14, 2016, orthopedist\nDavid Bauer, M.D., preformed an EME and opined the degenerative\ndisc disease<\/a> at L4-S5 and L5-S1\npre-existed the February 24, 2010 work injury. Dr. Bauer recommended Employee\nproceed with a nerve root injection. If the injection was successful, Employee\nmight then be a candidate for surgery. Dr. Bauer concluded the February 24,\n2010 work injury was not the substantial cause of any then-current disability\nor need for medical treatment, including surgery. <\/p>\n\n\n\n

On July 24, 2016, Dr. Coulter\nperformed an addendum SIME on the issue of the need for the revision surgery.\nDr. Coulter performed a physical examination of Employee, as well as a records\nreview, and opined: It remains my neurosurgical SIME opinion, counter to the\nhistorical inconsistencies pointed out supra, that there exists substantial\nfactual support for the claimant's assertion that she did not have S1 radiculitis<\/a> and radiculopathy<\/a> prior\nto the February 2010 lifting injuries in the course and scope of her employment\n...I consider the patient's presentation to be credible in view of the general\nfindings including definite radicular S1 nerve root motor and sensory\nimpairment, limited lumbar ranges of motion and limited right straight leg\nraising ...Dr. Flanum has continued to recommend a second disc excision in this\ncase at the L5-S1 level. He continues to opine that the second operation is\ndirectly related to the 2010 work injury, and as the neurosurgical SIME, I\nwould agree with Dr. Flanum concerning causation and need for surgical\ntreatment ...The objective MRI and physical examination evidence supports the\nprevious SIME opinion that the February 24, 2010 work injury did aggravate and\ncombine with the pre-existing lumbar\nspondylosis<\/a> at the L5-S1 level, and accelerated L4-L5 disc\ndegeneration to cause increasing impairment, and need for treatment, including\nthe L5-S1 lumbar\ndiscectomy<\/a>surgery performed 09\/20\/2013.<\/p>\n\n\n\n

In response to the question of\nwhether he agreed with Dr. Bauer's opinion that Employee should pursue only\nconservative care in the form of transforaminal nerve root injection prior to surgery,\nDr. Coulter opined:No, I do not agree with Dr. Bauer that Ms. Serafin should\npursue any further care of epidural\ninjection<\/a> prior to reasonable and necessary surgical treatment\n... She had lumbar epidural\nsteroid injection<\/a> in the past, which was of only brief\ntransient benefit of a few weeks pain modification. <\/p>\n\n\n\n

The Alaska Workers Compensation Board held that \u201cthe lack of significant prior back pain or radicular\nsymptoms in Employee's medical history, combined with her credible testimony\nand the credible testimony and opinions of Drs. Johnston and Flanum receive\nmore weight than the EME opinions of Drs. Bauer and Holley.\u201d<\/p>\n\n\n\n

Employee won.<\/p>\n\n\n\n

Johnston v Chez Lmtd and Commerce and Industry Insurance Co., <\/strong><\/em>AWCB Decision No 17-0004 (1\/11\/17)<\/strong><\/p>\n\n\n\n

On March 11, 2008, Employee was\nworking for Employer on a frame machine in an auto body shop. A clamp and chain\nslipped off a vehicle and Employee fell about three feet trying to avoid\ninjury. Employee landed hard on his right foot on a concrete floor and\nimmediately noticed sharp stabbing pain, like he had been electrocuted,\nradiating from his knee up and down his right leg into his groin and lower\nback. He also injured his right shoulder<\/p>\n\n\n\n

On July 24, 2008, on referral\nfrom Dr. Valentz, Employee had his first lumbar spine\nmagnetic resonance imaging<\/a> (MRI).\nHis symptoms included low back and right posterior thigh pain. Radiologist\nRonald Lewis, M.D., read decreased signal intensity at L1, L3 and L4\ninterspaces with a moderate posterior protrusion at L3-4. Dr. Lewis noted no\nother abnormalities at the L1-2 or L2-3 levels. There was a circumferential\ndisc protrusion at L3-4 with severe facet joint disease much greater on the\nleft than right, and a protruding disc into the left neural foramen but without\ncompressing the nerve root. At L4-5, Dr. Lewis saw a circumferential disc\nprotrusion with mild impingement on the lateral recess with facet joint hypertrophy<\/a>, which caused \u201csome definite encroachment on the exiting\nL4 root.\u201d The \u201cmajor abnormality is at L4-5, where a combination of facet\njoint disease and disc protrusion intrude into the right neural foramen with\nsome compression of the right L4 root as it exits through this foramen.\u201d Dr.\nLewis stated, \u201cPotentially, this may correlate with the patient's current\nsymptoms.\u201d<\/p>\n\n\n\n

On July 24, 2008, after reviewing\nthe MRI results, Dr. Valentz noted Employee's leg numbness and tingling was on\nthe anterior right thigh and said, \u201cIt looks like he has disc protrusion at\nL4-L5 involving the right lateral recess. His pain is mainly at right L4 nerve\nroot. I recommend an epidural steroid injection.<\/p>\n\n\n\n

On July 25, 2008, Dr. Valentz\nperformed a right L4 epidural steroid injection for right leg pain<\/p>\n\n\n\n

On August 21, 2008, Dr. Valentz\nperformed another right L4 epidural steroid injection. Employee reported good\nrelief for one week. Dr. Valentz referred Employee to Dr. Wright for surgical\nconsultation<\/p>\n\n\n\n

On September 19, 2008, Employee\nhad a lumbar spine CT without contrast. Radiologist Christopher Kottra, M.D.,\nfound moderate L4-5 degenerative\ndisc disease<\/a> with mild degenerative\ndisc disease<\/a> present throughout the\nremaining lumbar levels. At L4-5, there was a small, broad, posterior disc\nprotrusion resulting in at least mild canal stenosis and some degree of right\nforaminal stenosis, and moderate bilateral facet degenerative\njoint disease<\/a>. At L3-4 there was a\nsmall, mild, broad, posterior disc protrusion accompanied by degenerative\nhypertrophic ligamentum flavum on both sides and pronounced left-sided\nfacet degenerative\njoint disease<\/a> resulting in mild\ncanal stenosis. At L2-3 there was \u201cvery slight disc bulging as well as\nbilateral facet ligamentous flavum hypertrophy<\/a> resulting in canal stenosis.\u201d Dr. Kottra did not\nmention any soft tissue mass at or near L2-3.<\/p>\n\n\n\n

Dr. Wright opined Employee's\nsciatica symptoms, precipitated \u201cby his on-the-job injury,\u201d arose from the\nforaminal stenosis at L4-5 associated with marked facet disease. Dr. Wright\nsurmised Employee probably \u201cjammed\u201d the joint when he fell, narrowing the\nneural foraminal and precipitating sciatica. He recommended a contrast-enhanced\nMRI<\/a> scan to verify the suspected\nsoft tissue mass<\/p>\n\n\n\n

On October 4, 2008, Keith<\/strong> Holley<\/strong>,\nM.D. performed an employer's medical evaluation (EME) on Employee. Employee's\nchief complaints were low back and right leg pain. Dr. Holley reviewed\nEmployee's medical records, including two MRIs and noted nothing from those\nreports referencing L2-3, except Dr. Wright's reference. He also reviewed both\nlumbar MRIs and the lumbar CT digitally. (Deposition of Keith<\/strong> Holley<\/strong>,\nM.D., August 2, 2016, at 5-6). Dr. Holley said the CT \u201cmore clearly shows what\nappears to be a broad-based disc osteophyte<\/a> complex\nfar lateral to the right at L2-3.\u201d When asked about Employee's July 2008 MRI\nscan, Dr. Holley said the MRI showed facet joint arthritis<\/a>. He\nstated, \u201cThe arthritic changes in the facet joints are certainly traumatic in\nnature.\u201d On examination, Employee demonstrated weakness on the right side on heel\nwalking. Dr. Holley saw no leg atrophy but found decreased sensation on the\nright, anterior, medial thigh consistent with an L2 dermatome. Dr. Holley\ndiagnosed right lower extremity radiculopathy<\/a> with\nexamination findings suggesting sensory loss in the L2 dermatome, and\ncorresponding imaging suggesting a far right lateral disc osteophyte<\/a> complex\nat L2-3, both related to the work injury. He also diagnosed multilevel lumbar spondylosis<\/a>,\ndegenerative disc and facet joint changes, preexisting and not caused by the\nwork injury, but temporarily aggravated. Dr. Holley concurred with Dr. Wright's\nrecommendation for surgery at L2-3.<\/p>\n\n\n\n

On October 20, 2008, Dr. Wright performed surgery on Employee at L2-3. Employee had brief relief he attributed to surgical medications, but his symptoms returned.<\/p>\n\n\n\n

On February 3, 2010, Dr. Wang\nreviewed the July 24, 2008 MRI and noted a broad-based disc protrusion at L4-5 causing\nbilateral, lateral recess stenosis and severe facet joint hypertrophy<\/a> at this level. Relevant findings included right L3\nand L4 radiculopathy<\/a>. Dr. Wang recommended another MRI with and without\ncontrast, and a possible lumbar epidural\nsteroid injection<\/a> followed by PT\nand pain medication<\/p>\n\n\n\n

On June 17, 2010, Employee's\nprimary complaint was right-sided spasm in his low back. Dr. Wang diagnosed\nright L3 and L4 radiculopathy<\/a>, with right-sided muscle spasms possibly secondary to\nlumbar facet arthropathy<\/a>.<\/p>\n\n\n\n

On May 13, 2011, Employee\nreceived a right L3 and L4 medial branch and L5 dorsal rami block. The May 9,\n2011 reference to a \u201cleft\u201d injection was a dictation or typographical error. On\nJune 2, 2011, Employee received right L3 and L4 medial branch blocks and an L5\ninjection. On June 27, 2011, Employee received a right L3 and L4 medial branch\nblock and an L5 dorsal rami radiofrequency neurotomy<\/a>.\nThe prior two medial branch and dorsal rami injections resulted in greater than\n80 percent pain reduction. The radiofrequency neurotomy<\/a> was\ndone for therapeutic purposes. On June 30, 2011, Employee said the recent\nmedial branch and L5 dorsal rami radiofrequency neurotomy<\/a> provided\n90 to 95 percent lumbar pain relief and he had significantly reduced his pain\npill use as a result. On August 24, 2011, Employee reported doing better since\nhis radiofrequency neurotomy<\/a> and\nwas able to sit in a car for a longer period. He continued to have right-sided\nradicular symptoms, which were unresponsive to epidurals. Dr. Wang again\ndiagnosed right L3 and L4 radiculopathy<\/a>,\n\u201c\u201cunchanged.\u201d On November 23, 2011, Employee had restarted his pain medication.\nDr. Wang continued to diagnose right L3 and L4 radiculopathy<\/a>,\n\u201cunchanged\u201d and lumbar\nspondylosis<\/a>well-controlled following radiofrequency neurotomy<\/a>.<\/p>\n\n\n\n

On April 16, 2012, Employee\nreceived another right L3 and L4 medial branch and L5 dorsal rami\nradiofrequency neurotomy<\/a>.\nOn May 29, 2012, Employee told Dr. Wang the recent injections and\nradiofrequency neurotomy<\/a> provided\n90 to 100 percent pain relief. His remaining pain was localized in the right\nlow back and groin and he described it as an aching cramping sensation\nradiating down his right anteromedial thigh. By July 24, 2012, Employee\nreported low back pain relief but continued right anterolateral thigh pain. He\nused Percocet<\/a> daily\nto control pain<\/p>\n\n\n\n

On October 20, 2012, Dr. Holley performed another EME. Employee told Dr. Holley when his symptoms did not improve with conservative care Dr. Wright performed an \u201cL2-L3-L4 lateral\u00a0discectomy<\/a>.\u201d The surgery did not help. Employee moved to Michigan and had additional steroid injections and PT, which did not help. Employee still exhibited diminished sensation over the medial right thigh. Dr. Holley reviewed the February 9, 2010 MRI on a CD-ROM, which he interpreted to show multilevel\u00a0degenerative disc disease<\/a>\u00a0with a broad-based posterior bulge most prominent at L4-5 creating mild, central, lateral recess narrowing but no nerve root impingement. The L2-3 and L3-4 levels were mildly degenerative with lesser bulging and there was no recurrent herniation at L2-3. Dr. Holley diagnosed a right L2-3 far lateral disc herniation with associated right lower extremity\u00a0radiculopathy<\/a>, status post\u00a0discectomy<\/a>\u00a0in October 2008. He attributed this disc herniation to the March 11, 2008 work injury. He also found multilevel\u00a0spondylosis<\/a>,\u00a0degenerative disc disease<\/a>\u00a0and facet\u00a0arthropathy<\/a>, which in his view were all preexisting but temporarily aggravated by the March 11, 2008 work injury. Dr. Holley opined the substantial cause of Employee's current disability and need for medical care was natural progression of his degenerative lumbar changes and not the March 11, 2008 work injury. <\/span>Dr. Holley found no intervening factors affecting Employee's lumbar spine. In his view, Employee needed no further diagnostic studies, tests or treatment. Dr. Holley opined pain medications,\u00a0Flexeril<\/a>and epidural steroid injections were not reasonable or necessary going forward, though they were medically acceptable in the past. The substantial cause of the ongoing need for these modalities was, in Dr. Holley's opinion, natural progression of Employee's degenerative lumbar spine condition and not the March 2008 work injury.<\/span><\/p>\n\n\n\n

On January 12, 2015, given these\nresults Dr. Morris advised bilateral medial facetectomies<\/a> without\nfusion at L4-5. Employee wanted to proceedOn March 26, 2015, Dr. Morris\nperformed lumbar surgery on Employee. The surgical records are not found in the\nagency file.<\/p>\n\n\n\n

On June 25, 2015, Alan Roth,\nM.D., saw Employee for a second independent medical evaluation (SIME). Employee\nhad \u201csignificant degenerative spine and disc disease\u201d prior to his work injury,\nwhich was not caused by the injury. However, he also had \u201csome significant disc\nprotrusion, particularly pushing against the right L4 nerve root,\u201d which Dr.\nRoth opined \u201cprobably was related to the \u2014 more likely than not, was related to\nthe work injury.\u201d Dr. Roth said it was possible the disc protrusion at L4 could\nhave been caused by or impacted by the July 22, 2008 rock incident at home, but\nfurther stated \u201cit's my understanding that he had some radicular complaints in\nthe distribution of L4 and L3 levels at the time of \u2014 subsequent to the time of\nhis work injury, that he didn't have before his work injury, and that he\ncontinued to have and, possibly, became more significant after the home\ninjury.\u201d<\/p>\n\n\n\n

Employee's symptoms\nprogressively got worse from the beginning. His right foot drop was always\npresent, continuous and gradually got worse.<\/p>\n\n\n\n

Board weighed evidence and\nEmployee won.<\/p>\n\n\n\n

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

Keenan Powell has practiced Workers\nCompensation law in the State of Alaska\nfor over 35 years and has dedicated her practice to Workers Compensation\nrepresenting injured Alaskans handling hundreds of cases. www.keenanpowell.com<\/a>.<\/em><\/p>\n\n\n\n

All consultations are free.<\/strong>  To make an appointment, email:\nkeenan@keenanpowell.com<\/a> or call: \n907 258 7663.<\/p>\n","protected":false},"excerpt":{"rendered":"

In The Gang of Seven Episode III, I featured Dr. Dennis Chong. The Gang is a blog series devoted to identifying some of the insurance industry\u2019s most frequently-used \u201cindependent\u201d medical examiners. The Gang of Seven include: Dr. David Bauer, Dr. Lynne Bell, Dr. Dennis Chong, Dr. Keith Holley, Dr. Stephen Marble, Dr. Patrick Radecki, and ...continue reading \"Gang of Seven Episode IV: Keith Holley MD\"<\/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-984","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 IV: Keith Holley MD - 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\/05\/22\/gang-of-seven-episode-iv-keith-holley-md\/\" \/>\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 IV: Keith Holley MD - Keenan Powell, Attorney at Law\" \/>\n<meta property=\"og:description\" content=\"In The Gang of Seven Episode III, I featured Dr. Dennis Chong. 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