The URL can be used to link to this page

Home My WebLink About04-0064DOUGLAS LAW OFFICE 27 W. HIGH ST. WILLIAM P. DOUGLAS, ESQ. POD 261 Supreme Court I.D.# 37926 CARLISLE PA 17013 TELEPHONE 717-243-1790 Corine A. Rickabaugh In the Court of Common Pleas of Cumberland County Pennsylvania Plaintiff vs No. 04- (li Civil Term Goodville Mutual Casualty Company Civil Action Law Defendant Jury Trial Demanded NOTICE YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE ACTION WITHIN TWENTY DAYS AFTER THIS COMPLAINT AND NOTICE ARE SERVED, BY ENTERING A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILING IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. YOU ARE WARNED THAT IF YOU FAIL TO DO SO, THE CASE MAY PROCEED WITHOUT YOU AND A JUDGMENT MAY BE ENTERED AGAINST YOU BY THE COURT WITHOUT FURTHER NOTICE FOR ANY MONEY CLAIMED IN THE COMPLAINT OR FOR ANY OTHER CLAIM OR RELIEF REQUESTED BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 S. Bedford Street Carlisle PA 17013 717-249-3166 BY \ DATE: January 6, 2004 4 Complaint 1. The plaintiff, Corine A. Rickabaugh, is an adult individual residing at 1083 Grahams Wood Road, Cumberland County, Pennsylvania. /???, v, ((? ?1A 2. The Defendant, Goodville Mutual Casualty Company, is a corporation licensed to do business in the Commonwealth of Pennsylvania, with agents located throughout the Commonwealth of Pennsylvania and with a claims office located at 625 West Main St., New Holland, Lancaster County, Pennsylvania. 17:rf 7 3. On September 15, 2002, the plaintiff was involved in a motor vehicle accident while driving a motor vehicle insured with defendant Goodville. 4. There was a policy of insurance in effect at the time of the accident, with Goodville Mutual Casualty Company bearing policy number PA746801. The contract provided for payment of medical expenses, up to $100,000.00, which occurred as a result of a motor vehicle accident. 5. On the aforesaid date, the plaintiff was injured in a motor vehicle accident which occurred in Dickinson Township, Cumberland County, Pennsylvania. 6. As a result of that accident the plaintiff was required to undergo medical treatment for her injuries and incurred medical expenses. 7. Goodville wrongfully refused to pay for medical services which were provided to Corine A. Rickabaugh by her health care providers and have failed to comply with the provisions and/or abused the provisions of Act 6 with respect to the PRO process. 8. Goodville did fraudulently, knowingly and intentionally misrepresent and deceive Corine A. Rickabaugh and her medical providers with respect to the availability of medical benefit coverage under her policy of insurance. 9. Goodville has frivolously and with no proper foundation for their actions refused to pay proceeds under their policy of insurance and provide medical benefits in accordance with the terms of the policy. 10. The bad faith conduct of Goodville gives rise to a cause of action pursuant to 42 Pa. C.S.A. §8371. 11. The defendant, in retaliation for the plaintiff filing and pursuing a claim has cancelled the homeowners insurance of the plaintiff on a fraudulent basis. 12. The defendant did not act in good faith to effectuate prompt, fair and equitable resolution of claims, knowing that liability to pay medical bills is clear and coverage applies, and as a result, the plaintiff has been forced to incur expense to protect her interests. 13. The defendant failed to promptly provide a factually sound explanation for the basis of denial in the insurance policy in relation to the facts or applicable law for denial of the claim. 14. The defendant has willfully, maliciously and/or recklessly withheld benefits from the plaintiff, due to its failure to investigate the claim thoroughly which constitutes a breach of an implied covenant. 15. The defendant, in bad faith, has denied payment on behalf of its insured without a sound legal basis for its denial and in not fully inquiring into the possible basis which might support the insured's claim of coverage. 16. Goodville has deliberately acted in conscious disregard and with indifference to the rights of their insured. 17. The defendant impliedly and/or expressly warranted that it would, in good faith, provide insurance coverage to Corine A. Rickabaugh in accordance with the contract and abide by the terms of said contract. 18. As a result of the aforesaid, the defendant breached its contract and/or warranty, which breach resulted in loss to the plaintiff, and has impeded her ability to receive medical services, as well as aggravation, inconvenience and emotional distress. 19. The plaintiff hereby requests all remedial relief as provided in 42 Pa. C.S.A. §8371 and payment in full of all past and future reasonable and necessary medical expenses. Wherefore it is prayed that judgment be entered in favor of the plaintiff and against the defendant in an amount in excess of that requiring compulsory referral to arbitration. A jury trial is hereby demanded. Respectfupy submitted, 4 William P. Douglas, sq. Attorney for Plaintiff January 2, 2004 AFFIDAVIT I HEREBY SWEAR OR AFFIRM THAT THE FOREGOING IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND/OR INFORMATION AND BELIEF. THIS IS MADE SUBJECT TO THE PENALTIES OF 18 PA.C.S.§ 4904 RELATING TO UNSWORN FALSIFICATION TO AUTHORITIES. signature January 2, 2004 ??? GJ t- ? \, L_ J:+ ?? ?..? ? C ? ? ? -t? it ?' ? ? ,- i --? r i ?' C ? ? ? ?' ? i. ( ? ? _.. - ? ?? G? SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2004-00064 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND RICKABAUGH CORINE A VS GOODVILLE MUTUAL CASUALTY CO R. Thomas Kline Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT to wit: GOODVILLE MUTUAL CASUALTY COMPANY but was unable to locate Them in his bailiwick. He therefore deputized the sheriff of LANCASTER County, Pennsylvania, to serve the within COMPLAINT & NOTICE On January 26th , 2004 , this office was in receipt of the attached return from LANCASTER Sheriff's Costs Docketing 18.00 Out of County 9.00 Surcharge 10.00 Dep Lancaster Co 46.25 .00 83.25 01/26/2004 DOUGLAS LAW OFFICE So answers R. thomas Kline Sheriff of Cumberland County Sworn and subscribed to before me this ;ZQ? day of x(0_0 A . D/? ' // ,? \ Y"- Q ? ?-Ql", 1YO-cy Prothonotary O =)HER?FF'S OFFICE 50 NORTH DUKE STREET, F.O. SOX 83480, LANCASTER, PENNSYLVANIA 17608.3480 a (717) 299-8200 SHERIFF SERVICE PROCESS RECEIPT, and AFFIDAVIT OF RETURN I• PLAINTIFF/Si 3y DEFENDANT/S/ Corine A. Rickabaugt Goodville Mutual Casualty Company SERVE 5 NAME OF INDIVIDUAL, COMPANY, CORPORATION, ETC, TO BE SERVED Goodville Mutual Casualty Company 6. ADDRESS (Street or RFD, Apartment No., City, Born, Twp-, State and ZIP Code) AT 625 West Main Street: New Holland, PA 7. INDICATE UNUSUAL SERVICE: JlCorPUTIZE U OTHER CLUnberiand PLEAW DO NOT DE?`AOR ANT ES. ?2. COURT NUM8ER 04-64 civil 4. TYPE OF WRIT OR COMPLAINT Notice and Canplaint Now, January 9 20 04 1, SHERIFF OF 1 COUNTY, PA., do hereb d tize the Sheriff of T,anc:aGter County to execute this Writ AWPO na ?therof ac to law. This deputation being made at the request and risk of the plaintiff. s eai'or?t, oo?o , - ?' • w t? 8. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE: Cumberland NOTE ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN - Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession, after notifying person of levy OrattaChment, without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction or removal of any such property before sheriff's sale thereof. 9. SIGNATURE of ATTORNEY or other ORIGINATOR 10. TELEPHONE NUMBER 11, DATE WILLIAM P DOUGLAS DOUGLAS LAW OFFICE 717-241-1780 1/6/04 12. SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: (This area most be completed H notice is to be mailed). 3 H N n d H O O C H Lr. p1 SPACE BELOW FOR USE OF SHERIFF ONLY - DO NOT WRITE BELOW THIS LINE 13.1 acknowledge receipt of the writ NAME of Authorized LCSO Deputy or Clerk 14. Date Received 15. Exptrahon/Hearing date of complaint as indicated above. ANNETTE WALTON (717) r1-3609 I 1/9/04 I 2/5/04 16.1 hereby CERTIFY and RETURN Met 113 have personally served, rrnave legal evidence of service as shown in "Remarks", ? have executed as shown in "Remarks", the writ or complaint described on the individual, company, corporation, etc., at the address shown above or on the individual, company, cor- poration, etc., at the address inserted below by handing a TRUE and ATTESTED COPY thereof. 17. ? 1 hereby certify and return a NOT FOUND because I am unable to locate the individual, company, corporation, etc., named above. ISee remarks below) aannd title of individual served (it not shown abovee))((Relationship toDefendant) Q- e-f o e l j 19. ONO?os 18?sName - itlE J , b " z:> , nr- ! /-( I Be, Remarks Below (No. 30) 'O. Address of where served (complete only if different than shown above) (Street orRFD, Apartment No., City, Soto, Twp. 21. Date of Serv ice 22. Time ?_ State and Zip Code) PM EST .ATTEMPTS l pia I Mi De ??I Date Miles Dep. Int. I Date Milos I Dep. Int. Date I Miles I Dap, Int. I I Date Miles Dep. Int. Advance Costs 25. Service Costs 26. Notary Can. 27. Mileage/Postage/N.F. 28. Total Costs- { 29. COST DUE OR REFUND 7 S ` 11 *113 6? 150.00 36.50 I ''?y I ?1 4( (P:? I 103 REMARKS: t.T.A.: =1RMEDAn subs ibad to before me this / ? ? / f-7 72: ure of .? ? 33 ate '] ? C 20 C'!?? Dea er t "'Y T o ?L r ? 95. Signature of Sheriff 8. Date ?? Pratho tart/091Ab?NMutar ,bh. RCnr wr gyn w bR ??waaccc--...... ?TY ' f l (MISSION EXPIRES - Issuing Authority 2. PINK - Attorney 3. CANARY - Sheriff's Office 4. BLUE -Sheriff's Office- , _ `? 'C'0FFI 50 NORTH DUKE STREET. P.O. BOX 63480. LANCASTER. PENNSYLVANIA 17606-3486i1 oil* .. .... ............ ..? SHERIFF SERVICE P PROCESS RECEIPT, and AFFIDAVIT OF RETURN DO NOT I. PLAINTIFF/S/ '•,i•rRr' i 3, DEFENDANT/S/ 1 1 `:'••f lf7t't N SERVE I t' r 6 ADDRESS (Street or RFD Apartment No City Boro, Twp State and ZIP Code) c ,.. , , i a 1'7 3 t • t' AT 1 , sr ' v J ti I1jirl s • laud 1. INDICATE UNUSUAL SERVICE. 6 DEPUTIZE O OTHER £ Now, 20 nq 1, SHERIFF OF COUNTY, PA., do hereby d?pUti I . I r nca,ke County to execute this Writrn t to law. This deputation being made at the request and risk of the plaintiff. sncRiFF or 4 6. SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE: CraT+klerlatt? j. 111, i , I MOTE ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMAN -Any deputy sheriff levying upon or attaching any p(ppN}X within writ may leave same without a watchman, in custody of whomeveris found in possession, after notifying person of levy oratlachment wit the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction or removal of any such property before sheriff's salmi 9 SIGNATURE of ATTORNEY or other ORIGINATOR 10. TELEPHONE NUMBER 1 t,Ta ?A, Ol W',-,' _ A[9 2 Jt3UG ,is 004v Hf f AW C'PFICE 2 3- f 7 ') I 11 {X? It SEND NOTICE OF SERVICE COPY TO NAME AND ADDRESS BELOW: (This area must be completed it notice is to be Mal" i ( "0,- Cr'- t?5 "q! Vp- Y?V SPACE BELOW FOR USE OF SHERIFF ONLY DO NOT WRITE BELOW TH S a NAME of Authorized LCSO Deputy or Clerk 14, Date Received i? 15. t7Me 13.1acknowledge receipt the writ t j orcomplaint asindicated atrove. 1[SN'c='PTF d»,TpN f"'1/!.-,?? -;36 ;-`9 ?,1±)r? 2r?`?{44, 16.4 ttareby CERTIFY and RETURN that 1 ? have personally served, t have legal evidence of service as shown in "Remarks , O have executedjia ingwp lit ""Retnarks", the writ or complaint described on the individual, company, corporation, etc., at the address shown above or on the Individual, edmpahq'10. #'mration, etc., at the address inserted below by handing a TRUE and ATTESTED COPY thereof y „ ,. 7..01. hereby certify and return a NOT FOUND because I am unrr ^ • : •,:rc pv r l-. •n)tie (See remade brtpay 6-t(Attxs Vol title at individual s rued (it not shown strove) (Bela. r, )e t.•^ ?.-t. , ,f. ,.. 4..p:- 5... i....? f'7?. < ,v'. ,-r. f ..._. Jr' Y .s wJY ( ,+e_.. ,.e I sae Romance DelPw (14o:'9q 'r < • ,: . Address of where sewed (complete only if different than shown above) (Street or RFD, Apartment No., City. Soto, Twp. 21. Date of Ser•licR lvnfIra A State and Zip Code) L 50, ?iT6MPT5 Data- I Miles Dsp t,) Date Miles IDep. tit.) Date Miles Dep. Int. Date Miles Dep. Int. DaMNN C#pIM, b ,dvonce Costs ! 11 25. Service Costs 26. Notary Cert, 27. Mileage/Postage/N:F. 26. Total Coster 26y GDS9 „ T"A. r ..... ...... .............. ..... _ ?..r •• , SO ANSW R , ?a subs rrbetl to before me this r r ' 32, 5cgglh 'e Pt ?iJ l 20. DeP Sheri ?+ ?:e°?°.?..e„"'1`• R*'R+63+..: ', I _. J 35. Signature at Sfferlfl ?*.. y c.? - ° v nC "? Pmihonotary/8epotyrNOtaVvtrhc- FF OF {pN EXPIRES NoWng Authority 2. PINK - Attorney 3. CANARY - Sheriffs Office 4. BLUE - Sheriff's Office CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-64 CIVIL TERM CIVIL ACTION LAW JURY TRIAL DEMANDED DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S COMPLAINT A. Motion for More Specific Complaint 1. On or about January 7, 2004, Plaintiff filed a Complaint against Defendant alleging bad faith in the handling of her insurance claim pursuant to 42 Pa.C.S. §8371. 2. In paragraph 7 of said Complaint, Plaintiff alleges that the Defendant "wrongfully refused to pay for medical services which were provided to Corine A. Rickabaugh by her healthcare providers and have failed to comply with the provisions and/or abused the provision of Act 6 with respect to the PRO process." 3. No where in Plaintiff's Complaint does Plaintiff identify the medical services at issue, the healthcare providers at issue, and the manner in which it is contended that the Defendant "failed to comply with the provisions and/or abused the provisions of Act 6 with respect to the PRO process." 4. In paragraph 8 Plaintiff alleges: "Goodville did fraudently, knowingingly and intentionally misrepresent and deceive Corine A. Rickabaugh and her medical providers with respect to the availability of medical benefit coverage under her policy of insurance." However, pertinent facts underlining these allegations have not been plead in compliance with Pa.R.C.P. §1019 (a) and (b). 5. In paragraph 9 Plaintiff alleges that "Goodville has frivolously and with no proper foundation for their actions refused to pay proceeds under their policy of insurance and provide medical benefits in accordance with the terms of the policy" without any statement of the underlying material facts in compliance with Pa.R.C.P. §1019. 6. In paragraph 11 Plaintiff again alleges "fraudulent" conduct but no material facts have been plead. 7. In paragraph 12 Plaintiff, in conclusory form, alleges that "the Defendant did not act in good faith to effectuate prompt, fair and equitable resolution of claims, knowing that liability to pay medical bills is clear and coverage applies, and as a result, the Plaintiff has been forced to incur expense to protect her interest." Again, the allegations are vague and do not comply with the pleading requirements in the Pennsylvania Rules of Civil Procedure. 8. Plaintiff's allegations in paragraphs 13, and 18 are likewise deficient for failure to set forth the material facts on which the alleged cause of action is based and the failure to plead averments of fraud with particularity. 2 9. Additionally, in paragraph 19 Plaintiff seeks "payment in full of all past and future reasonable and necessary medical expenses" without specifying the particular expense involved. WHEREFORE, pursuant to Pa.R.C.P.1028 Defendant asserts that Plaintiff's pleading is insufficiently specific and requests that the Court direct the Plaintiff to file a more specific Complaint in compliance with the Pennsylvania Rules of Civil Procedure. B. Demurrer In paragraph 19 of Plaintiff's Complaint, the Plaintiff seeks: "all remedial relief as provided in 42 Pa.C.S. §8371 and payment in full of all past and future reasonable and necessary medical expenses." The aforesaid request seeks payment for future medical expenses which fails to state a valid claim for relief. WHEREFORE, it is respectfully requested that paragraph 19 of Plaintiffs Complaint to the extent that it seeks recovery for "future reasonable and necessary medical expenses" be dismissed for failure to state a valid cause of action. C. Motion to Strike For the reasons set forth above Defendant requests that paragraph 19 of Plaintiff's Complaint be stricken to the extent it seeks relief for "future reasonable and necessary medical expenses." Respectfully submitted, NESTICO, DRUBY & HILDABRAND, L.L.P. By: `- Karl R. Hildabrand, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Date: Attorney for Defendant 4 CERTIFICATE OF SERVICE I, Karl R. Hildabrand, of the law firm of Nestico, Druby & Hildabrand, L.L.P., hereby certify that on the __q__ day of March, 2004, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: William P. Douglas, Esquire Douglas Law Office 27 West High Street PO Box 261 Carlisle, PA 17013 arl R. Hildabrand 5 n N c ° O , O w R7 T V 1 7 m r m i] { • O 1 .f W 7 •< CORINE A. RICKABAUGH, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04-64 CIVIL TERM GOODVILLE MUTUAL CASUALTY COMPANY, CIVIL ACTION LAW Defendant JURY TRIAL DEMANDED PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of undersigned counsel on behalf of Defendant, Goodville Mutual Casualty Company in the above matter reserving all rights to plead. Respectfully submitted, NESTICO, DRUBY & HILDABRAND, L.L.P. By: Karl R. Hildabrand, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Date: Lb Attorney for Defendant CERTIFICATE OF SERVICE 1, Karl R. Hildabrand, of the law firm of Nestico, Druby & Hildabrand, L.L.P., hereby certify that on the -Y- day of March, 2004, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: William P. Douglas, Esquire Douglas Law Office 27 West High Street PO Box 261 Carlisle, PA 17013 arl R. Hildabrand C N O - c? r T T t ?-w co 0 4 cil %? PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. CAPTION OF CASE (entire caption must be stated in full) Corine A. Rickabaugh (Plaintiff) V5. Goodville Mutual Casualty Company (Defendant) No. 64 Civil Term XT, 2004 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Preliminary objections to Plaintiff's Complaint 2. Identify counsel who will argue case: (a) for plaintiff: William P. Douglas, Esquire Address: 27 W. High St., PO Box 261, Carlisle, PA 17013 (b) for defendant: Karl R. Hildabrand, Esquire Address: 840 E. Chocolate Ave., Hershey, PA 17033 3. I will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: April 21, 2004 Dated: Attorney far -? r G `] Q -`? r o ::r DOUGLAS LAW OFFICE 27 W. HIGH ST. POB 261 CARLISLE PA 17013 TELEPHONE 717.243-1790 WILLIAM P. DOUGLAS, ESQ. Supreme Court I.D.# 37926 r.............._ .............................__._._._..................._._._.._................_........................................................._._ ......... ....... _........ ....._ . _ ............. . _._._._._...._......._._.........._...................................._._....._..._ .. Co u1 . . i Corine A.13ickabaugh In the ._.. .. t ._ of Common.Pleas. of i Cumberland County Pennsylvania Plaintiff i vs ! No. 04- 64 Civil Term Goodville Mutual Casualty Company Civil Action Law Defendant Ju Trial Demanded ........... ..... ................ .. .. .. ................... .................. ORDER OF COURT On this the 20t` day of April, 2004, in response the preliminary objects of the defendant Goodville Mutual Casualty Company, the plaintiff is hereby order to file an amended complaint within 20 days hereof. Hon. Kevin A. Hess, J. n O? . r1 1 i? 1,?? ?d € ICI( .. ._, _. . tv?i? Z! .? !!ti ?i ?:au?FCQZ :? DOUGLAS LAW OFFICE 27 W. HIGH ST. POB 261 CARLISLE PA 17013 TELEPHONE 717-20.3.1790 WILLIAM P. DOUGLAS, ESQ. Supreme Court I.D.Y 37926 Cumberland County Pennsylvania Plaintiff vs No. C4- 64 Civil Term Goodville Mutual Casualty Company Defendant Civil Action Law try 'Trial Demanded Amended Complaint NOTICE YOU HAVE BEEN SUED IN COURT. IF YOU WISH TO DEFEND AGAINST THE CLAIMS SET FORTH IN THE FOLLOWING PAGES, YOU MUST TAKE ACTION WITHIN TWENTY DAYS AFTER THIS COMPLAINT AND NOTICE ARE SERVED, BY ENTERING A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILING IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. YOU ARE WARNED THAT IF YOU FAIL TO DO SO, THE CASE MAY PROCEED WITHOUT YOU AND A JUDGMENT MAY BE ENTERED AGAINST YOU BY THE COURT WITHOUT FURTHER NOTICE FOR ANY MONEY CLAIMED IN THE COMPLAINT OR FOR ANY OTHER CLAIM OR RELIEF REQUESTED BY THE PLAINTIFF. YOU MAY LOSE MONEY OR PROPERTY OR OTHER RIGHTS IMPORTANT TO YOU. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THI:i OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Cumberland County Bar Association 32 S. Bedford Street Carlisle PA 17013 717-249-3166 DATE: May 21, 2004 BY_\cljlL- Y , Amended Complaint 1. The plaintiff, Corine A. Rickabaugh, is an adult individual residing at 1083 Grahams Wood Road, Cumberland County, Pennsylvania. 2. The Defendant, Goodville Mutual Casualty Company, is a corporation licensed to do business in the Commonwealth of Pennsylvania, with agents located throughout the Commonwealth of Pennsylvania and with a claims office located at 625 West Main St., New Holland, Lancaster County, Pennsylvania. 3. On September 15, 2002, the plaintiff was involved in a motor vehicle accident while driving a motor vehicle insured with defendant Goodville. 4. There was a policy of insurance in effect at the time of the accident, with Goodville Mutual Casualty Company bearing policy number PA746801. The contract provided for payment of medical expenses, up to $100,000.00, which occurred as a result of a motor vehicle accident. 5. On the aforesaid date, the plaintiff was injured in a motor vehicle accident which occurred in Dickinson Township„ Cumberland County, Pennsylvania. 6. As a result of that accident the plaintiff was required to undergo medical treatment for her injuries and incurred medical expenses. 7. Goodville wrongfully refused to pay for medical services which were provided to Corine A. Rickabaugh by her health care providers and have failed to comply with the provisions and/or abused the provisions of Act 6 with respect to the PRO process. The wrongful conduct includes untimely Peer Reviews which address the issue of causation which is not permitted by statute and regulation. 8. Goodville did fraudulently, knowingly and intentionally misrepresent and deceive Corine A. Rickabaugh and her medical providers with respect to the availability of medical benefit coverage under her policy of insurance. The conduct includes writing to providers, with no basis in fact, in an attempt to thwart her ability to receive care and treatment. 9. Goodville has frivolously and with no proper foundation for their actions refused to pay proceeds under their policy of insurance and provide medical benefits in accordance with the terms of the policy. 10. The bad faith conduct of Goodville gives rise to a cause of action pursuant to 42 Pa. C.S.A. §8371. 11. The defendant, in retaliation for the plaintiff filing and pursuing a claim has cancelled the homeowners insurance of the plaintiff on a fraudulent basis. Specifically, they represented to the Insurance Commissioner that the reason for the cancellation was the fact they do not insure mobile homes. Said allegation by Goodville is not true. 12. The defendant did not act in good faith to effectuate prompt, fair and equitable resolution of claims, knowing that liability to pay medical bills is clear and coverage applies, and as a result, the plaintiff has been forced to incur expense to protect her interests. 13. The defendant failed to promptly provide a factually sound explanation for the basis of denial in the insurance policy in relation to the facts or applicable law for denial of the claim. 14. The defendant has willfully, maliciously anal/or recklessly withheld benefits from the plaintiff, due to its failure to investigate the claim thoroughly which constitutes a breach of an implied covenant. 15. The defendant, in bad faith, has denied payment on behalf of its insured without a sound legal basis for its denial and in not fully inquiring into the possible basis which might support the insured's claim of coverage. 16. Goodville has deliberately acted in conscious disregard and with indifference to the rights of their insured. 17. The defendant impliedly and/or expressly warranted that it would, in good faith, provide insurance coverage to Corine A. Rickabaugh in accordance with the contract and abide by the terms of said contract and the laws of the Commonwealth of Pennsylvania. 18. As a result of the aforesaid, the defendant breached its contract and/or warranty, which breach resulted in loss to the plaintiff, and has impeded her ability to receive medical services, as well as aggravation, inconvenience and emotional distress. 19. The plaintiff hereby requests all remedial relief as provided in 42 Pa. C.S.A. §8371, the Pennsylvania Motor Vehicle Financial Responsibility Law and payment in full of all reasonable and necessary medical expenses incurred. Wherefore it is prayed that judgment be entered in favor of the plaintiff and against the defendant in an amount in excess of that requiring compulsory referral to arbitration. A jury trial is hereby demanded. Respectfully submitted, William P. _Douglas, Esq. Attorney for Plaintiff May 21, 2004 AFFIDAVIT I HEREBY SWEAR OR AFFIRM THAT THE FOREGOING IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE AND/OR INFORMATION AND BELIEF. THIS IS MADE SUBJECT TO THE PENALTIES OF 18 PA.C.S.§ 4904 RELATING TO UNSWORN FALSIFICATION TO AUTHORITIES. May 21, 2004 signature t? o -G lil=y :rJ'Ti U y (Y t,l inl PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. CAPTION OF CASE (entire caption must be stated in full) CORINE A. RICKABAUGH, (Plaintiff) VS. GOODVILLE MUTUAL CASUALTY COMPANY, (Defendant) No. 0064 Civil Term 19 2004 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to complaint, etc.): Preliminary Objections to Plaintiff's Amended Complaint 2. Identify counsel who will argue case: (a) for plaintiff: William P. Douglas, Esquire Address: 27 W. High Street, P.O. Box 261, Carlisle, PA 17013 (b) for defendant: Karl R. Hildabrand, Esquire Address: 840 E. Chocolate Avenue, Hershey, PA 17033 3. I will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: July 28, 2004 Dated: Attorney for Defendant l:} O Y Q ? C ? ?,,..?? n G=. r [: Ql ..0 ' YT L '!,,t_, ? ? ,,??n j __ ? ..q CORINE A. RICKABAUGH, Plaintiff V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term GOODVILLE MUTUAL CASUALTY CIVIL ACTION - AT LAW COMPANY, JURY TRIAL DEMANDED Defendant DEFENDANT'S PRELIMINARY OBJECTIONS TO PLAINTIFF'S "ENDED COMPLAINT A. Motion for More Specific Complaint 1. On or about January 7, 2004, Plaintiff filed a Complaint against Defendant alleging bad faith in the handling of her insurance claim pursuant to 42 Pa.C.S. §8371. 2. After Preliminary Objections were filed and an Order was entered (by argument) directing the filing of an Amended Complaint, an Amended Complaint was filed on or about May 24, 2004. 3. In paragraph 7 of said Complaint, Plaintiff alleges that the Defendant "wrongfully refused to pay for medical services which were provided to Corine A. Rickabaugh by her healthcare providers and have failed to comply with the provisions and/or abused the provision of Act 6 with respect to the PRO process. The wrongful conduct includes untimely Peer Reviews which address the issue of causation which is not permitted by statute and regulation." 4. Nowhere in Plaintiffs Complaint does Plaintiff identify the medical services at issue or the healthcare providers at issue. Furthermore, by use of the word "includes," it is implied that there are additional ways that Defendant allegedly "failed to comply with the provisions and/or abused the provisions of Act 6 with respect to the PRO process." 5. In paragraph 8 Plaintiff alleges: "Goodville did fraudulently, knowingingly and intentionally misrepresent and deceive Corine A. Rickabaugh and her medical providers with respect to the availability of medical benefit coverage under her policy of insurance. The conduct includes writing to providers, with no basis in fact, in an attempt to thwart her ability to receive care and treatment." However, pertinent facts underlining these allegations have not been plead in compliance with Pa.R.C.P. §1019(a) and (b). Furthermore, the use of the word "includes" implies that there are additional facts to support the allegations against Defendant. 6. In paragraph 9 Plaintiff alleges that "Goodville has frivolously and with no proper foundation for their actions refused to pay proceeds under their policy of insurance and provide medical benefits in accordance with the terms of the policy" without any statement of the underlying material facts in compliance with Pa.R.C.P. §1019. 7. In paragraph 11 Plaintiff again alleges "fraudulent" conduct but no material facts have been plead. 8. In paragraph 12 Plaintiff, in conclusory form, alleges that "the Defendant did not act in good faith to effectuate prompt, fai- and equitable resolution of claims, knowing that liability to pay medical bills is clear and coverage applies, and as a result, the Plaintiff has been forced to incur expense to protect her interest." Again, the allegations are vague and do not comply with the pleading requirements in the Pennsylvania Rules of Civil Procedure. 9. Plaintiffs allegations in paragraphs 13, 14, 15, 16 and 18 are likewise deficient for failure to set forth the material facts on which the alleged cause of action is based and the failure to plead averments of fraud with particularity. 10. Additionally, in paragraph 19, Plaintiff seeks "payment in full of all reasonable and necessary medical expenses" without specifying the particullar expense involved. WHEREFORE, pursuant to Pa.R.C.P. 1028 Defendant asserts that Plaintiffs pleading is insufficiently specific and requests that the Court direct the Plaintiff to file a more specific Amended Complaint in compliance with the Pennsylvania Rules of Civil Procedure. B. Motion to Strike For the reasons set forth above, Defendant requests that Plaintiffs Amended Complaint be stricken for lack of conformity to law or Rules of Court, or for scandalous or impertinent matter. Respectfully submitted, NESTICO, DRUB'Y & HILDABRAND, L.L.P. By: ar R. Hildabrand, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Date: 6 O Attorney for Defendant CERTIFICATE OF SERVICE 1, Michelle M. Bross, of the law firm Nestico, Druby & Hildabrand, LLP, on this day of June 2004, hereby certify that I served a true and exact copy of the foregoing document as follows: By First Class Mail, Postaee Pre-paid: William P. Douglas, Esquire Douglas Law .flee 27 W. Nigh Slreet P.O. Box 261 Carlisle, PA 17013 NESTICO, DRUBY & HILDABRAND, L.L.P. 'Michelle IVi. Bross n ? o _ 4y 4. rn 3 O U F _ -C W =G CORINPEL INT FFABAUGH, V. GOODVILLE MUTUAL CASUALTY, COMPANY, DEFENDANT IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA 04-0064 CIVIL. TERM BEFORE BAYLEY J. AND HESS. J. ORDER OF COURT ( 1/ day of August, 2004, the preliminary AND NOW, this plaintiff's complaint, ARE DISMISSED. objections of defendant top th t;ourt,/ By Edgar illiam P. Douglas, Esquire For Plaintiff a rl R. Hildabrand, Esquire For Defendant :sal OS 0-?? , J. PLAINTIFF'S COMPLAiro! C~ tb ' < V c._ c l7 N `) CORINE A. RICKABAUGH, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOCKET NO. 04-64 Civil Term GOODVILLE MUTUAL CASUALTY CIVIL ACTION - AT LAW COMPANY, Defendant NOTICE TO PLEAD TO: Corine A. Rickabaugh, Plaintiff c% William P. Douglas, Esquire Douglas Law Office 27 W. High Street P.O. Box 261 Carlisle, Pennsylvania 17013 You are hereby notified to plead to the enclosed Answer and New Matter within twenty (20) days from service hereof or a default of judgment may be entered against you. Respectfully submitted, NESTICO, DRUBY & HILDABRAND, L.L.P. Date: Karl R. Hildebrand Attorney I.D. No. 30102 840 E. Chocolate Avenue Hershey, PA. 17033 (717) 533-5406 Telephone (717) 533-5717 Fax Attorney for Defendant CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term CIVIL ACTION - AT LAW DEFENDANT'S ANSWER AND NEW MATTER TO PLAINTIFF'S AMENDED COMPLAINT 1. Admitted 2. Admitted in part. Denied in part. It is admitted that the Defendant is Goodville Mutual Casualty Company, a corporation licensed to do business in Pennsylvania with a claims office located at 625 W. Main Street, New Holland, Lancaster County, Pennsylvania. The remaining averments of paragraph 2 are specifically denied and proof thereof is demanded at trial. 3. Admitted. 4. Admitted in part. Denied in part. It is admitted that Goodville Policy No. PA746801 was in effect at the time of the accident and that the policy provided medical expense coverage pursuant to the provisions of the policy. The remaining averments of paragraph 4 are specifically denied. 5. Admitted in part. Denied in part It is admitted that the Plaintiff alleges injuries arising out of the motor vehicle accident of September 15, 2002, although the nature and extent of those injuries are in question. 6. Admitted in Part. Denied in hart. It is admitted that the Plaintiff alleges injuries arising out of the motor vehicle accident of September 15, 2002, although the nature and extent of those injuries are in question. 7. Denied. The averments of paragraph 7 are specifically denied and proof thereof is demanded at trial. 8. Denied. The averments of paragraph 8 are specifically denied and proof thereof is demanded at trial. 9. Denied. The averments of paragraph 9 are specifically denied and proof thereof is demanded at trial. 10. Denied. The averments of paragraph 10 are specifically denied and proof thereof is demanded at trial. H. Denied. The averments of paragraph 11 are specifically denied and proof thereof is demanded at trial. 12. Denied. The averments of paragraph 12 are specifically denied and proof thereof is demanded at trial. 13. Denied The averments of paragraph 13 are specifically denied and proof thereof is demanded at trial. 14. Denied The averments of paragraph 14 are specifically denied and proof thereof is demanded at trial. 15. Denied The averments of paragraph 15 are specifically denied and proof thereof is demanded at trial. 16. Denied The averments of paragraph 16 are specifically denied and proof thereof is demanded at trial. 17. Paragraph 17 states a conclusion of law to which no answer is required. To the extent that an answer is necessary, the Defendant provided a policy of insurance which provided coverage for matters covered under the policy. Furthermore, Defendant has at all times acted in good faith with respect to the Plaintiff s claim. 18. Denied The averments of paragraph 18 are specifically denied and proof thereof is demanded at trial. 19. No answer required, however it is specifically denied that Plaintiff is entitled to any relief. NEW MATTER 20. Plaintiff s Complaint fails to state a valid cause of action. 21. Plaintiffs Complaint fails to state a valid cause oFaction under 42 Pa.C.S. §8371. 22. Plaintiff lacks standing to bring the within action. 23. Defendant has at all times acted reasonably, in good faith, and in compliance with the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law and Act VI, 75 Pa.C.S. §1702, et seq., as amended by the Act of February 7, 1990, P.C. 11, No. 6, and any and all applicable regulations. 24. Defendant has at all times acted in compliance with the statutory requirements, and in good faith. 25. Defendant has at all times issued payment to medical providers herein in compliance with the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law and Act VI, 75 Pa.C.S. §1701, et seq., as amended by the Act of February 7, 1990, P.C. 11, No. 6. 26. Defendant's decision to deny payment of certain medical expenses incurred by Plaintiff was based upon competent medical opinion as the result of medical records peer reviews. 27. On July 21, 2003, a peer review was conducted by Dane K. Wukich, M.D. A copy of the peer review report by Dr. Wukich is attached hereto, incorporated herein by reference, and marked as Exhibit A. 28. Dr. Wukich concluded in his report that certain treatment received by Plaintiff was not reasonable and necessary. 29. On November 12, 2003, Stephen M. Thomas, M.D., conducted a peer review of treatment allegedly received by Plaintiff. Attached hereto, incorporated herein by reference, and marked as Exhibit B is a copy of Dr. Thomas' report. 30. Dr. Thomas concluded in his report that certain treatment received by the Plaintiff was not reasonable and necessary. 31. On October 23, 2003, Mark Manzione, M.D., conducted a peer review of Plaintiff's medical treatment. Attached hereto, incorporated herein by reference, and marked as Exhibit C is a copy of Dr. Manzione's report. 32. Dr. Manzione concluded in his report that certain treatment received by the Plaintiff was not reasonable and necessary. 33. On October 6, 2003, Richard H. Bennett, M.D., conducted a peer review of some of Plaintiff's treatment. Attached hereto, incorporated herein by reference, and marked as Exhibit D is a copy of Dr. Bennett's report. 34. Dr. Bennett concluded in his report that certain treatment received by the Plaintiff was not reasonable or necessary. 35. On October 14, 2003, Jay D. Kauffman, P.T., M.B.A., conducted a peer review of some of Plaintiff's treatment. Attached hereto, incorporated herein by reference, and marked as Exhibit E is a copy of Mr. Kauffman's report. 36. Mr. Kauffman concluded in his report that certain treatment received by the Plaintiff was not reasonable and necessary. 37. Based upon the foregoing peer review reports., Defendant Goodville has paid some of Corine Rickabaugh's medical expenses and has declined to pay others. 38. Defendant believes that the Plaintiff is misrepresenting her medical condition as documented by numerous physicians who have reviewed her records and treated her as indicated above in order to continue to receive medical treatment for which bills are submitted to Goodville. 39. Defendant Goodville believes that some or all of the conditions for which Plaintiff has treated and continues to treat are resulting from pre-existing neck and back pain unrelated to the accident in question. 40. Defendant has at all times acted in good faith and in full compliance with the dictates of Pennsylvania law including, but not limited to, the rights and procedures attendant to peer reviews of medical treatment. 41. Plaintiff is not entitled to a jury trial with respect to allegations of bad faith under 42 Pa.C.S. § 8371. Respectfully submitted, NESTICO, DRUBY & HILLD?ABRAND, L.L.P. Y By: , r R. Hildabran d, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Date: August 27, 2004 Attorney for Defendant EXHIBIT A f27if3%2003 94.59 PM 44 r' July 21, 2003 Concentra Medical Examinations 700 American Avenue Suite 300 King of Prussia, PA 19406 Attention: Suzanne Sehl, RN, Medical Review Coordination DANE K. WUKICH, MA Board Certified Orthopedic Surgeon Practice Limited To Orthopedic Surgery 121B7ta RE: CORINE RICKABAUCH " CLAIM k: 129402 OUR FILE k: 002803882.01 Dear Ms. Sehl: At your request, I reviewed the medical records that you forwarded to me regarding the claimant, Ms. Rickaba:igh. The purpose of this review was to determine if the treatment was medically appropriate and medically necessary as it pertains to an injury of September 15, 2002. The following medical records were reviewed: 1. Police accident report. 2. Bills from the ambulance company. 3. Emergency room record dated September 15, 2002. '4. Belvider Medical Group, September 16, 2002 through May 12, 2003. 5. MRI report of the lumbar spine dated October 24, 2002. 6. Orthopedic Institute of Pennsylvania, Dr. Richard Boat, dated October 22, 2002 and October 29, 2002. 7. Alexander Spring Rehabilitation, October 16, 2002 through April 21, 2003. S. Bills from the pharmacy. 9. Photographs. 10. Norman Haueison, D.O., pain management, dated May 9, 2003. REPORTED HISTORY 12/03/20 3 0_4: 9 M r • R&: RICK"AUGH, CODFNw JULY 21, 2003 PAGE2 • a4 1 1 go Synopsis: These medical records reflect that the patient was involved in a motor vehicle accident on September 13,, 2002. The examinee was treated in the emergency room on the date of admission. The emergency room records reflect that the patient was an unrestrained driver in a motor vehicle accident with it head-on collision. The patient noted a long history of back pain but felt stiff. At that time, the patient was examined and was ibund to have thoracic tenderness. They did not document any lumbosacral tenderness. X-rays of the chest and thoracic spine were entirely normal. The patient was treated and released. Subsequent to this, the following day, the patient was seen by the Belvider Medical Group. At that time, she complained of right-sided pain. She was unable to take anti-inflammatory medications because of an exacerbation to her asthma. The only medication that she could tolerate was Vicodin. At that time, they examined her and found that she had mid thoracic tenderness to palpation and right tower paravertebral muscle tenderness. She had tenderness with flexion of the right hip. At that time, she was given a prescription for soma and Vicodin. Re-evaluation took place on September 23, 2002. She indicated that her right leg had buckled, She had hyperraflexir, but this was known to have been present since 1993. At that time, soma was discontinued and the patient was begun on Ativan. Vicodin was refilled. On October ?, 2002, she was re-evaluated. At that time, she was referred for physical therapy to Alexander Spring: Rehabilitation. She was subsequently evaluated by Dr. Richard Boil, an orthopedic surgeon. He was concerned about the possibility of a herniated disc at L4•5. He initially evaluated the patient on October 22, 2002 and then referred the patient for an MRI on October 24, 2002. The WU of the lumber spine was entirely normal. He saw the patient back in follow-up on October 29, 2002 and felt that the patient should continue physical therapy and have follow-up with the orthopedic surgeon. He also prescribed Predaisone. On October 31, 2002, she was diagnosed to have a lumbosacral strain by her primary care physician. On November 14, 2002, she was re-evaluated, and Vicodin was prescribed with one rcdll. On December 17, 2002, she was re-evaluated for her, lumbosacral strain which was improved. Vicodin was given in the form of 30 tablets. She wits taking Prodnisone for asthma. On January 10, 2003, she was seen for evaluation of low-grade fevers.' On February 3, 2003, the was seen again for an upper respiratory tract infection, an exacerbation of asthma, and a lumbosacral strain, which was worse with coughing. On February 19, 2003, her asthma was doing much better. She had some mild back tenderness with palpation of the left paraspinal lumbosacral area and seemed to be much improved. At that time, she was given it note to return to work on March 6 and continue physical therapy. She was re-evaluated again on March 13, 2003. She was given a work excuse for being out of work for another month. She was given Vicodin, 30 tablets. She indicated that she had been back at work for four days and had a bad flare-up of her back pain. She had radicular pain. On April 11, 2003, she was able to return to her job at school. Sho was not tatting physical therapy. She had some problems with lumbosacral spasm and radiuular pain going to the left foot. Somu helped. 12(03/200, 04:59 PM R8s RICKABAUGH, CO AP JULY 31, 200) PAGE 3 • 1 1 t;1p At that time, she was prescribed soma once again. On April 17, 2003, she was re-evaluated. . Zanaflex was prescribed for muscle spasm and Darvocet. It was recommended that she be seen in the pain clinic. She then saw Dr. Haueisen on May 19, 2003. Dr. Haueisen indicated that she had an 1.4.3 disc protrusion/hem ation. That was not consistent with the MRI report. He did note that she had some sacroiliac dysfbnedon. She returned to see her family doctor on May 12, 2003, and at that time, she was diagnosed to have a chronic lumbosacral strain. On May 27, 2003, she was given a prescription for Vicodin, 51500 mg, as well as Soma, 350 mg. . CONCLUSIONS Summary: After reviewing these medical records,*it Is my opinion that the treatrnent'rendered by Dr. Steven Hatleberg is documented to be appropriate and medically necessary for the September 15, 2002 accident. The treatment that I have reviewed up through May 27, 2003 is documented, to be reasonable and medically necessary. The referral for physical therapy which took place on October 16; 2002 would be considered reasonable and medically necessary. The duration of physical therapy in this particular case should be no more than three months. This patient had a normal MRt=d normal neurological examination. There are no usual circumstances to warrant physical therapy beyond a throe month program. The referral to Dr. Haueisen for pain management is appropriate. It should be noted, however, that Dr. Haueisen recommended a discogram at L4.5, stating that the patient had an abnormal MR1 at 4-5. The MRI reports did not indicate that at all. He did document that she had sacroiliac dysfunction, and treatment towards a sacroiliac joint would be appropriate. The physical therapy beyond February 3, 2003 would not be documented to be reasonable or medically necessary. At that time, the patient only had mild tenderness in the left lumbosacral area The medication such as Soma is useful for the treatment of muscle spasms. Vicodin is a commonly prescribed pain medication, and the dosages that were presoribed seemed to be within the normal range. No telephone called was requested by Dr. Hatleberg. Should you have any further questions, please do not hesitate to contact me D,na L wWd4 bt orrhopaodfc swzwn EXHIBIT B • 0 r? mli Pain & D 1o5 e4unlich Dr. (Mtlfniglrt Flet;l sub 0 FltUbt ah. FA 15237 entry Medial lxamlnadons American Avenue 1300 of Pngels, PA 18405 Suzanne Sol Codne Rickabsugh 09115/02 rM Fps N: 128401 Filets: 007904365.01 Tdephansi 412-M-2R4n Facsimile: 412.635.0577 November 12, 2003 I d been eked to perform an Act 5 Peer Review to detamllns the appropriaferisse end recessily, of treatment for tit ate of injury providod by Susquehanna Pain ManagemenvHsalth9outh for Curlna Rickabsugh from W15/02 aq ongoing. 1. Cover latter; 0ua;anme 9ehl. Concor*s Medial Examinations 2. Records fhlm provider under review. Susquehanna Pain MonagsmeM JiftSouth R04valudlon Report 05109/03 PMOMII and Procedure Notes 06/13103 and 07/03/03 3. Records from add lIonai provider. Neurology Center, Inc. Initial Evaluation 07131103 NCS/EMO 07/31/03 Fok*up Note 08121103-05127/03 Preedtl*n 05121/03 Dleignutler MRI of Braln 07/310 MRI of Cervical 07/31193 MRI lumbar Spine 09/01103 MRI of Thoracic Spine 001/03 Lob Report 05/04/03 Joseph A. Pion. DO; Oft Notes 03/24/03 Hu5h5Cuth; Re-Evaluation, Progress and Procedus Notes, and SCripts 009/03-071O3/03 Alosondor Spring Rehab, Inc.; Progress Notes and Consepondenoe 08/0,11103.01125/03 MY Thompson, PA-C; afte Note 07/29/03 Progress Natr not 91g ed 07/31/03 Douglas Law bAlw; ortupondence and Aufhorblon b Disclose Health Information 08121/03 t3oodvllle Mutual Casualty Company; Carroepondence and 111MW Loa ROCW 08115102-05115103 NOV 14 VS; P.C. 12103/2003'04- Is PM - . _..._.. _ _..., . 2 ;oriels Rickabough A File #: 128402 File t 00260436601 0 • try 14= i Health Insurance Claim Fame and Explanation of SeneSb W/24103.09003 4. Records of additional provider: Belvedere Medical Corp ON NOW 02113/03.02/18103 Atbndrlg Physician Rs 10107102 MRI Lumber Spine 10124102 Richard J. Goal, MD; Evaluation Report 10=2 Alexander III Rohob, Inc.; PT Inidal Evaluation, Plan of Can, and Follow-up Evaluations 10/15102• E HeaNhSoulh; Pain Management Wvalustlon 05409/03 j Carilala Regional; Admlulon Record 09/15102 I5. Records of additional provider. Ortho" Institute of PA Was Visit Notes 1012 M-CIV2aro3 Wpb 100/02.0@6/03 OlagneaOae: Lumber Spine X-rays 10122102 Lab Report 10122/02 i MRI of the lumbar Spine 10124/02 i MRI of Thoracic Spine 001/03 MRI of Lumbar spine 06101103 i Cable Regional Medical Carrier; Orthopedic ER Records 09/15102 HubSoulh; Paln ManagemeM Re-Evaluation 07103103 Neurology Center, P.C.; Initial Evaluation, Folbw-up Evaluatiun, and 14061EMt3 07131/03-05/21/03 8. Records of additional provide Alexander Spring Rshab, Inc. progress Noise 10115112.04118103 8110ng 10116/02.041230 So" 10/01/02-04/19103 PkMro of Vehicle 09/23102 Work Excuse 09115/02 7. Records from additional provider. Ooodvllle MubW Casually Company Police Report 09115/02 Ambulance Claim Fors 015/02 ER Recode 09115/02 04no rice; MRI of the Lumbar Spins 10/24102 Orthopedic Institute of PA; Office AsIt Notes and Heath Insurance Claim Forme 10/22102.10129102 Corlne Mol abough Is, according to the records received for rsview, a 36-year-old woman who was MOW In a rr YftIs s cklaM on 09116102. In that motor vehicle acoldsnt, the car In whiall she was driving sustahed a al frontal bnped w11h another vetdcle. The Claimant stated Stet she had the Immediate onset of low back pain, was evaluated at and rate" from the emergency room. She treated with her primary care physician end was n anaillo ft spectilcally Vkodin and Some as a muscle relaxant She was enrolled in physical them. W* iyskal therapy, she underwent waft moM11 of peaslve physlatheraptmate modalities and complained or a We ty of pains and stl5ness. These Included pah in her low back, difNss stiffness, headedte as well a radiation of ialn trio the hip and left loo. Shot made modest pains In physical therapy. 12/03/2003 94:55 PM '' Pei"e 3 R Corine PAsbough tent FOe 8: 129402 C _ FIIeM: : 00280436601 • rjy 14 = can under the care of the provider under review, Susquehanna Pain Management, on 08109103. She olakred of back pain with radiation of the pain Into Mr laps. The doctor evahretlng her, Norman Hauaisen. D.O., d e history of an Loa die* protrusion (The source of this Information Is unclear), The physical examination was rrkable Por pain In her right budook, tenderness over the SI Joint and the absence of motor, sensory or reflex r of redladapalhy. The doctor proscribed Percomt He stated that he felt thin her rymptoms were coming from 44 disc, although he did not appinuidy review her MR, The MIN study of 10/24/02 was normal. On 09/13103, Iaueleen performed a lumber opidunl siarold Injection, again staling that the patient had an MR, which revealed .4.6 Am protrusion' He did not annotate what part of her examination was'suspiclous for in L44 left ulopathy; a she had no decrement in motor, sensory or reflex function, The patient followed up with Dr. rlaen on 07103103. Fallowing the epidural stemlcl injection, she began to complain of 'overall dite weakness.' not appear to be d1flo eM then her other diffuse symptom. It wee attdbuhd m the coNcoehrold, altl?ough msterold myopetity Iwwle to produce proximal gnaterfhan dlital woolmse. The doctor N raow nkdng her, d that she had non•physlotoglc weakness of her left lower extremity and a tremor In her quadriceps. He noted her deep tendon reMxes were symmetrical and no clones was ippreclebd. Ile noted a variation between her d weakness and her normal gift, Because of the vedatlon between her nomination and her symptoms, a well etween her observed abli tles end non-physiologic weakness, he referred her to back to the orihopaedbt and to Amy care physician. ratuming to rare of the orthopsedlst, Dr, Baal, the patient's nemination was notably normal and she was td for a nemlogk evaluation With respect to dlegnoetlc testing, it Is noteworthy that Ms. Ridlabough had a i lumbar MRI on 10124102 and 08101103, a normal thoreclc MRI on 08101103„ a normal MRI of The brain on 03 and a normal cervical MRI on 07/31/03. Additionally, on 07/31/03 she had a normal 1MWNCV study of her ear abremlty, provider under review Susquehanna Pain Managemen/HealOtSouth did request a telephone consuftation prior e rendering of a final determinWon. diapnoale supported by the records received for review Is nonspecific low beck pain complaints with non- dolagie weakness of Ore left lower extremity. There Is no evidence to support the conclusion of lumbar ,ulopathy, a them is no evidence to support the conclusion that the patient had an L43 disc probualon, Olen mailable Irdornation, the performance of the lumbar epidural steroid Injection was not indicated on 07103103. Dr. elsen in follow-up, however, nwgnlnd the Inconsistencies in the history, physical nomination and the nsafs reported symptom and returned the patient's care to her primary are physician. The referral to the tpadla physlelen, Dr. Baal, was not necessary for the are of the patient It was, however, consistent with dard practice. As she had previously been evaluated by Dr. Bowl and Wtuwn to rust have r aurglcrl kwiwi, givmr )mvkxn nornal lumber MR, that rehrrol was not reasonable or nemaory. Dr. Haueteen did not however, refer o the neurologlat, Dr. Todd Samuels. The dlagnosie of Or. Samuels, that Me. Mckabsugh sustained a cerviml contusion and thus had spastic panpanesle is a result, Is unsupported by the database gathered, Including the tal cervlml MR, the normal lumbar MR, lire normal thorede MR, and the normal EMWNCV studies, ft Is worthy that her gift was considered normal by All observer; except for Dr. bamuala, who considered it gametic In m. Dr. SamuoW examinitlon also varied from the examinations of Dr. Baal and Or. Haudesn. Me evaluation of Me patient on 06/09/08 was reasonable and necessary Shen that she wag Marred to ehanna Pain Management at Met lima. The performance of the lumbar epidural steroid Iniectlon was not t 2?0?%fbb3 .Y odne Rlckabough int Flle t 129402 Flo #; 002804365-01 • 0 14 31ig able and necessary given the dance of any significant lesion of the lumber spine to be treated in that rr, The subsequent referral to the orthopeedlet was not reeanobks or necessary. With respect to maximal W Improvement, fie schlevem l: of maximal medkel improvement to some extant depende upon the atrtatning databass that clarifies the absence of sipnhtcent pathology. That database wee not obtained until 08101103. It air why the delay In obtaining those sludlas ooeumid. Hower, following the swift in my opinion me t had reached maximal medical improvement, so the diagnosis was one of nonspecific back pain complaints, would nornnrdly dapect to resolve with the phyeiotherapeudo am sho hod undergone, Clinical Pain Management Chronic Pain: Edited by Troels S. Jensen, MD, DMScl, Arnold publisher, copyright 2003. Intamandonal Pain Management edited by Waldman; WO Sounders publisher, copyright 2000. Neureloole Onniee: Low illack Pain, Wad by Haldeman, Volume 17, Number 1, W.B. Saunders, publisher, February 1999, "Y , , , `'gyp r,.t4 ..1 M. Thoma" , M.D. J Management Physician mete, American Board of Aneetheelolo9y Into of Added Ounfi ieations h Poln Management EXHIBIT C 12/03/2003 04:55 PM ARC MANZION89 M.D., F.A.A. UI 28 e ae771oreole ANe Oe0DNe71tueefve IYIIeMr Ilol,r ewe?af nloreluaeAL aea 777.7LeN WA0. !117111 111 UM Me00N VALM, 7A 1100/ 4210141.71" . ?Ax (r10) %74770 October 23, 2003 SVXM= Sahl, RN Medical Review Specialist CONCENTRA MEDICAL EXAMINATIONS 700 American Avenue Suite 300 King dPrussla, PA 1%06 Re: Corine Rickabsugh ##804363.01 Der Ms, Sebl: I have reviewed the medical records on Conine Rickabaugh which you have provided. The following information was reviewed: Finagency Room fbm Carlisle Regional Medial Center, 9/13/02 Records oPDr. Hatieberg, 9/102 thru 3/12/03 Records from Alexander Spring Rehab, 10/16/o2 thru 8!26/03 Records from the Orthopaedic Institute of Pennsylvania (Dr. Boa!), 10!22/02 thru 8126/03 Report ofMRI scan of lumbar spine done 10/24/02 Records ofM Fhu4cA 319103 thru 7/3/03 Records of Dr. Samuels, 7/31/03 hru 8/27/03 Report of ME scan of brain Repo Of MU scan of horacispine cervical spies done / and hUmbAr Spine done 8/1/03 Police accident report Copy of vehicle photographs Miscellaneous pharmacy records On 9/13/02 he patient was evaluated in the ROWBOecy ROOM of Carlisle Regional Medical Center. At he time of this evaluation the patient was 35-years old. According to this note, the patient had been involved in a motor vehicle accident and was complaining of neck, left shoulder pain, and right lower quadrant pain, As part of this evaluation, x-rays of the thoracic spine were performed- These x-rays were reported to be normal. The patient was discharged from the Emergency Room with the diagnoses of chest wall contusion turd thoracic strum. On 9/16/02 the patient was evaluated by Dr, Hadeberg. Dr, Mdsberg noted that the patient was compWaIng of back pale The patient denied having any pare heslar. Dr. Hadebarg's physical 12/03/2003 04!56-PM s Rr Carina Rickabsugh October 23, 2003 Page 2 exnninetion document no neurologic abnormalities. Dr. Hatleberg disposed a musculosksieW strain and sprain with muscle spasm. On 9/23/02 Dr. Hatleberg noted that the patient was complaining of lower back pain, and also pain and weilmas involving the logo. After examining the patient, Dr, Hatlebft diagnosed a lumbosacral muscle strain On 10/7/02 Dr. Hatleberg re-examined the patient. This examination documented (among other things) a negative Babinaid sign and very brisk reflexes in both the upper and lower extremities, Dr. Hadeberg noted that the hyper-radoxia has been present since 1993. The only diagnosis listed on this date was persistent lumbosacral muscle spasm. Oa 10/16/02 the patient began a course of physical therapy at Alexander Spring Rehab. The records provided document physical therapy at this facility continuing through 4/21/03. On 10/22/01 the patient was evaluated at the Orthopaedic Institute of Pennsylvania by Dr. Baal, Dr. Boil noted that the patient was complaining of back pain, pain involving the buttocks, and palm extending down the left leg, Dr. Bad examined the patient and performed x-rays of the lumbar spine, He Indicated that the x-rays showed a lumbar curvature which Dr. Baal felt was mast likely secondary to muscle spasm. Dr. Boat diagnosed lower back pain with a possible let-sided disc herniation at L4-LS. Dr. Boil recommended that the patient be evaluated with a lumbar MM acan. A lumbar MEU scan was done on 10/24/02. This study was reported to be normal, Dr. Baal re-evaluated the patient on 10/29/02. He noted that the lumbar WE scan was entirely within normal limits. He noted that the patient still had left lower lumber pain. Dr. Boal's physical examination documented that the patient stood with a list and an unlevel pelvis, Be noted let-sided muscle spasm, No other physical examination abnormalities were noted, Dr. Baal specifically indicated that there were no neurologic abnormalities involving the lower vMmides. The only diagnosis listed by Dr. Bad on this date was a lumbar strain. Dr. Boil indicated that that was no indication for sugary. He recommended that the patient follow-up with bar gamily physician, Dr. Ebtleberg re-evaluated the patient on 12117/02, He noted that the patient had been attending physical therapy on a regular bests. The examinatoc on this date documented tenderness in the lower back area. It was specifically noted that the neurologic examination was normal, no patient was diagnosed as suffering from an Improved lumboucnal muscle strain. No other diagnoses were listed, Dr. Hillaberg continued to evaluate the patient on a periodic basis. On 2/19/03 Dr. Hadeberg noted that the patient was making steady progress with physical therapy, He stated that the 12/03/2003 04:56 PM """°' __... __ ..... • • 0,28 k. Re: Coders Rickabaugh October 23, 2003 page 3 patient wanted to return to work The only physical examination abnormality noted was some mild tenderness over the left paraspinal lumbosacral area, Dr. Hatleberg indicated that the patient could return to work on 3/6/03, He stated that the patient would continue with physical therapy after her return to work On 3/13/03 br. Hatleberg noted that the patient had been back to work for four days and had mcparienced a bad flare-up of her lumboucral muscle strain, 'rhe only phydcal examinstion abnormality anted on this date was left puaspieal muscle tenderness and spasm. The only diagnosis listed on this date was a lumbomc nd muscle wain. On 4111/03 Dr. Hatleberg noted that the patient had been able to return to work. He stated that the patient was rw longer attending physical therapy. His examination documented tenderness In the left peaapinat region. He also noted hyper-reSexia which he again indicated was normal for the patient. No other physical examination abnormalities were noted. Dr. Hateberg diagnosed an improving lumbosacrai muscle strain On 4/17/03 Dr. Hatleberg noted ongoing complaints of lower badk pain He indicated that tbere was pain In the left sacroiliac joint and pain in the lower sacrum area. No sprAc physical examination abnormalities were noted. Dr. Hatleberg listed his diagnostic assessment as "chronic back pats status-post MVA." It should be noted, however, that this is not a diagnosis indicative of any specific pathology, but Is rather a reiteration of the patient's histoty and subjective complaints, On 519103 the patient was evaluated by a pain management specialist, Dr. Hausnsen. Dr. Haueisen indicated that an MItI scan of the lumber spine had been performed Lad this showed evidence of an L4-L5 disc protrusion1berniation. The records which I previously summarized would not support this ootdention. After examining the patient, Dr. Haueisen listed his diagnostic impression as lower back pain with significant lumbar spasms. Dr. Haueisen felt that the patient's symptoms were coming fl'om L4-LS diet pathology. It is clear, however, tom the results of the previously performed lumbar MRI seen that this patient was not suffering from any clinically significant lumbar disc pathology. On 713/03 Dr. Hau"a re-avaluated the patient. He indicated In tiffs note that a lumbar epidural injection had beta performed on 6/13/03. He stated that following the injection, the patleot's hip felt better, but subsequently, the patient experienced overall ,diffuse weakness. Following this examnation, Dr, Hau lsen commented that there were some Inconsistent findings and be recommended a neurological evaluation including an EMG study. He also indicated that an orthopedic evaluation would be warranted, As I have already noted, Dr. Boat had previously evaluated the patient on two separate occasions and following his last evalulon, he recommended that follow-up be performed by the patient's fuWy physician. 12/03/2003 04:57 PM • n U Re; Carina Rickabaugh October 23, 2003 Page 4 On 7/29/03 the patient was rs-evaluated by Dr. Baal. According to this note, the patient was complaining of back pain, pain extending into the buttocks, and pain extending down the leg. Dr. Baal's physical examinadon documented left lumbar tenderness and a marked decrease in lumbar motion. No other physical examination abnormalities ware noted. Dr. Baal listed h]s diagnosis a "low back pain." Again, it should be noted that this is not a diagnosis indicative of any specific pathology, but is rather a reiteration of the patient's subjective complaints. Dr. Baal recommended a repeat MRI scan of the lumbar spine and evaluation by a neurologist (which bad already been recommended by Dr. Hausisen). On 7/31/03 the patient was evaluated by a neurologist, Dr, Samuels, Dr. Samuels' physical examination documented hyper reflexia at the knees, it positive LAB Bsbinak] sign, and a positive right Hoffmann's sign. He also noted bilateral aalde clone. Dr. Samuels fait that the patient was suil"ering &am spastic paraparesis. He ordered additional diagnostic studies. On 7/31/03 Dr. Samuels performed electrodiagnostic studies of the left lower extremity. He indicated that these were normal. On 7/31103 MU scans of the brain and Cervical spine were performed. These studies were reported to be normal. . On 8/7/03 MRI scans of the thoracic spine and lumbar spine were perfonned. These studies were reported to be normal. On 8/21/03 Dr. Samuels noted that the patient was still experiencing lower back pain and 1011108 Pain He commented on the results of the MRI scans. He indicated that the physical examination showed evidence of spastic parapmesis. He suspected that the patient had sustained a spinal cord contusion In the 9/13/02 accident. On SM/03 Dr. Baal re-evaluated the patient. His physical examination documented lower extremity clonus. No other physical examination abnormalities were noted. The only diagnosis listed by Dr. Baal on this date was low back pain. Dr. Baal again commented that surgery was not indicated. He recommended that the patient return on an a needed basis. On 8/27/03 Dr. Samuels reevaluated the patient. He commented that the patient had a spieal cord contusion and this would take several months to heal. I will answer the questions which have been asked in the cover letter based on the assumption that the information contained in this file is accurate. Dr. Goal saw the patient on two occasions in the early stages following the motor vehicle accident. Following his examination on 10/29/02, he diagnosed a lumbar strdn and recommended that the patient fillow.up with bar Amity physiciza. Dr. Boa] did not note any 12/03/200104:57 PM Rr: Codoellu"augh October 23, 2003 Page 5 musculoskeleal problems on 10/29/02 which would necessitate Luther evaluations or treatment by an orthopedic surgeon, Even if one were to assume that the patient did sustain a cervical spinal cord contusion (a suggested by Dr. Samuels), this is not something which would necessitate evaluation and treatment by an orthopedic surgeon In July of 2003. This type of problem is best managed by a neurologist and indeed the patient was being teen by a neurologist in July of 2003. The records provided do not support the contention that the patient sustained any musculoskeletal injury on 9/15/02 which would necessitate evaluation or treatment by an orthopedic surgeon beginning in July of 2003 (particularly when one considers that the patient lad already been evaluated on two occasions by Dr. Boal in October of 2002). In my opinion, the treatment rendered by Dr. Bow (i.e. Orthopsedic Institute of Pennsylvania) through 10/29/02 was appropriate and necessary for musculoskeletal injuries sustained on 9/15/02. In my opinion, none of the other tr atment rendered by Dr. Bow was appropriate or necessary with respect to specific musculodtehetal injuries sustained on 9/15/02. In my opinion, the length of treatment by Dr. Boil, which Is documented in these records, was not appropriate given the nature of the musculoskeletal injuries sustained on 9/15/02. In my opinion, the only treatment by Dr. Boal which was appropriate and necessary for injuries sustained on 9/15/02 was that treatment rendered through 10/29/02. I note from the cover letter that Dr. Boil did not with to discuss this case with me Thank you for asking me to review these records, Sincerely, fM one, M.D. dm EXHIBIT D 3/2003 04:55 FM KATMENNETT•LEVIN NEUROLOGY ASSOCIATES, P.C, RICHARD I, KATZ, M,D. RICHARD H. BENNETT, M.D, ALBERT EINSTEIN MEDICAL CENTER, NORTHERN DIVISION HOWARD llVIN, M.D. KIAIN SUIIDINO, SUITE ADS $401010 YORK ROAD PMIIADUPHM, PA 191 d l 21532A-3300 1`0 71 3.3240150 October 6, 2003 Suzanne Sehl Concentra Medical Examinations 700 American Avenue Suits 300 King of Prussia, PA 19406 RX: CORINZ AICXARAUC$ Dear Ms. Sehl: I received the following medical records Pertaining to Corine R ickabaugh. Ms. Rickabaugh is a 35-year-old female who was involved in a cle accident dated 9/15/02, The foll medical recordstwereereviewed pertaining to treatment rendered bygDr. Todd Samuels. The following is a summary of the records received. The reports from the Carlisle Regional Medical Center were reviewed. Ms. Rickabaugh was evaluated on 9/15/02. The records indicate she was an unrestrained driver involved in a motor vehicle accident and diagnosed with chest wall contusion and thoracic strain. X-rays of the chest were negative. X-rays of thoracic spine were negative. The medical records from the Belvedere Medical Corporation, Internal Medicine were reviewed. Ms. Rickabaugh was seen on 9/16/02 complaining of back pain. Her examination was normal otherwise. There was a history of asthma. She was provided a note for work. She was given medications, i.e., Soma Compound and Vicodin without refills. A report from the Orthopedic Institute of Pennsylvania dated 10/22/02 was noted. Ms. Rickabaugh was evaluated by Richard Boal, M.D. A chief complaint of back pain was noted. The history states she had problems with her back in the past. Her examination on this occasion was unremarkable, although she was reported to have weakness in dorsiflexion of the left foot and a possible disk herniation was suggested. An MRI was recommended and a predn13one 2407 E. AU10HENY AVENUE, PHIIADEIPHIA, PA 10134 EINSTEIN CENTER 1, 9880 SUSTIETON AVENUE AT HAIDEMAN, PHIIADRIPMIA, PA 19 115 12/03/2003 04:56 PM RZ : CORlNE RICKnA17tia dV 81 gm 10/06/03 PAOS TWO Dosepak was provided. A follow-up note dated 10/29/02 was reviewed. Ms. Rickabaugh was noted to have undergone an MRI of the lumbar spine. The diagnosis was now lumbar strain. The MRI was reported to be within normal limits. The reports from Alex Spring Rehab were reviewed. Ms. Rickabaugh was referred for physical therapy and received treatment from 10/16/02 to 4/21/03. A report from Todd Samuels, M,D „ a neurologist dated 7/31/03 was reviewed. Dr. Samuels evaluated Ms. Rickabaugh having been referred for a neurological consultation by Richard Boal, M.D. She had complaints of lower back pain radiating towards the left leg down the posterior thigh to the left heel. There was a remote cervical .spine according to herb history. n Therphysical o examination rrev back aledano sensory deficits, full strength in both upper and lower extremities. She reportedly had a left Babinski sign and hyperreflexia in the lower extremities. There was sustained ankle clonus bilaterally. There was a tremor in the left lower extremity with spastic gait. Dr. Samuels ordered cervical, thoracic and brain MRI, as well as a metabolic work-up. The report dated 8/21/03, Dr. Samuels states that the diagnostic imaging, i.e., MRI of brain, cervical and thoracic spine, as well as lumbar MRI were all normal. Nevertheless he implied that there was a cervical spinal cord contusion and a spastic paraparesi.s. This appears to be impossible based upon Ms. Rickabaugh's complaints, the mechanism of the accident and her previous examinations. A spinal cord contusion would imply that there was a serious problem to the cervical cord. Complaints at the time of the accident were chest wall contusion and a thoracic sprain followed by lower back pain. Dr. Samuels prescribed baclofen for spasticity. A follow-up report dated 8/27/03 was noted. Dr. Samuels implied'. that Ms. Rickabaugh again had a spinal cord contusion that would take several months to heal and she was unable to return to work as a teachers aide. He also implied that she would resume physical therapy. Dr. Samuels' comments appear to be unsupported once again by the medical facts as noted. A report of an MRI of the lumbar spine dated 8/1/03 was noted to be normal. An MRI of the thoracic spine dated 8/1/03 was noted to be normal. A chemistry profile ordered by Dr. Samuels dated 8/4/03 including cardiac and thoracic studies, vitamin Bci, and folic acid level, studies which have nothing to do with investigating the medical 12/03/2003 04:56 PM • • or 31 va • Ra: CORi11Z RZCRAUV= 10/06/08 PAU TZUZ condition of Ms. Rickabaugh as a result of the accident in question. A report from Alex Spring Rehab dated 8126102 was noted. The follow-up reports from the Salvador* Medical Group were reviewed. A report of 9/16/02 indicated that she was a passenger in the front seat of a car that had been involved in an accident on 9/15/02. She was complaining of lower back pain. There was no loss of consciousness. She ambulated without assistance. There was a negative straight leg raising. There was tenderness in the lower back radiating from the right side. The neurological examination was noted to be normal. Follow-up report dated 9/23/02 was also noted to have a normal neurological examination. The diagnosis was a muscle strain indicated on 10/31/02. An exacerbation of asthma was reported on 2/3/03 with severe coughing. on 3/19/03, a diagnosis of lumbosacral muscle strain was again reported to be present. A report from pain management, i.e., Health Soilth Rehabilitation of Mechanicsburg dated 5/9/03 was noted. A report from Norman Heaudisen, D.O. felt the problems were related to an L4-5 disk causing diskogenic pain. Dr. Heaudisen indicated to Ms. Rickabaugh at the time that he would not provide her with chronic pain medication. The MRI of the lumbar spine report dated 10/24/02 was noted to be normal. An EMG report from Todd Samuels dated 7/31/03 was noted to be normal. Based upon my review of medical records, Carina Rickabaugh was involved in a minor motor vehicle accident date 9/15/02 from which she may have sustained a lumbar strain/sprain. There was no indication that she sustained serious internal injuries involving the nervous system. There is no indication to support a brain or spinal cord traumatic contusion. One would anticipate based upon the nature of the accident itself, Ms. Rickabaugh's complaints, and response treatment, a full recovery would have been anticipated to occur within 8 to 12 weeks at the maximum from the date of accident. The medical records from Dr. Todd Samuels were reviewed. Dr. Samuels implied that there was a cervical spinal cord contusion. This would be impossible based upon the mechanism of accident noted and the records reviewed. Dr. Samuels' involvement in Ms. 12/03/2003 0456 PM • der a I = RSS CORiNS RTC8ABAUGH 10/06/03 PADS POUR Rickabaugh's care did not take place until nearly eight month's from the date of accident. His evaluations of 7/12/03, 8/21/03 and 8/27/03 appear to be neither appropriate or necessary in so far as the evaluation of the condition of Ms. Rickabaugh stemming from the motor vehicle accident of 9/15/02. Likewise, inappropriate was the acquisition of an MRI of the brain, cervical and thoracic regions and an EMG for the accident of 9/15/02. I can be of further help or if specific issues need to be addressed, please feel free to contact me. Sincere yo RICHARD H. BENNETT, M.D. RHB/09; EXHIBIT E 12/03/2003 04:57 PM"" _ • • J•y A KBIIIIII llAn, MBA, IPT '11 Dwa/arsRoad' Law"' PA 1P 41f 015) 074951 Phone and,/bx Octoba 14, 2003 Suaw" 90111, RN Conoantre Medical Examim ions 700 American Avenue, Suite 300 1014 of Prussia, PA 19406 RE: Corlne Rickabaugh Account File IN: 129402 CME (rile 0: 002404326.01 I uww: Sartre DOA: 9/15/02 Deer W. 90h1: At your request, I have performed a physical therapy peer review rcconsidum0vn in regards to the treatment rendered to Co&e Rickabaugh by Alexander Spring itchah. 'Ilu: following doeumentedca was provided for my review: 1 • A police accident report for the date 9/15/02. 2• A billing statement from Breaches EMS, Inc, dated 9/15/02. 3• Emergency mom documents from the Carlile Regional Medical ('enter dated 9/15/02, 4• Medical documentation from Belvedere Medical Corp for the dates 9/16/o2 as well as billing statements for the dates 9116102 through 4117103. 5. An MRI of IM lumbar spine dated 10/24/02. 6. Medical doctIments from the Orthopedic Institute of Pennsylvania liar the dates 10/22/02 through 10/29/02, along with corresponding billing statement,, 7. Physical therapy documentation tow Alexander Spring Rehab for thu dales 10/16V2 through 4/25/03, along with multiple billing statements, 4• Multiple pharmaceutical prescription receipts from the K-Man Phartnncr. 9. Copies of the vehicle involved in the accident. FUSTORY: Collins Rickabangh Is a 3S-year old female who was Involved In a motor vuhiclc accident on 9/15/02, It to a documented ae a vehicle that sustained that at that time, the patient ml,head on Impact, was the restrained Rasscnger in complained of pain afiietlag the right shoulder, cheat, elbow Following hendere hand, incident, along w flu Willi p;rtiunt beXc lower ack ps Mw patient noted that the Iowa back pain extended into thu lower "Iron d ?a?y' the Patient did note intermittent left calf and Coot pain wirh 11110611015 and a bueling sensation; Along with radiation of symptunts inns tiu Off 20= 12/03/2003 04:59 P R$: Corine Riclubaug5 I'ugc 3 'October 141 2003 right lower extremity. It was Author documented that the patient reported falling secondary to the lower extremity symptoms. The patient's past medical history is significant for interstitial cystitis, as well u. tan appendectomy, vaginal hysterectomy, asthma, erthritls, bilateral carpal tunnel surgery in 1986 and she was on elorpeetin therapy, COURSE OF TREATMENT: As Indicated above, this patient received multiple medical evaluations. 'I'he puticnt alma received diagnostic studies and an MR1 of the lumbar spine. Tlds MRI was completed an 10/24/02. The conclusion at that time was a normal lumbar h4RI; however, her history wait noted to be significant for a 1.4-5 herniated nucleus pulposus on the left. In addition to this, the patient was referred for a coarse of physical therapy, physical therapy treatments were tendered by Alexander Spring Rehab. An initial physical therapy evaluation was completed on 10116102 by Shelly Bitnor, PT. On this date an in-depth musculoskeletal evaluation was completed. Following this evaluation, the puticnt tank part in a physical therapy program. This program lasted from 10/16/02 and cuntinuv%l through 7/16/03. During this time, the patient's care included manual therapy tachniquc,.s in the form of myofaselal release. Her care also included manual traction techniques tn,d joint Mobilization. The patient's treatment was documented on a daily basis throual, handwritten SOAP notes. Physical therapy progress notes were also offered. These progress notes are dated IV17/020 1/15/03, 2/13/03 and 4/13/03. 1 was also tsflLrcd n letter written by Shelly Bitner, PT dated 8/26/03, requesting it reconsideration at' lhis case. This latter also detailed the patient's response to treatment. It is important to note that this letter tvf rencad physical therapy treatment notes and examinations heyond 4/21/03, However, I do not have physical therapy notes to be reviewed beyond 8/25/0.1. ANALYSIS AND CONCLUSIONS: The following analysis is based on the information available for nay review, It is io he understood that this analysis in presented without a physical examination nNhc puticnt. It is my professional opinion that the treatment tendered to Corinc Rickubaugh by Alexander Spring Rehab from 10/16/02 through 5/13/03 would be considered rcosonahle. To begin, physical therapy Is an establishedtreatment protocol given this diagnosis. '17u patient's diagnosis included lower back pain with radiating symptoms into the lower extremity. Physical therapy treatments may include manual traction techniques, joint mobilizations and myof scial release. Prior to beginning a course of physical therapy. the therapist provided an In-depth musculoskeletal evaluation. This evalumion documanted significant physiologic and functional deficits which could be linprnvcd through a souse of skilled therapy. It had also outlined goals which were to be rcisched through a course of physical therapy. The evaluation, assessment and goals were appropriste aed consistent with the patient's complaints. Physical therapy truaununts were documented approptisteiy on a daily basis through SOAP notes. In addition to this. 12/03/20 3 a R9. Coriaa Ricksbaugh October 14, 2003 1141g1 :3 re-evaluttiom wen offered, and the data of these evaluations were noted above, '1'11c Physical therapy notes and evaluations indicate that the patient did steadily improve through a coarse of skilled therapy. It is my professional opinion, however. that there is Insufficient documentation to justify ongoing care beyond 5/13/03. Specifically. then were no in-depth re-evaluations offered beyond 4/13/03. The care rendered through 5/13/03 is justified by the ro-assessment completed on 4/13/03. In addition to this, ilia phyalcal therapy notes indiew that this patient bad ongoing complaints of pain that wciv not resolving with continued therapy. Based on the documents offered for my rcviu%. the patient's stars had plateaued. The patient did not demonstrate any improvVmcnt wills her complaints of pain, range of motion or strength. In spite of the lack of progres. therapy was continued, Olven this information, it is my professional opinion than they is insufficient documentation to justify say ongoing treatments beyond 5/13/03. As requested, a telephone conversation took place with this provider. Specifically. I spoke with Shelly Bimer, PT on 10106103. We discussed this patient's truaunent and response to treatment as well as a detailed discussion regarding the content rat' the physical therapy daily notes and re-evaluations. We also included in our discussion tl,c length of time that this patient was seen in physical therapy, In Summary, it Is my professional opinion that the treatment rendered to ('urine ftickabaugh by Alexander Spring Rehab from 10/16/02 through 5113103 would he considered reasonable. The patient's treatment and response to treatment was appropriate given the patient's diagnosis and subjective complaints and the information ol'lewd lior my review does indicate that the patient was making steady progress as a direct rcsuft of the spy rendered. It is my professional opinion; however, that at this time there is insufficient documentation to justify any ongoing skilled physical therapy intervenliun beyond 3113103. This conclusion is supported by standards set forth by the nmcrican Physical Therapy Association as documented in the APTA"s Guide to Coding and Payment and APTA's Oulde to Physical Therapy Practice. I would like to dm* you for allowing me to perform this review, for you. Sincerely, ,!?; -P <l?oy;, lay D- Xsuf huu% PT, MBA IDK.jk 12/03/200104:S7 PM --- --••- 9 • BlblloSmphyt •+Amd"n Phy&ical ThmPY Anocitdon'a Q]j j ? stud Payment 1994 Acnodoa Physical 71OMPY Agociedoa'i 6l."- m Phv.f ?.ti-- "ti 1. Aeaed lod20Thwvy Associadotl' a ?'??97 ,uul 00/27184 13:09:14 08!27/200410:40 AM 08!$6/~3:¢4?!RM 717-354-5158-> 7175335717 VERWICATION PAGE 09 1, Glen E. Hess, Sr. Claims Representative for Goodvdle Nrutual Casualty Compa%. being duly authorized to do so. ven$ that the statements made in the foregoing document are truc and con ect to the best of my knowledge, information and belief. GOODVILLE MUTUAL CASUAT TY CO. Date 08/27/04 By. Glen E. Henn 7175335717 Page 002 CERTIFICATE OF SERVICE' I, Karl R. Hildabrand, Esquire, of the law firm Nestico, Druby & Hildabrand, LLP, on this -? day of August 2004, hereby certify that I served a true and exact copy of the foregoing document as follows: By First Class Mail, Postage Pre-paid: William P. Douglas, Esquire Douglas Law Office 27 W. High Street P. O. Box 261 Carlisle, PA 17013 NESTICO, DRUB Y & HILDABRAND, L.L.P. ' dY By C' Karl R. Hildabrand CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term CIVIL ACTION - AT LAW JURY TRIAL DEMANDED DEFENDANT'S PETITION TO COMPEL PLAINTIFF CORINE A. RICKABAUCH TO SUBMIT TO A PHYSICAL EXAMINATION BYA PHYSICIANPURSUANT TO 75 Pa.C.S..$1796 On or about September 15, 2002, at approximately 2:45 p.m., Plaintiff Corine Rickabaugh, while riding as a passenger in a car driven by Bryan Rickabaugh, was involved in a two-vehicle collision on a one-lane bridge with a vehicle operated by Phyllis A. Henry. The accident occurred on Bundt House Road, approximately three (3) miles northwest of Mt. Holly Springs. 2. As a result of the aforesaid collision, Corine Rickabaugh was transported by ambulance to Carlisle Regional Medical Center where she was treated in the emergency room and released. The diagnosis at the time of treatment was contusion of the chest wall and thoracic strain - post-motor vehicle accident. X-rays of the chest were negative. X-rays of the thoracic spine were normal. 3. On October 24, 2002, an MRI of the lumbar spine was conducted and found to be normal with no evidence of herniation. 4. There is some indication in the medical records which have been obtained from Plaintiff's medical providers that the Plaintiff had upper lumbar and thoracic problems prior to the accident, a long history of back pain, and an exacerbation of her back after the motor vehicle accident. 5. The Plaintiff underwent a course of treatment for complaints of back pain with Stephen Hatleberg, M.D., whom she saw on September 16, September 23, and October 7, 2002. 6. On July 21, 2003, a peer review was conducted of Dr. Hatleberg's treatment by Dane K. Wukich, M.D. A copy of the peer review report by Dr. Wukich is attached hereto, incorporated herein by reference, and marked as Exhibit A. 7. Dr. Wukich concludes in that report that Ms. Rickabaugh "noted a long history of back pain." His diagnosis was a "lumbosacral strain." The MRI of October 24, 2002, showed the lumbar spine to be entirely normal. Dr. Wukich concluded: Summary: After reviewing these medical records, it is my opinion that the treatment rendered by Dr. Stephen Hatleberg is documented to be appropriate and medically necessary for the September 15, 2002 accident. The treatment that I have reviewed up to May 27, 2003, is documented to be reasonable and medically necessary. The referral for physical therapy which took place on October 16, 2002, would be considered reasonable and medically necessary. The duration of physical therapy in this particular case should be no more than three (3) months. This patient had a normal MRI and normal neurological examination. There are no unusual circumstances to warrant physical therapy beyond a three (3) month program. . . . . Physical therapy beyond February 3, 2003, would not be documented to be reasonable or medically necessary. At that time, the patient only had mild tenderness in the left lumbosacral area. 8. Corine Rickabaugh was referred by Dr. Hatleberg for physical therapy and pain management at Susquehanna Pain Management/HealthSouth. 9. The peer review report was submitted dated November 12, 2003, from Stephen M. Thomas, M.D., regarding this treatment. Attached hereto, incorporated herein by reference, and attached as Exhibit B is a copy of Dr. Thomas' report. 10. Dr. Thomas concluded, in part, as follows: The diagnosis supported by the records received for review is non-specific low back pain complaints with non-physiologic weakness of the left lower extremity. There is no evidence to support the conclusion of lumbar radiculopathy, as there is no evidence to support the conclusion that the patient had a L4-5 disc protrusion. Given the available information, the performance of the lumbar epidural steroid injection was not indicated on 07/3/03.... The referral to the orthopedic physician, Dr. Boal, was not necessary for the care of the patient.... The diagnosis of Dr. Samuels, that Ms. Rickabaugh sustained a cervical cord contusion and thus had spastic paraparesis as a result, is unsupported by the database gathered, including the normal cervical MRI, the normal lumbar MR], the normal thoracic MRI, and the normal EMGlNCV studies.... Thus, the evaluation of the patient on 05/09/03 was reasonable and necessary given that she was referred to Susquehanna Pain Management at that time. The performance of the lumbar epidural steroid injection was not reasonable and necessary given the absence of any significant lesion of the lumbar spine to be treated in that manner. The subs-quent referral to the orthopedist was not reasonable or necessary. With respect to maximal medical improvement, the achievement of maximum medical improvement to some extent depends upon the obtaining of the database that clarifies the absence of significant pathology. That database was not obtained until 08/01/03. It is unclear why the delay in obtaining those studies occurred. However, following the studies, in my opinion, the patient had reached maximal medical improvement, as the diagnosis was one of nonspecific back pain complaints, which would normally expect to resolve with the physiotherapeutic care she had undergone. 11. Ms. Rickabaugh also treated with Richard J. Boal, M.D. On October 23, 2003, Marc Manzione, M.D., performed a peer review of Dr. Boal's services. Attached hereto, incorporated herein by reference, and attached as Exhibit C is a copy of Dr. Manzione's October 23, 2003 report. 12. Dr. Manzione concluded in his report as follows: Dr. Boal saw the patient on two occasions in the early stages following the motor vehicle accident. Following his examination on 10/29/02, he diagnosed a lumbar strain and recommended that the patient follow-up with her family physician. Dr. Boal did not note any musculoskeletal problems on 10/29/02 which would necessitate further evaluations or treatment by an orthopedic surgeon. Even if one were to assume that the patient did sustain a cervical spinal cord contusion (as suggested by Dr. Samuels), this is not something which would necessitate evaluation and treatment by an orthopedic surgeon in July 2003. This type of problem is best managed by a neurologist and indeed the patient was being seen by a neurologist in July 2003. The records provided do not support the contention that the patient sustained any musculoskeletal injury on 09/15/02 which would necessitate evaluation or treatment by an orthopedic surgeon beginning in July 2003 (particularly when one considers that the patient had already been evaluated on two occasions by Dr. Boal in October 2002). In my opinion, the treatment rendered by Dr. Boal (i.e., Orthopedic Institute of Pennsylvania) through 10/29/02 was appropriate and necessary for musculoskeletal injuries sustained on 09/15/02. In my opinion, none of the other treatment rendered by Dr. Boal was appropriate or necessary with respect to specific musculoskeletal injuries sustained on 09/15/02. In my opinion, the length of treatment by Dr. Boal, which is documented in these records, was not appropriate given the nature of the musculoskeletal injuries sustained on 09/15/02. In my opinion, the only treatment by Dr. Boal which was appropriate and necessary for injuries sustained on 09/15/02 was that treatment rendered through 10/29/02. 13. Dr. Boat referred the Plaintiff to Todd Samuels, M.D., a neurologist, who saw Corine Rickabaugh on July 31, 2003. Peer review report of Richard H. Bennett, M.D., dated October 6, 2003, which is attached hereto, incorporated by reference herein, and marked as Exhibit D, commented upon Dr. Samuels' treatment and expenses for treatment as follows: Dr. Samuels ordered cervical, thoracic, and brain MRI, as well as a metabolic work-up. The report dated 08/21/03, Dr. Samuels states that the diagnostic imaging, i.e., MRI of brain, cervical and thoracic spine, as well as lumbar MRI were all normal. Nevertheless, he implied that there was a cervical spinal cord contusion and a spastic paraparesis. This appears to be impossible based upon Ms. Rickabaugh's complaints, the mechanism of the accident, and her previous examinations. A spinal cord contusion would imply that there was a serious problem to the cervical cord. Complaints at the time of the accident were chest wall contusion and a thoracic sprain followed by lower back pain.... Dr. Samuels implied that there was a cervical spinal cord contusion. This would be impossible based upon the mechanism of accident noted and the records reviewed. Dr. Samuels' involvement in Ms. Rickabaugh's care did not take place until nearly 8 months from the date of accident. His evaluations of 07/12/03, 08/21/02, and 8/27/03 appear to be neither appropriate or necessary insofar as the evaluation of the condition of Ms. Rickabaugh stemming from the motor vehicle accident of 09/15/02. Likewise, inappropriate was the acquisition of an MRI of the brain, cervical and thoracic regions, and an EMG for the accident of 09/15/02. 14. Finally, Corine Rickabaugh sought treatment in October 2002 at Alexander Spring Rehab. J.D. Kauffman, M.B.A., P.T., provided a peer review of these records and bills. Attached hereto, incorporated herein by reference, and marked as Exhibit E is a copy of the report dated October 14, 2003, from Mr. Kauffman. He concluded as follows: It is my professional opinion that the treatment rendered to Corine Rickabaugh by Alexander Spring Rehab from 10/16/02 through 05/13/03 would be considered reasonable.... It is my professional opinion; however, that there is insufficient documentation to justify ongoing care beyond 05/13/03. . . . Based on the documents offered for my review, the patient's status had plateaued. The patient did not demonstrate any improvement with her complaints of pain, range of motion or strength. In spite of the lack of progress, therapy was continued. 15. Based upon the foregoing peer review reports, Defendant Goodville has paid some of Corine Rickabaugh's medical expenses and declined to pay others. 16. Corine Rickabaugh has filed the within action against Goodville, attempting to assert contractual and bad faith theories. 17. Corine Rickabaugh continues to consult physicians for her condition and, in fact, on or after July 27, 2004, Defendant Goodville received a bill from the Internists of Central Pennsylvania for a new visit which Corine Rickabaugh had with them. Attached hereto, incorporated herein by reference, and marked as Exhibit F is a copy of the note from the Internists of Central Pennsylvania and the accompanying bill. 18. Defendant believes that the Plaintiff is misrepresenting her medical condition as documented by numerous physicians who have reviewed her records and treated her as indicated above in order to continue to receive medical treatment for which bills are submitted to Goodville. 19. Defendant Goodville believes that the medical reports generated to date indicate that the Claimant sustained a sprain/strain injury from which she should have recovered by now. Furthermore, there are serious issues of pre-existing neck and back pain which may be precipitating the complaints which the Claimant continues to raise at this time. 20. Based upon the medical records, reports, and information reviewed by Goodville to date, it is believed that the Claimant has made a full recovery from any injuries sustained in the motor vehicle accident in question and that her ongoing treatment may be completely unrelated to the motor vehicle accident in question. 21. Defendant desires to have the Plaintiff submit to an independent medical evaluation by an orthopedic surgeon of its choosing, John S. Rychak, M.D., 99 November Drive, Camp Hill, Pennsylvania, as soon as possible to obtain a full medical evaluation of the Plaintiff's physical condition, the state of her recovery, the reasonableness and necessity of further medical treatment, and whether or not any of the complaints registered by the Plaintiff at this time are due to other medical conditions unrelated to the accident in question. 22. Defendant believes that there is substantial and sufficient good cause for the Court to direct the examination. WHEREFORE, Defendant Goodville Mutual Casualty Company respectfully requests this Honorable Court enter an Order, pursuant to 75 Pa.C.S. § 1796, directing that Plaintiff Corine Rickabaugh submit to an independent medical evaluation by John S. Rychak, M.D., or another duly-qualified orthopedic surgeon selected by Defendant within ninety (90) days of the date of this Court's Order. Respectfully submitted, Date: NESTICO, DRU?BY & HILDABRAND, L.L.P. By: - 4, 1 R. Hildabrand, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Attorney for Defendant fW/2003 04:59 PM July 21, 2003 9 DANE K WU"CH, M.D. Board Certified Orthopedic Surgeon Practice Limited To Orthopedic Surgery Concentra Medical Examinations 700 American Avenue Suite 300 King of Prussia, PA 19406 Attention: Suzanne Sehl, RN, Medical Review Coordination RE: CORINE RICKABAUCH CLAIM #: 129402 OUR FILE #: 002803882-01 Dear Ms. Sehl: =ZIsm At your request, I reviewed the medical records that you forwarded to me regarding the claimant, Ms. Rickabarigh. The purpose of this review was to determine if the treatment was medically appropriate and medically necessary as it pertains to an injury of September 15, 2002. The following medical records were reviewed: 1. Police accident report. 2. Bills from the ambulance company. 3. Emergency room record dated September 15, 2002. 4. Belvider Medical Group, September 16, 2002 through May 12, 2003. 5. MRI report of the lumbar spine dated October 24, 2002. 6. Orthopedic Institute of Pennsylvania, Dr. Richard Boa], dated October 22, 2002 and October 29, 2002. 7. Alexander Spring Rehabilitation, October 16, 2002 through April 21, 2003. 8. Bills from the pharmacy. 9. Photographs. 10. Norman Haueisen, D.O., pain management, dated May 9, 2003. REPORTED HISTORY 12/03/2003 04:59 PM RE: RICKABAUGH, COt# «• = JULY 21, 2003 PAGE2 0 a II= Synopsis: These medical records reflect that the patient was involved in a motor vehicle accident on September 15, 2002. The examinee was treated in the emergency room on the date of admission. The emergency room records reflect that the patient was an unrestrained driver in a motor vehicle accident with it head-on collision. The patient noted a long history of back pain but felt stiff. At that time, the patient was examined and was found to have thoracic tenderness, They did not document any lumbosacral tenderness. X-rays of the chest and thoracic spine were entirely normal. The patient was treated and released. Subsequent to this, the following day, the patient was seen by the Belvider Medical Group. At that time, she complained of right-sided pain. She was unable to take anti-inflammatory medications because of an exacerbation to her asthma. The only medication that she could tolerate was Vicodin. At that time, they examined her and found that she had mid thoracic tenderness to palpation and right lower paravertebral muscle tenderness. She had tenderness with flexion of the right hip. At that time, she was given a prescription for soma and Vicodin. Re-evaluation took place on September 23, 2002. She indicated that her right leg had buckled. She had hyperreflexia; but this was known to have been present since 1993. At that time, soma was discontinued and the patient was begun on Ativan. Vicodin was refilled. On October t 2002, she was re-evaluated. At that time, she was referred for physical therapy to Alexander Spring: Rehabilitation. She was subsequently evaluated by Dr. Richard Boal, an orthopedic surgeon. He was concerned about the possibility of a herniated disc at L4.5. He initially evaluated the patient on October 22, 2002 and then referred the patient for an MRI on October 24, 2002. The HE of the lumbar spine was entirely normal. He saw the patient back in follow-up on October 29, 2002 and felt that the patient should continue physical therapy and have follow-up with the orthopedic surgeon. He also prescribed Prednisone. On October 31, 2002, she was diagnosed to have a lumbosacral strain by her primary care physician. On November 14, 2002, she was re-evaluated, and Vicodin was prescribed with one refill. On December 17, 2002, she was re-evaluated for her lumbosacral strain which was improved. Vicodin was given in the form of 30 tablets. She was taking Prednisone for asthma. On January 10, 2003, she was seen for evaluation of low-grade fevers.' On February 3, 2003, she was seen again for an upper respiratory tract infection, an exacerbation of asthma, and a lumbosacral strain, which was worse with coughing. On February 19, 2003, her asthma was doing much better. She had some mild back tenderness with palpation of the left paraspinal lumbosacral area and seemed to be much improved. At that time, she was given a note to return to work on March 6 and continue physical therapy. She was re-evaluated again on March 13, 2003, She was given a work excuse for being out of work for another month. She was given Vicodin, 30 tablets. She indicated that she had been back at work for four days and had a bad flare-up of her back pain. She had radicular pain. On April 11, 2003, she was able to return to herjob at school. She was not taking physical therapy. She had some problems with lumbosacral spasm and radicular pain going to the left foot. Soma helped. 12103(2003 04:59 PM y RE: RICKABAUGH, CO Al JULY 31, 2003 RM • AN 1 1 aW PAGE3 At that time, she was prescribed soma once again. On April 17, 2003, she was re-evaluated. Zanallex was prescribed for muscle spasm and Darvocet. It was recommended that she be seen in the pain clinic, She then saw Dr. Haueisen on May 19, 2003. Dr. Haueisen indicated that she had an L4.5 disc protrusion/hemiation. That was not consistent with the MW report. He did note that she had some sacroiliac dysfunction. She returned to see her family doctor on May 12, 2003, and at that time, she was diagnosed to have a chronic lumbosacral strain. On May 27, 2003, she was given a prescription for Vicodin, 51500 mg, as well as Soma, 350 mg. CONCLUSIONS Summary: After reviewing these medical records, 'it is my opinion that the treatment'rendered by Dr. Steven Hatleberg is documented to be appropriate and medically necessary for the September 15, 2002 accident. The treatment that I have reviewed up through May 27, 2003 is documented, to be reasonable and medically necessary. The referral for physical therapy which took place on October 16; 2002 would be considered reasonable and medically necessary. The duration of physical therapy in this particular case should be no more than three months. This patient had a normal Mnud normal neurological examination. There are no usual circumstances to warrant physical therapy beyond a three month program. The referral to Dr. Haueisen for pain management is appropriate. It should be noted, however, that Dr. Haueisen recommended a discogram at L4.5, stating that the patient had an abnormal MRI at 4.5: The MRI reports did not indicate that at all. He did document that she had sacroiliac dysfunction, and treatment towards a sacroiliac joint would be appropriate. The physical therapy beyond February 3, 2003 would not be documented to be reasonable or medically necessary. At that time, the patient only had mild tenderness in the left lumbosacral area. The medication such as Soma is useful for the treatment of muscle spasms. Vicodin is a commonly prescribed pain medication, and the dosages that were prescribed seemed to be within the normal range. No telephone called was requested by Dr. Hatleberg. Should you have any further questions, please do not hesitate to contact me. anm $ wuldch,bc D, Orrhopoodic Swima, PM 103 1 Suite • • NOV 1 4 2w; Pain & Disability Management Consultants, P.C. ch Dr. (Mdinlliht Plash Telephone: 419-SMAV2t) PA 18237 N=MW 112, 2003A? Wire Medical Examinadons 4nerican Avenue 300 of Prussia. PA 19406 Suzanne Gene A" I PEER PHEW Codne Riokabwpb 09/15412 intftlk 129401 Fdo #. 004804395-01 been asked to perfomt an Act 8 Peer Re*w to determine the appropriateness and necessKy of 6eaknent for to of INury prw4dod by 6uoquehanno Pain ManagaMwnVHaahh9oulh for COAne Riakabaugh from09115/02 Renewed: 11. Cover letter Guumna Gehl, Cancenbe Medial Exeminsdone i 2. Records from provider under rn4ew. Susgushanns Pain MaisgemenWea9hSorth Re-Evsludwl Report 05109103 Progress and Procedure Notes 06113103 end 07103103 3. Reconis from add0lornl provider. Neurology Center, Inc. InIdW Evaluation 07/31103 NCSSMG 07131103 Fokwup Notes M110348/27/D3 i Preaelipdon 08121!03 r Dlegnosdw. MR] of Brain 07131/03 MRI of Celvlcai 07/31103 ` MR[ lumbar Spina 08+01103 MRI of Thorsrao Sp(rA 08/01/03 Lob Joseph A. Pion, DO Oft Notes 03!24/03 Halth3outh; Re-Evsluadan, Progress and Procedure Notes, and Scdpm 08109/03-07103103 Alaaandor Spdng Rehab, Inc.; Prograa Nobs and Corrommdanca 06102103.09003 Boy Thompo n, PA-C; OfAae Note 07/290 Progress Note; trot stgg"(107131!03 Douglas Law Cmae; Consspondence and Authorlxadon to Disclose NOW Infonnadon 05/21103 GoodvOe MAW Casualty Compan); Correspondence and Itemized Lose Rocco OW1 02-08115103 PM 2 'acne Rkdrabsugh A File P 129402 File A 002604366-01 E • = 14 zv 1 Health Insurance Claim Forme and Explanation of SeneOta 03/2403.09102/03 Records of additional prodder. Belvedere W *0 Corp Oft Notes 02103103.07118103 Abn ft Physician Repot 10107102 4 MRI Lumber Spine 104102 Richard J. Boal, MO; Evaluation Report 10/26102 t' Alexander Bpdrgl Rohab, Inc.; PT Initial Evaluation, Plan of Can, and Follow-up Valuations 10/16/02- 1 05130M3 HedhSoulh; Pain Management R& Evaiu*n O09/03 CartInle Regional: AdmWm Record 09/15/02 S. Records of additional prodder, Orthopedic K OM* of PA Oft$ Malt Nola 104210.09196103 Sollpts i0119M2.0/28103 Lumber Spina krays 1012202 Lab Report 1012202 MRI of the lumbar Spins 10/24102 MRI of Thoracic Spina 001103 MRI of Lumbar spine 0801/03 Carlisle Regional Medical Canter, Orthopedk: ER Records 09/15/02 Healifftth; Pain Management Ro-Evaludan 0703103 Neumbgy Center, P.C.; Initial Evaluation, Follow-up EvWwUu, and NCSIEMO 0713103-00103 0. Records of additional provider. AlexaMer Spring Rehab, Inc. Progress Nobs 1011102.04/16/03 Oiling 10/11102.0412303 Salpb 1OM1M2.04/1903 Pictures of Vehicle 09123/02 Work Excuse 09115/02 7. Records from additional provider, Qoadville Mutual Casualty Company Pollee Report09MSM2 Ambulam Claim Form 09/1502 ER Retards 0811502 Diagnooks. MRI of the Lumbar Spine 10124102 Orlhapedc Insltiuts of PA; Office Melt Notes and Heath Insurance Cielm Forms 10/27/0210/2802 flog, WON: Conine Rickabough b, aocwdng to dhe nocards received for review, a 35-year-old woman who was involved In s or vehicle a citlent on 09/15102. In that motor vehicle acdderd, the car In which she was driving sustained a al florist Impact with another vehicle, The Clehmmt stand that she had the Immediate onset of low back pain, was evaluated at and released from the emergency mom. She treated with her primary care physiden and was n analgesics, speaWy Vlcodkh and Some as a muscle relaxent She was enrolled In physical Iherapy. Whb ryslc ll therapy, she underwent Several MWI Ne of passive physlolharapeuuc modalltra and complained of a wide sty of pains and stilNhass. These Included pain in her low back, ditso li ffhen, headsdw as well as radiation of pain Into the hip and left lag, She muds modest pains In physical therapy. 12/03/2003 04: P PM - - t ?+ • • 14 Pts 3 FICorlne Ridaabough A ' unt Filet 129402 C F FileP 0028043SUI Sh?came under the care of Ore provider under review, Susquehanna Pain Management, on 05100103. She 00 lolned of back paln with radiation of the pain Into her legs. The doctor rwrhraMng her, Nomura Hauelsen, D.O., no d e history of an 1.45 disc protrusion. (The source of this Information is untdw. The physical examination we remarkable for pain in her right budockt "men over the $I joint and the absence of motor, sensory or reflex slg of rMloulopsmy. The doctor preecdbed Pecoocet. No dated that he left that her symptoms were coming from the 4-0 disc, although he did not apparently review, her MRI, The MRI study of 1044/02 was normal. On 00113103, Or. lawken performed a lumbar opidurat steroid injection, again stating that the patient had an MRI, which revealed an 4-6 disc prohwion." He did not annotate what part of her examds0on was 'suspicious for an M left jt opathy,' as the ha d no decrement in motor, sensory or reflex function. The patient followed up w th Dr. en on 07103003. Following the spidtuai steroid injection, sM began to complain of "overell dNfttee weakness.' ot appearto be different than her other diflse symptoms, steroid myopWty lwoda to produce proximal grater then distal weakness. The doctor, in toaxamkdng her, that she had non-physlcloglc weakness of her left lower a tremky and a tremor In her quadriceps. He noted r deep tendon reflexes were symmetrical end no clone wa appreclated. He noted a variation between her weakness and liar nom al gait Because of the vedation between her examination and bar symptoms, a waft ween her observed abli les and non-physiologlc weakness, he referred her to back to the orthopaedist and to mary can ohwetclan. muming to rArw of the orthopaedist Dr, Baal, the patients examination was notably normal and she was let for a neurotogle evaluation. With respect to dlagm* testbtg, h is noteworthy that Me. Rickabsugh had a ii lumbar MRI on 10/24102 and 08101103, a normal thoracic: MR) on ON 1103, a nomW MRI of the brain on 103 and a normal cervical MR) on 07731ID3. Addlflonft on 07131103 she had a normal 9MWNCV study of bar ver extremity. with Provide Under Review. T4 provider under review Susquehanna Pain ManagemeM/HeahnSou01 did request a telephone consultation prior to o rendering of a Anal determination. dipnosts supported by the records received for review is nonspaclAc low back pain complaints with non. slologic weakness of the left tower extremity. There is no evidence to support the conclusion of lumbar cutopathy, as them is no evidence to support the conclusion that the patient had an L44 d* protrusion. t31»n avalable Information, the performance of the lumber epidural seroid injection was not Indicated on D71D3103. Dr. le wen In follow-up, however, rawnb ed the inconsistencies in the his0ay, physical uAmitstlon and the manra reported symptoms and repined the patlenPs cam to bar primary care pttysk wm The referral to the opaedie physician, Dr. Boas, was not necessary, for the we of 5e patient It was, however, consistent with tdard practice. As she had previously been evaluated by Dr. Bowl and clown lu rwt have a wwgiu d loksi, givan previous normal lumber MRI, that referral was not reasonable or necessary. Dr. Hauelsen did not, however, refer to the neurologist, Dr. Todd Samuels. The diagnosis of Or. Samueb, that W. Ricksbaugh sustained a ceMoai I conbtston and thus had spastic pamparosis a a result„ is unsupported by the database gathered, including the nail cervical MRI, tie normal lumbar MRI, the normal thoracic MRI, and the normal EMG MCV studies, it Is nwonmy that her gaff was considered normal by as observers except for Dr. Samuels, who considered it spastic In are. Dr. SamueW examination also varied from the examinations of Dr. Baal and Dr. Hauaisen. W evaluation of the patient on 05MM3 was reasonable and necessary given that she was referred to ahanns Pain Management at that time. The peformance of the lumber pidural starold Injection was not 12/0315003 .x,6 PM • • 0 14= adne Rickadeu4h ant Re M 129402 File 9: 002804385.01 re nable and necessary given the absence of any 4nikmt lesion of the lumbar spine to be bested in that ma ` n The subsequent roferral to die orthopoediat was rot reasonable or necessary, With rsspect to maximal men cal improvement, the achievement of mardmal medical Improvement to some extent depends upon the obtaining oft database that clerl9ss the absence of spnMcard pathobgy. That database was not obtained und109101103. it is clear why the delay In obtaining those studies occurred. However, following tie studies, in my Olen tie pat had reached maximal medical improvement, as the diagnosis was one of nonspecific back pain complaints, w"No would normally expect to resolve with the physiotherspeub eero oho had undergone. Minkel Pain MrPageraw t: Chronic Pain; Edited by Trcels S. Jensen, MD, DMSCI, Arnold publisher, oopyngM 2003. Interventional Pain Management edited by Waldman; WO Bearden; publisher, copyripM 2DW. Neumfo& ClInieo; Loww Back Pain, edited by Haldeman, Volume 17, Number 1, W.S. Saunders, publisher, February 1999. 7N -v- M. Thomas, M.D. Menegemint Pnyskien mat, American Board of Anssthesfology !cat of Added QualMeaWns h Poln Management i 12/03/2003 04:56 PM *IARC MAintoNE, M.D., F.A.A. W 28 ffi ORTNOPMCAND RROONVMUCTM 9URORRT HOLY RMMM911 MSJCNAL?Arta MWU MROARRUM111 MUNTMODON VAL V. ?A 1,099 (219)947.7150 - Mx(21!)%74t90 October 23, 2003 Summa Sehl, RN Medical Review Specialist CONCENTRA MEDICAL .EXAMNATIONS 700 American Avenue Suite 300 King of Pnods, PA 19406 Re. Corine Rickabaugh #002804363.01 Dear Ma. Sebl: I have reviewed the medical records on Corine Rickabaugh which you have provided. The following information was reviewed: - Emergency Room thorn Carlisle Regional Medical Center, 9/15/02 Records of Dr. Hatleberg, 9/16/02 thru 5/12/03 Records from Alexander Spring Rehab, 10/16/02 tbru 8/26/03 Records tfom the Orthopaedic Institute of Pennsylvania (Dr. Boal), 10/22102 tbtu 8/26/03 Report of= scan of lumbar spine done 10/24/02 Records of Dr. Haueisen, 5/9/03 thru 7/3/03 Records ofDr. Samuels, 7/31/03 thru 8/27/03 Report of MRI scan of brain and cervical spice done 7/31/03 Report of MRI am of thoracic spine and lumbar spine done 8/1/03 Police accident report Copy of vehicle photographs Miscellaneous pharmacy records On 9115/02 the patient was evaluated in the Emergency Room of Carlisle Regional Medical Center. At the time of this evaluation the patient was 35 years old. According to this note, the patient had been involved in a motor vehicle accident and was complaining of neck, left shoulder pain, and right lower quadrant pain. As part of this evaluation, x-rays of the thoracic spine were pw%rmed. These x-rays were reported to be normal. The patient was disebarged from the Emergency Room with the diagnoses of chest wall contusion and thoracic strain. On 9/16102 the patient was evaluated by Dr. Hatleberg. Dr. Meberg noted that the patient was complaining of back pain. The patient denied having any pareathasias. Dr. Hadeberg's physical 12103/2003 04!56-PM Re: Codne Rickabaugh October 23, 2003 Page 2 mramination document no neurologic abnormalities. Dr. Hatlebarg diagnosed a musculoskeletal strain and sprain with muscle spasm. On 9/23/02 Dr. Hazleberg noted that the patient was complaining of lower back pain, and also pain and weakness involving the loge, After examining the patient, Dr. Moberg diagnosed a lumbosscral muscle strain, On 10/7/02 Dr. Hatleberg re-examined the patient. This examination documented (among other things) it negative Babinski sign and very brisk reflexes in both the upper and lower extremities. Dr. Hadeberg noted that the hyper-ratlexia has been present since 1993. The only diagnosis listed on this date was persistent lumbosacral muscle spasm. On 10/16/02 the patient began a course of physical therapy at Alexander Spring Rehab. The records provided document physical therapy at this facility continuing through 4/21/03. On 10/22/02 the patient was evaluated at the Orthopaedic Institute of Pennsylvania by Dr. Baal. Dr. Baal noted that the patient was complaining of back pain, pan involving the buttocks, and pain extending down the left leg. Dr. Boat examined the patient and performed x-rays of the lumbar spice. He indicated that the x-rays showed a lumbar curvature which Dr. Baal felt was most likely secondary to muscle spasm. Dr. Baal diagnosed lower back pain with a possible left-sided disc herniation at L4-L5. Dr. Baal recommended that the patient be evaluated with a lumbar MRl scan. A lumbar MR1 scan was done on 10/24/02. This study was reported to be normal, Dr. Baal re-evaluated the patient on 10/29/02. He noted that the lumbar MM scan was entirely within normal limits. Ha noted that the patient still had left lower lumbar pan. Dr. Boal's physical examination documented that the patient stood with a list and an unlevel pelvis. He noted left-sided muscle spasm, No other physical examination abnormalities were noted. Dr. Baal specifically Indicated that there were no neurologic abnormalities involving the lower extremities. The only diagnosis listed by Dr. Boat on this date was a lumbar strain. Dr. Boat indicated that there was no indication for surgery. He recommended that the patient follow-up with liar Family physician, Dr. Hatloberg re-evaluated the patient on 12/17/02. He noted that the patient had been attending physical therapy on a regular basis. The examination on this date documented tenderness In the lower back area. It was specifically noted that the neurologic examination was normal, no patient was diagnosed as suffering from an improved lumbosacral muscle strain. No other diagnoses wen listed. Dr. Hatleberg continued to evaluate the patient on a periodic basis. On 2119/03 Dr. Hattebarg noted that the patient was making steady progress with physical therapy. He stated that the 12/03/2003 04:56 PM - * • • fad' 28 ru Re: Codne Rickabaugh October 23, 2003 Page 3 patient wanted to return to work. The only physical examination abnonmality noted was some mild tenderness over the left paraspind lumbotaaal area. Dr. Hatleberg indicated that the patient could tenon to work on 3/6/03, He stated that the patient would continue with physical therapy after her return to work On 3/13/03 Dr. ffidebarg noted that the patient had been back to work fbr four days and had experienced a bad flare-up of her lumbosacral muscle strain, The only physical examination abnormality noted on this date was left parespinal muscle tenderness and spasm. The only diagnosis listed on this date was a lumbosacral muscle strain. On 4/11/03 Dr. ETsatlloberg noted that the patient had been able to return to work. He stated that the patient was no longer attending pbysical therapy. His examination documented tenderness in the left paraspical region. He also noted bypeareflexis which he again indicated was normal for the patient. No other physical examination abnormalities were noted. Dr. Hatleberg diagnosed an improving lumbosacral muscle strs iai. On 4/17/03 Dr. Hatieberg noted ongoing complaints of lower back pain. He indicated that there was pain in the left sacroiliac joint and On in the lower sacrum area. No specific physical examination abnormalities were noted. Dr. Hatleberg listed his diagnostic assessment as "chronic back pain status-post MVA." It should be noted, however, that this is not a diagnosis indicative of any specific pathology, but is rather a reiteration of the patient's history and subjective complaints. On 519103 the patient was evaluated by a pain management specialist, Dr. Haueisen. Dr. Hauoisen indicated that an MRI scan of the lumbar spine had been performed and this showed evidence of an L4-L5 disc protnision/barniation, The records which I previously summarized would not Support this wrdention. Agar examining the patient, Dr. Hausisen listed his diagnostic impression as lower back pain with significant lumbar spasms. Dr. Ifaueisen felt that the patient's symptoms were coming font L415 disc pathology. It is clear, however, ftom the results of the previously performed lumbar MRI scan that this patient was not suffering ftom any clinically significant lumbar disc pathology. On 7/3/03 Dr. Haueisea re-evaluted the patient, He indicated in this note that a lumbar epidural injection had been performed on 6/13/03. He stated that following the injection, the patient's hip felt better, but subsequently, the patient experienced overall diffuse weakness. Following this examination, Dr. Haueisen commented that there were some inconsistent Sodings and he recommended a neurological evaluation including an BUG study. He also indicated that an orthopedic evaluation would be warranted, As I have already noted, Dr. Hoal had previously evaluated the patient on two separate occasions and following his last evaluation, be recommended that follow-up be performed by the patient's family physician. 12103/2003 04:57 PM • Re; Corine Rickabaugh October 23, 2003 Page 4 On 7/29/03 the patient was re-evahtated by Dr. Boal. According to this note, the patient was complaiaing of back pain, pain extending into the buttocks, and pain extending down the leg. Dr. Boal's physical examination documented left lumbar tenderness and a narked decrease in lumbar motion. No other physical examination abaonuslities woe noted. Dr. Boal listed his diagnosis as "low back pain." Again, it should be noted that this is not a diagnosis indicative of any specific pathology, but is rather a reiteration of the patient's subjective complaints. Dr. Boal recommended a repeat MR1 scan of the lumber spine and evaluation by a Aeurologist (which bad already been recommended by Dr. Haueiwn). On 7/31/03 the patient was evaluated by a neurologist, Dr, Samuels. Dr. Samuels' physical examination documented hyper-reflexia at the knees, a positive leg Babinsid sip, and a positive right Hollmoom's sign. He also noted bilateral aalde clocus. Dr. Samuels felt that the patient was suffering from spastic paraparesis. He ordered additional diagnostic studies. On 7/31/03 Dr. Samuels performed electrodiagnostic studies of the left lower extremity. He indicated that these were normal On 7/31103 MM Scans of the brain and cervical spine were performed. These studies were repotted to be normal. On 8/1/03 MRI Scans of the thoracic spine and lumbar spine were performed. These studies were reported to be normal. On 841/03 Dr. Samuels noted that the patient was still experiencing lower back pain and left leg pain. He commented on the results of the MRI scans. He indicated that the physical examination showed evidence of spastic paraparesis. He suspected that the patient had sustained a spinal cord contusion in the 9/15/02 accident. On 8/26/03 Dr. Bost re-evaluated the patient. His physical examinatioa documented lower extremity clonus. No other physical examination abnormalities were noted. The only diagnosis listed by Dr. Boa] on this date was low back pain. Dr. Beal again commented that surgery was not indicated. He recommended that the patient return on an as needed basis. On 8/27/03 Dr. Samuels re-evaluated the patient. He commented that the patient had a spinal cord contusion and this would take several months to heal, I will answer the questions which have been asked in the cover letter based on the assumption that the information contained in this file is accurate. Dr. Boal saw the patient on two occasions in the early stages following the motor vehicle accident. Following his examination on 10/29/02, he diagnosed a lumbar Wain and recommended that the patient follow-up with bar family physician. Dr. Boal did not note any 12/03/2003 04:57 PM Its: CorineRicksbaugh October 23, 2003 Page 5 museuloskeletal problems on 10/29/02 which would necessitate further evaluations or treatment by an orthopedic surgeon. Even if one wen to assume that the patient did sustain a cervical spinal cord contusion, (as suggested by Dr. Samuels), this is not something which would necessitate evaluation and treatment by an orthopedic surgeon in July of 2003. This type of problem is best managed by a neurologist and indeed the patient was being seen by it neurologist in July of 2003. The records provided do not support the contention that the patient sustained any museuloslteletal injury on 9/15/02 which would necessitate evaluation or treatment by an orthopedic surgeon beginning in July of 2003 (particularly when one considers that the patient had already been evaluated on two occasiow by Dr. Boal in October of 2002). In my opinion, the treatment rendered by Dr. Goal (i.e. Orthopaedic institute of Peonsylvania) through 10/29/02 was appropriate and necessary for musculoskeletal injuries sustained on 9/13/02. In my opinion, none of the other treatment rendered by Dr. Boal was appropriate or necessary with respect to specific musculosiwletalinjuries sustained on 9/15/02. In my opinion, the length of treatment by Dr. Boas, which is documemed In these records, was not appropriate given the nature of the musculosk ertal injuries sustained on 9/15/02. In my opinion, the only treatment by Dr. Boas which was appropriate add necessary for injuries sustained on 9/15/02 was that treatment rendered through 10/29/02. I note from the cover letter that Dr. Boal did not wish to discuss this case with me. Thaak you for asking me to review these records. Sincerely, 9 M ' ne, M.D. dm 12/0312003 04:56 PM KATZ•BENNETT•LEVIN NEUROLOGY ASSOCIATES, P.C, RICHARD 1. KATZ, M.D. RICHARD H, BENNETT, M.D. I, HOWARD IEVIN, M.D. AIBERT EINSTEIN ME ICAI CENTER, NORTHERN DIVISION KIEIN BURRING, SUITE 405 5401 OID YORK ROAD PHIIADEIPHIA, ?A 19141 215324.7300 FAX! 2151240150 October 6, 2003 Suzanne Sehl Concentra Medical Examinations 700 American Avenue Suite 300 King of Prussia, PA 19406 RE : CORINZ RIClU1 MOR Dear Ms. Sehl: I received the following medical records pertaining to Corine Rickabaugh. Ms. Rickabaugh is a 35-year-old female who was involved in a motor vehicle accident dated 9115102. The following medical records were reviewed pertaining to treatment rendered by Dr. Todd Samuels. The following is a summary of the records received. The reports from the Carlisle Regional Medical Center were reviewed. Ms. Rickabaugh was evaluated on 9/15/02. The records indicate she was an unrestrained driver involved in a motor vehicle accident and diagnosed with chest wall contusion and thoracic strain. X-rays of the chest were negative. X-rays of thoracic spine were negative. The medical records from the Belvedere Medical Corporation, Internal Medicine were reviewed. Ms. Rickabaugh was seen on 9/16/02 complaining of back pain. Her examination was normal otherwise. There was a history of asthma. She was provided a note for work. She was given medications, i.e., Soma Compound and Vicodin without refills. A report from the Orthopedic Institute of Pennsylvania dated 10/22/02 was noted. Ms. Rickabaugh was evaluated by Richard Boal, M.D. A chief complaint of back pain was noted. The history states she had problems with her back in the past. Her examination on this occasion was unremarkable, although she was reported to have weakness in dorsiflexion of the left foot and a possible disk herniation was suggested. An MRI was recommended and a prednisone 2407 E. AIIEGHENY AVENUE, PHIIADEIPHIA, PA 19134 EINSTEIN CENTER I, 9800 SUSTIETON AVENUE AT HAIDEMAN, PHIIADEIPHIA, PA 1911$ 1210312003 04:56 PM 0 ar 81 am RR: CORnM RICKARAUG8 10/06/03 PAGE TWO Dosepak was provided. A follow-up note dated 10/29/02 was reviewed. Ms. Rickabaugh was noted to have undergone an MRI of the lumbar spine. The diagnosis was now lumbar strain. The MRI was reported to be within normal limits. The reports from Alex Spring Rehab were reviewed. Ms. Rickabaugh was referred for physical therapy and received treatment from 10/16/02 to 4/21/03. A report from Todd Samuels, M.D., a neurologist dated 7/31/03 was reviewed. Dr. Samuels evaluated Ms. Rickabaugh having been referred for a neurological consultation by Richard Boal, M.D. She had complaints of lower back pain radiating towards the left leg down the posterior thigh to the left heel. There was a remote cervical spine injury. There was no prior history of lower back pain according to her history. The physical examination revealed no sensory deficits, full strength in both upper and lower extremities. She reportedly had a left Babinski sign and hyperreflexia in the lower extremities. There was sustained ankle clonus bilaterally. There was a tremor in the left lower extremity with spastic gait. Dr. Samuels ordered cervical, thoracic and brain MRI, as well as a metabolic work-up. The report dated 8/21/03, Dr. Samuels states that the diagnostic imaging, i.e., MRI of brain, cervical and thoracic spine, as well as lumbar MRI were all normal. Nevertheless he implied that there was a cervical spinal cord contusion and a spastic paraparesis. This appears to be impossible based upon Ms. Rickabaugh's complaints, the mechanism of the accident and her previous examinations. A spinal cord contusion would imply that there was a serious problem to the cervical cord. Complaints at the time of the accident were chest wall contusion and a thoracic sprain followed by lower back pain. Dr. Samuels prescribed baclofen for spasticity. A follow-up report dated 8/27/03 was noted. Dr. Samuels implied that Ms. Rickabaugh again had a spinal cord contusion that would take several months to heal and she was unable to return to work as a teachers aide. He also implied that she would resume physical therapy. Dr. Samuels' comments appear to be unsupported once again by the medical facts as noted. A report of an MRI of the lumbar spine dated 8/1/03 was noted to be normal. An MRI of the thoracic spine dated 8/1/03 was noted to be normal. A chemistry profile ordered by Dr. Samuels dated 8/4/03 including cardiac and thoracic studies, vitamin B12, and folic acid level, studies which have nothing to do with investigating the medical 12/03/2003 04:56 PM • J ar 81 M3 RX: CORINZ RICRAS1 = 10/06/09 PA= TRRRE condition of Ms. Rickabaugh as a result of the accident in question. A report from Alex Spring Rehab dated 8126102 was noted. The follow-up reports from the Belvedere Medical Group were reviewed. A report of 9/16/02 indicated that she was a passenger in the front seat of a car that had been involved in an accident on 9/15/02. She was complaining of lower back pain. There was no loss of consciousness. She ambulated without assistance. There was a negative straight leg raising. There was tenderness in the lower back radiating from the right side. The neurological examination was noted to be normal. Follow-up report dated 9/23/02 was also noted to have a normal neurological examination. The diagnosis was a muscle strain indicated on 10/31/02. An exacerbation of asthma was reported on 2/3/03 with severe coughing. on 3/19/03, a diagnosis of lumbosacral muscle strain was again reported to be present. A report from pain management, i.e., Health So th Rehabilitation of Mechanicsburg dated 5/9/03 was noted. A report from Norman Heaudisen, D.O. felt the problems were related to an L4-5 disk causing diskogenic pain. Dr. Heaudisen indicated to Ms. Rickabaugh at the time that he would not provide her with chronic pain medication. The MRI of the lumbar spine report dated 10124/02 was noted to be normal. An EMG report from Todd Samuels dated 7/31/03 was noted to be normal. Based upon my review of medical rscorda, Corine Rickabaugh was involved in a minor motor vehicle accident date 9/15/02 from which she may have sustained a lumbar strain/sprain. There was no indication that she sustained serious internal injuries involving the nervous system. There is no indication to support a brain or spinal cord traumatic contusion. One would anticipate based upon the nature of the accident itself, Ms. Rickabaugh's complaints, and response treatment, a full recovery would have been anticipated to occur within 8 to 12 weeks at the maximum from the date of accident. The medical records from Dr. Todd Samuels were reviewed. Dr. Samuels implied that there was a cervical spinal cord contusion. This would be impossible based upon the mechanism of accident noted and the records reviewed. or. Samuels' involvement in Ms. 12/03/2003 kss PM REs CORINE RICRABAUGH 0 dwa1 W 10/06/03 PAGE FOUR Rickabaugh's care did not take place until nearly eight month's from the date of accident. His evaluations of 7/12/03, 8/21/03 and 8/27/03 appear to be neither appropriate or necessary in so far as the evaluation of the condition of Ms. Rickabaugh stemming from the motor vehicle accident of 9/15/02. Likewise, inappropriate was the acquisition of an MRI of the brain, cervical and thoracic regions and an EMG for the accident of 9/15/02. I can be of further help or if specific issues need to be addressed, please feel free to contact me. Sincere yo , RICHARD H. BENNETT, M.D. RH3/09: 12/03/2003 04:57 PM-" C CJ Jay A Kauffman, MBA, PT Professional Consultation Services 33 Douglass Road, lawdele, PA 10446 (215).097-3951 phone mid, fi x October 14, 2003 Surzaane Sehl, RN Coneeatra Medical Examindons 700 American Avenue, Suite 300 King of Prussia, PA I M06 RE: Account File /1: CME File 0: Insured: DOA: Dear Ms. SOW: Conine Rlekabaugh 129402 00280432"1 Same 9115/02 At your request, 1 have performed a physical therapy peer review rccunxidsaGan i? regards to the treatotent rendered to Corms Rickabaugh by Alexander Spring Rehab,] 11V following documentation was provided for my review: t. A police aceideru report for the date 9/15102. 2. A billing statement from Breeches EMS, Inc. dated 9115102. 3. Emergency room documents from the Carlile Regional Medical Center dated 9113/02. 4. Medical docamentation from Belvedere Medical Corp for the dates 9/ 16102 as well Y billing statements for the dates 9116102 through 4/17/03. S. An MRI of the lumber spine dated 10/24/02. 6. Medical documents from the Orthopedic Institute of Pennsylvania (iir the dates 10=02 through 10/29102, Along with corresponding billing statemens. 7. Physical therapy documentation from Alexander Spring Rehab lire the Jaws 10116102 through 8/25/03, along with multiple billing statements. 8. Multiple pharmaceutical prescription receipts from the K-Man Pharmacy. 9. Copies of the vehicle involved in the accident. HISTORY: Conine Rickabaugh Is a 3S-year old female who was involved in a motor vehicle uceident on 9115102. It is documented that at that time, the patient was the restrained pumeni cr ill a vehicle that sustained a asml-head on impact. Following the incident, the pausal complained of pain afhattng the right shoulder, chest, elbow and hand, along with lower back per. The patient noted that the lower back pain extended into the lo%%er exuramidea. SpadBeaily, the patient did note intermittent left calf and fbot pain wish numbness, tangling and a burning sensation; along with radiation of symptoms hill) the WT 20W 12/03/2003 04.57 PM • • RE: Corine Ridmbsugb Pngc 2 'October 14, 2003 right lower extmmity, it was further documented that the patient reporied I'allint; secondary to the lower extremity symptoms. The patiam's past medical history is significant for interstitial cystitis, tts well as an appendectomy, vaginal hysterectomy, asthma, arthritis, bilateral carpal tunnel surgery in 1986 and sbe was on clorpectin therapy. COURSE OF TREATMENT. As indicated above, this patient received multiple medical evaluations. The patient asst, received diagnostic studies and an MRI of the lumbar spine. This MRI was completed till 10/24/02. The conclusion at that time was a normal lumbar MRI; however. her history wsa noted to be significant for a L4-S hemiated nucleus pulposus on the left. In addition to this, the patient was referred for a course of physical therapy. Physical therapy treatments were rendered by Alexander Spring Rehab. An initial physical theral+y evaluation was completed on 10/16/02 by Shelly Bitner, PT. On this date an in-depth mtsculoakeletal evaluation was completed. Following this evaluation, the patient took part in a physical therapy program. This program lasted from 10/16102 and continued through 7/16/03. During this time, the patient's care included manual therapy tcchniquca in the form of myofaseial release. Her care also included manual traction techniques and joint mobilization. The patient's treatment was documented on a daily hasis through handwritten SOAP notes. Physical therapy progress notes were also ollcrcd. These progress notes are dated 12!17102, 1/15/03, 2/13103 and 4/13103. 1 was also ullI rcd it letter written by Shelly Bitter, PT dated 8/26/03, requesting a reconsideration of this case. This letter also detailed the patient's response to treatment. It is important u, now that this letter referenced physical therapy treatment notes and examinations heyond 4/21/03. However, I do not have physical therapy notes to be reviewed heyond 8/2.5/03. ANALYSIS AND CONCLUSIONS: The following analysis is based on the information available for my review. It is at he understood that this analysis is presented without a physical examination of the palient. It is my professional opinion that the treatment tendered to Corine Rickabaugh by Alexander Spring Rehab from 10/16/02 through 5/13/03 would be considered reasonable. To begin, physical therapy is an established treatment protocol given this diagnosis. Ilse patient's diagnosis included lower back pain with radiating symptoms into the hatwr extremity. Physical therapy treatments may include mantel traction techniques. ,joint mobilizations and myofascial release. Prior to beginning a course of physical therapy. the thergist provided an in-depth musculoskeletal evaluation. This evaluation documented significant physiologic and Atnctional deficits which could be hitpmucd through a course of akilled therapy. It had also outlined goals which were to be reached through a course of physical therapy. The evaluation, assessment and goals were appropriate and eoneietant with the patient's complaints. Physical therapy trcnuncnts were documented appropriately on a daily basis through SOAP notes. In addition to this. 12/03/2003 04:57 PM • • e Rg: Corins Ricksbaugh 11uge ? October 14,1003 re-evaluations wort offered, and the dates of these evaluations were noted above. 'fhr physical therapy notes and evaluations indicate that the patient did steadily improve through a course of skilled therapy. It is my professional opinion; however, that there is insufficient documentation to justify ongoing care beyond 5/13/03. Specilictlly. there were no in-depth re-evaluations offered beyond 4/13/03. The care rendered through 5/13/03 is justified by the re-assessment completed on 4/13/03. In addition to this. fhr physical therapy notes indicate that this patient bad ongoing complaints of pain that weir not resolving with continued therapy. Based on the documents offered for my revic%. fhr patient's status had plateaued. The patient did not demonstrate any improvement with her complaints of pain, range of motion or strength. In spite of the lack of progress. therapy was continued. Given this information, it is my professional opinion tlun there is insufficient documentation to justify any ongoing treatments beyond 5/13/03. As requested, a telephone conversation took place with this provider. Specilictlly. I spoke with Shelly Bitner, PT on 10106103. We discussed this patient's treatment and response to treatment as well as a detailed discussion regarding the content of fhr physical therapy daily notes and re-evaluations. We also included in our diACU9%iUn fhr length of lima that this patient was seen in physical therapy. In summary, it is my professional opinion that the treatment rendered to ('urine Rieksbaugh by Alexander Spring Rehab from 10116101 through 5113103 would he considered reasonable. The patient's treatment and response to treatment was approprime given the patient's diagnosis and subjective complaints and the information oflewd fin my review does Indicate that the patient was making steady progress as a direct result u( the therapy rendered. It is my professional opinion; however, that at this linty there is insufficient documentation to justify any ongoing skilled physical therapy intervention beyond 5/13/03. This conclusion is supported by standards set forth by the American Physical Therapy Association as documented in the APTA's Guide to Coding and Payment and APTA's Guide to Physical Therapy Practice. I would like to thank you for allowing me to perform this review for you. Sincerely, ??. `egow0y", Jay D. Kauf> huA PT, MBA JDK:jk 1210312003 04:57 PM • • Bibliography: .° Ammicaa Physical Therapy Association's t}nide to Coding and Pavmcgl. 1994 American Physical Therapy Association's GuWe to Phvsical Theravv Practice. 1997. American Physical Therapy Association's Guide to Physical Thcr,3M.-j'q !- . ;md yttllmNon Review. 2001. VERIFICATION I, Glen E. Hess, Sr. Claims Representative for Goodville Mutual Casualty Company, being duly authorized to do so, verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. GOODVILLE MUTUAL CASUALTY CO. Date: 08/23/04 By: ( ) 4- Glen E. Hess CERTIFICATE OFSERVICE I, Karl R. Hildabrand, Esquire, of the law firm Nestico, Druby & Hildabrand, LLP, on this 13 day of September 2004, hereby certify that I served a true and exact copy of the foregoing document as follows: By First Class Mail, Postage Pre-paid: William P. Douglas, Esquire Douglas Law Office 27 W. High Street P.O. Box 261 Carlisle, PA 17013 NESTICO, DRUBY & HILDABRAND, L.L.P. By: Karl R. Hildabrand SEP 16 2004 CORINE A. RICKABAUGH, : IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : DOCKET NO. 04-64 Cicil Term GOODVILLE MUTUAL CASUALTY CIVIL ACTION -'AT LAW COMPANY, JURY TRIAL DEMANDED Defendant RULE TO SHOW CAUSE AND NOW, this -?:::day of S???- Defendant's Petition pursuant to 75 Pa.C.S. § 1796 to compel a physical examination lof Plaintiff Corine Rickabaugh, a Rule is hereby issued upon Plaintiff Corine Rickabaugh to show cause, if any she has, why the relief requested in said Petition should not be granted. Rule returnable -4-Sdays from date of service. BY y?/ f L iX,t?X ? CA-,j.t9 "t-a, '41 tap J. a9-c21-05l r c? I Z c' IS U0Z Nestico, Druby & Hildabrand, LLP Attorneys At Law G 840 East Chocolate Avenue Hershey, PA 17033 717-533-5406 CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term CIVIL ACTION - AT LAW DEFENDANT'S PETITION TO MAKE R ULE ABSOL UTE 1. On or about September 15, 2004, Defendant filed a Petition to Compel Plaintiff to submit to a physical examination by a physician pursuant to 75 Pa.C.S. § 1796. 2. On September 21, 2004, this Court issued a Rule to Show Cause returnable fifteen (15) days from the date of service. 3. The Rule to Show Cause was served upon William P. Douglas, Esquire, counsel for Corinne A. Rickabaugh, by certified mail, return receipt requested, on October 5, 2004. Attached hereto, incorporated herein by reference, and marked as Exhibit "A" is the signed return receipt card for said service. 4. No timely response has been filed by Plaintiff to the Rule to Show Cause. WHEREFORE, Defendant respectfully requests that this Honorable Court issue an Order making the rule absolute and directing that Plaintiff Corinne A. Rickabaugh submit to an independent medical examination by John S. Rychak, M.D., or another duly-qualified orthopedic surgeon selected by Defendant within ninety (90) days of the date of this Court's Order. Respectfully submitted, NESTICO, DRUBY & LDABRAND, L.L.P. Date: l? Z - Karl R. Hildabrand Attorney I.D. No. 30102 840 E. Chocolate Avenue Hershey, PA 17033 (717) 533-5406 Telephone Attorney for Defendant `? --a ?, ? 6??W7 j i ?`r?i t , --.7 w, J ;'`.,? s. _? ?-Tl ?.w - C. yJ ? ?,? ` NO 1 8 2004 CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term CIVIL ACTION - AT LAW ORDER OF COURT AND NOW, thisZZ-day of November 2004, Defendant's Petition to Make Rule Absolute is hereby granted. Plaintiff Corinne A. Rickabaugh is hereby directed to submit to an independent medical examination by John S. Rychak, M.D., or another duly-qualified orthopedic surgeon selected by Defendant, within ninety (90) days of the date BY THVCOURT: J. Q) FILED?RIGE Oc THc PR i HChNOPM 2004 NOV 23 k 8.20 PN?NISyLVANIA CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term : CIVIL ACTION - AT LAW DEFENDANT'S PETITION TO MAKER ULE ABSOLUTE 1. On or about September 15, 2004, Defendant filed a Petition to Compel Plaintiff to submit to a physical examination by a physician pursuant to 75 Pa.C.S. § 1796. 2. On September 21, 2004, this Court issued a Rule to Show Cause returnable fifteen (15) days from the date of service. 3. The Rule to Show Cause was served upon William P. Douglas, Esquire, counsel for Corinne A. Rickabaugh, by certified mail, return receipt requested, on October 5, 2004. Attached hereto, incorporated herein by reference, and marked as Exhibit "A" is the signed return receipt card for said service. 4. No timely response has been filed by Plaintiff to the Rule to Show Cause. WHEREFORE, Defendant respectfully requests that this Honorable Court issue an Order making the rule absolute and directing that Plaintiff Corinne A. Rickabaugh submit to an independent medical examination by John S. Rychak, M.D., or another duly-qualified orthopedic surgeon selected by Defendant within ninety (90) days of the date of this Court's Order. Respectfully submitted, NESTICO, DRUBY & LDABRAND, L.L.P. Date: `l Z By: CC-?? Karl R. Hildabrand Attorney I.D. No. 30102 840 E. Chocolate Avenue Hershey, PA 17033 (717) 533-5406 Telephone Attorney for Defendant CERTIFICATE OF SERVICE I, Karl R. Hildabrand, Esquire, of the law firm Nestico, Druby & Hildabrand, LLP, on thisw2 day of November 2004, hereby certify that I served a true and exact copy of the foregoing document as follows: By First Class Mail, Postage Pre-paid: William P. Douglas, Esquire Douglas Law Office 27 W. High Street P.O. Box 261 Carlisle, PA 17013 NESTICO, DRUBY & HILDABRAND, L.L.P. Karl R. Hil labrand r_.? ?a '= L .? , r i -' --a d.? i -, ` ; -_..x ? ` ' ? ; _ ` . : ;=T?, ,,, ?? :: r^. ? ,I '?".; Cv t ..} ?i CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-64 CIVIL TERM CIVIL ACTION LAW JURY TRIAL DEMANDED DEFENDANT'S PETITION TO COMPEL ANSWERS TO DISCOVERY PURSUANT TO Pa R.C.P. 4019 1. On or about January 7, 2004, Plaintiff filed a Complaint against Defendant alleging bad faith in the handling of her insurance claim pursuant to 42 Pa.C.S. §8371. 2. On August 19, 2004, Defendant served its First Set of Interrogatories and First Request for Production of Documents upon Plaintiff. Attached hereto, marked as Exhibits "A" and "B" respectively are copies of the Interrogatories and Request for Production of Documents. 3. No answers or objections have been filed of any kind to the discovery request. 4. On January 11, 2005 defense counsel wrote to Plaintiffs counsel asking that full and complete answers be furnished "within the next two weeks." No response was ever received from Plaintiff's counsel. Attached hereto as Exhibit "C." 5. Again on February 24, 2005, Defendant's counsel wrote to Plaintiff's counsel indicating "I have been asked to proceed with a Petition to Compel if the responses are not forwarded within the next seven (7) days." No response was received from Plaintiff's counsel. Attached hereto as Exhibit "D." WHEREFORE, Defendant respectfully requests that this court enter an order directing Plaintiff to provide full and complete answers to Defendant's Discovery requests within 20 days or suffer the entry of sanctions. Respectfully submitted, NESTICO, DRUBY & HILLDDABBRANDD,, L.L.P. By: Karl R. Hildabrand, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 D- (717) 533-5717 Date-2 Attorney for Defendant 2 CORINE A. RICKABAUGH, IN THE COURT OF COMMON PLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 04-64 CIVIL TERM GOODVILLE MUTUAL CASUALTY COMPANY, CIVIL ACTION LAW Defendant JURY TRIAL DEMANDED DEFENDANT'S FIRST SET OF INTERROGATORIES TO PLAINTIFF TO: Corine A. Rickabaugh c/o William P. Douglas, Esquire Douglas Law Office 27 West High Street PO Box 261 Carlisle, PA 17013 Please take notice that you are hereby required, pursuant to Pa.R.C.P. 4005 and 4006, to serve upon the undersigned within thirty (30) days after service of this notice, your answers in writing and under oath to the following Interrogatories. The Interrogatories shall be deemed to be continuing Interrogatories. If between the time of your answer to said Interrogatories and the time of the trial of this case you or anyone acting on your behalf learns of or discovers the existence, the identity or whereabouts of any other witnesses not disclosed in your answers, the existence of any other documents or data not provided in your answers, or if you obtain or become aware of additional requested information not supplied in your answers you shall promptly furnish the same to the undersigned by supplemental answers under oath. NESTICO, DRUBY & HILDABRAND, LLP arl R. Hildabrand, Esquire 840 Fast Chocolate Avenue Hershey, PA 17033 (717) 533-5406 Attorneys for Defendants O, DEFENDANT'S FIRST SET OF INTERROGATORIES TO PLAINTIFF Definitions: 1. "You" and "your" mean Plaintiff Corine A, Rickabaugh, or anyone acting on her behalf, including attorneys, insurance representatives, servants, agents, employees, investigators and independent contractors. 2. "The accident" means the motor vehicle accident of September 15, 2002, in which the Plaintiff was allegedly injured as more specifically alleged in Plaintiff's Amended Complaint. 3. "The policy" means the policy of insurance which Plaintiff had with Defendant, Policy Number PA746801, which was in effect at the time of the motor vehicle accident of September 14, 2002. Interrogatories: State your full name, date and place of birth, and social security number. ANSWER: State your residence address at the time of the accident and your current residence address. ANSWER: 3. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant "wrongfully refused to pay for medical services which were provided to Corine A. Rickabaugh by her healthcare providers", and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 4. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant "failed to comply with the provisions and/or abused the provisions of Act 6 with respect to the PRO process," and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 5. State all facts in support of the allegations of your Amended Complaint that Defendant's "wrongful conduct includes untimely Peer Reviews which address the issue of causation which is not permitted by statute or regulation," including: a. identify each Peer Review in question by provider, peer review, date of review/report, bills in question; b. in what manner you contend the review was "untimely;" C. in what manner you contend "the issue of causation" was impermissibly addressed; and d. the statutes or regulations you alleged were violated. ANSWER: 6. Provide the name and address of each person who will testify in support of the allegations in your Complaint that the Defendant "fraudulently, knowingly, and intentionally misrepresented and deceived Corine A. Rickabaugh and her medical providers with respect to the availability of medical benefit coverage under her policy of insurance," and set forth a full description of the information that they given or are expected to give regarding this matter. ANSWER: 7. State all facts in support of the allegations of your Amended Complaint that Defendant wrote to providers "with no basis in fact, in an attempt to thwart her ability to receive care and treatment," including: a. date, description, author, and addressee of each writing; b. all facts in support of your contention that each identified writing had "no basis in fact;" C. all facts in support of your contention that the Defendant attempted to "thwart her ability to receive care and treatment." ANSWER: 8. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant "frivolously and with no proper foundation for their actions refused to pay proceeds under their policy of insurance and provide medical benefits in accordance with the terms of the policy", and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 9. State all facts in support of the allegations of your Amended Complaint that Defendant has "frivolously and with no proper foundation for their actions refused to pay proceeds under their policy of insurance and provide medical benefits in accordance with the terms of the policy," including: a. each proceeds which you allege was due and not paid by Defendant or not paid timely; b. the reason you contend each of the aforementioned proceeds were due and payable; C. identify each medical benefit which you contend Defendant did not pay or did not pay timely by provider, date of treatment, date submitted, and reason given by Defendant for non-payment. ANSWER: 10. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant "had engaged in bad faith conduct in the handling of Plaintiff's claims for medical expenses or benefits under the terms of her policy with Goodville," and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 11. State all facts that support your contention in your Amended Complaint that Defendant acted in "bad faith," and identify by detailed description all documents that you contend support your contentions (identify all documents by author, date, addressee, and description of contents). Attach copies of all identified documents to your answers to these Interrogatories. ANSWER: 12. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant "in retaliation for the Plaintiff filing and pursuing a claim has canceled the homeowners insurance of the Plaintiff on a fraudulent basis," and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 13. State all facts in support of the contention in your Amended Complaint that Defendant "represented to the Insurance Commissioner that the reason for the cancellation was the fact they do not insure mobile homes" when "said allegation by Goodville is not true." Include the following in your answer: a. Identify each representation you rely upon, state if oral or in writing, identify date, author, means of communication, addressee, and attach copies of all identified representations to your answers to these Interrogatories; b. Identify all witnesses who will testify in support of your contentions; and c. Identify all documents that support your contention that said alleged representations were "not true." ANSWER: 14. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant Goodville "did not act in good faith to effectuate prompt, fair and equitable resolution of the Plaintiff's claim," and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 15. State all facts in support of your contention of your Amended Complaint that Defendant "did not act in good faith to effectuate prompt, fair, and equitable resolution of claims, knowing that liability to pay medical bills is clear and coverage applies," including: a. Identify each medical bill in question by provider, date of service, treatment received, date bill was submitted, and amount paid/unpaid; b. Identify all documents in support of your contention and attach copies to your answers to these Interrogatories; and C. Identify all "expenses" Plaintiff alleges she was forced to incur "to protect her interests" by date, amount, description, and reason expense was incurred. ANSWER: 16. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant Goodville "failed to provide a factually sound explanation for the basis of denial in the insurance policy in relation to the facts or applicable law for the denial of the claim", and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 17, State all facts in support of your contention in your Amended Complaint that "the Defendant failed to promptly provide a factually sound explanation for the basis of denial in the insurance policy in relation to the facts or applicable law for denial of the claim." ANSWER: 18. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant Goodville "has willfully, maliciously, and/or recklessly withheld benefits from the Plaintiff due to its failure to investigate the claim thoroughly which constitutes a breach of an implied covenant," and set forth a full description of the information that they have give or are expected to give regarding this matter. ANSWER: 19. State all facts that support your contention in your Amended Complaint that "the Defendant has willfully, maliciously, and/or recklessly withheld benefits from the Plaintiff, due to its failure to investigate the claim thoroughly which constitutes a breach of an implied covenant," and state: a. each benefit allegedly withheld (identify by date, description, service provided, provider, and basis for your contention with respect to each; and b. identify all documents that support your contention and attach copies to your answers to these Interrogatories. ANSWER: 20, Provide the name and address of each person who will testify in support of the allegations in your Complaint that the Defendant Goodville "has deliberately acted in conscious disregard and with indifference to the rights of their insured," and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 21. State all facts to support your contention in your Amended Complaint that the Defendant "deliberately acted in conscious disregard and with indifference to the rights of their insured," and identify: a, each employee of Defendant whom you contend did so; b. the date(s) of each identified employee's alleged conduct; C. a description of the alleged conduct on each specified date that you believe supports your contention; and d. identify all documents which you believe supports your contention (identify by date, author, and description), and attach copies of all identified documents to your answers to these Interrogatories. ANSWER: 22. Provide the name and address of each person who will testify in support of the allegations in your Amended Complaint that the Defendant Goodville "breached its contract and/or warranty, which breach resulted in loss to the Plaintiff, and has impeded her ability to received medical services, as well as aggravation, inconvenience and emotional distress," and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 23. Identify by date, description, author, and format each implied or express warranty that you allege in Paragraph 17 of your Amended Complaint that Defendant made to Plaintiff. ANSWER: 24. Identify all documents which you contend support your allegation that the Defendant acted in bad faith with respect to the Plaintiff's claim for medical expenses following the accident in question. ANSWER: 25. With respect to your claim for "aggravation, inconvenience, and emotional distress," provide the complete factual basis for this claim, including: a. date or dates; b. identify all physicians or health care providers seen for this (identify each visit by date, provider, reason for visit, amount of bill, and amount paid and by whom up to the present; and c. identify all documents which support this contention and attach copies to your answers to these Interrogatories. ANSWER: 26. Identify all representatives of the Defendant which you have had any communication with whether it be in writing, verbal, email, fax or otherwise, and with respect to each communication provide the following: a. Date of each communication; b, Method of each communication; C. Content of each communication (attach copies of all written or otherwise documented communications to your answers to these interrogatories); and d. If you contend that any of the identified communications are evidence of the Defendant's bad faith, state a full description of your basis for this contention, ANSWER: 27. Provide the name and address of each person, including potential expert witnesses, from whom you have obtained any information in support of your allegation that the Defendant's conduct was in bad faith, and with respect to each individual, state their name and address and specify what information each person has given concerning this subject. ANSWER: 28. Provide the name and address of all other witnesses whose names were not given in answer to the proceeding interrogatories, with relevant information pertaining the claim which you have submitted or the defenses thereto, whether or not you intend to call any of said witnesses at trial, and set forth a full description of the information that they have given or are expected to give regarding this matter. ANSWER: 29. Have you obtained from any person or persons any reports, statements, memoranda or testimony concerning the matters alleged in Plaintiff's Amended Complaint? If so, state: a. Name and address of each such person; b. When such information was obtained or made; C. Where such information was obtained or made; d. By whom such information was obtained or made; e. Where such information is presently located; and f. Attach a copy of each such report, statement, memorandum or testimony to your answers to these interrogatories. ANSWER: 30. Please provide a complete description of all injuries you received in the accident in question and indicate whether or not you have recovered from each injury. ANSWER: 31. Have any doctors or any oth--r medical personnel examined or treated you for your injuries received as identified in response to the preceding interrogatory? If so, for each such doctor or other medical personnel state: a. Name, address and specialty; b. Each date of examination or treatment; C. Type of examination or treatment and a description thereof; d. An itemization of each charge for such examination or treatment; e. Amount paid, and by whom, up to the date of filing these answers to interrogatories; and f. Whether any further treatments or examinations will be necessary, and if so, a description thereof. ANSWER: 32. Have you been hospitalized as a result of injuries received in the accident? If so, for each period of hospitalization state: a. Name and address of the hospital; b. Inclusive dates of hospitalization; C. A description of the injuries for which you were hospitalized; d. A description of the trea:ment received while at the hospital; e. An itemization of each charge for such hospitalization; f. Amount paid, and by whom, up to the date of filing answers to these interrogatories; and g. Whether further hospitalization will be necessary, and if so, a description thereof. ANSWER: 33. Have you been involved in any other incidents or occurrences since the accident in question in which you were injured? If so, state: a. Date of each incident or occurrence; b. Places where each incident or occurrence (indicating the address or other fixed point of reference, city, county and state); C. Name and address of each other person involved; d. A description of each injury that you sustained indicating with particularity the part of your body injured; e. Names and addresses of each physician examining and treating you for such injuries; and f. Whether the injury sustained in the incident involved in this lawsuit were in anyway aggravated by any subsequent incident or occurrence, and if so, explain in detail. ANSWER: 34. Please provide a complete itemization of all insurance benefits paid to you or on your behalf as a result of this accident (whether by Defendant Goodville or by another entity) (including but not limited to medical expenses, rehabilitation expenses, lost wages and replacement services), indicate the name and address of the insurance carrier, the policy number, and whether you are continuing to receive such benefits? ANSWER: 35. Did you have any incidents, injuries or medical problems requiring medical care and/or resulting in impairment or disability prior to the accident in question? If so, state: a. Date of each incident, problem or occurrence and a description thereof; b. Nature of the injury, problem, disability or impairment; C. Names and addresses of each physician examining and/or treating you for such condition and/or each hospital involved; and d. Whether the injury, problem, disability or impairment was in any way aggravated or harmed by the accident in question, and if so, explain in detail. ANSWER: 36. With respect to each medical or other expert witness which you intend to call to testify in the trial of this matter, state; a. Name, address and telephone; b. Professional occupation and the field in which the person is allegedly an expert; C. Attach a copy of the expert's curriculum vitae or describe in detail what education, background, experience or other qualifications the individual has to be comaidered as an "expert"; d. The subject matter or matters on which the expert is expected to testify; e. The opinions on which the expert is expected to give concerning these matters; and f. The substance of all facts and opinions on which the expert bases his opinion and a summary of the grounds for each opinion. ANSWER: This interrogatory is propounded pursuant Pa.R.C.P. 4003.5 which directs the party answering the interrogatory to either file as his answer a report of the expert of have the interrogatories answered by the expert. In either case, the answer or separate report shall be signed by they expert. 37. Identify each physician or healthcare provider which provided medical treatment to the Plaintiff following the accident in question, and with respect to each, provide the following: a. A description of treatment; b, Dates of treatment; C. Charges rendered for specified treatment; d. Itemization of those expenses paid by Defendant; e. Itemization of those expenses not paid by Defendant; and f. Itemization of those expenses paid by Defendant but which you contend were not paid in a timely manner. ANSWER: 38. For each publication, document, treatise, standard, book or other material that you or your experts intend to use or rely upon at trial, please provide a complete description thereof, including date of publication, publisher and a description of each document or publication. ANSWER: 39. Give the name and address of each witness that you intend to call in the trial of this matter and provide a summary of the facts and other information that each witness is expected to give. ANSWER: 40. Identify and describe each exhibit which you intend to use or introduce in the trial of this case. ANSWER: 41. Provide a complete description of all facts that support your contention that the Defendant acted in bad faith in the handling of Plaintiff's claim for medical expenses following the accident in question. ANSWER: Date: 7 NESTICO, DRUBY & HILDABRAND, LLP B Y: Karl R. Hildabrand, Esquire Attorney I.D. No. 30102 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 Attorneys for Defendant 1 r CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-64 CIVIL TERM CIVIL ACTION LAW JURY TRIAL DEMANDED DEFENDANT'S FIRST REQUEST FOR PRODUCTION OF DOCUMENTS TO PLAINTIFF TO: Corine A. Rickabaugh c/o William P. Douglas, Esquire Douglas Law Office 27 West High Street PO Box 261 Carlisle, PA 17013 Pursuant to Pa.R.C.P. 4009, you are hereby requested to produce for inspection and copying at the offices of the Defendants' counsel, Karl R. Hildabrand, Esquire, 840 East Chocolate Avenue, Hershey, PA 17033, or at such other location as may be mutually agreed upon by counsel not later than thirty (30) days after service of these Requests the following documents. In lieu of the formal scheduled production, copies of all requested documents may be forwarded to Defendant's counsel at the above address within thirty (30) days after service of these Requests. ((R 11 1. A copy of the complete insurance policy and declaration page(s) which you contend was in effect with the Defendant at the time of the September 15, 2002 accident as alleged in your Amended Complaint. 2. Copies of any and all correspondence, letters, emails, faxes, or other communication between you and the Defendant or any individual acting on behalf of the Defendant. 3. Copies of any and all witness statements, whether written, typewritten, recorded, handwritten or in any other fashion whatsoever involving any witness with knowledge pertaining to the subject matter of this litigation. 4. Copies of any and all expert and non-expert investigation reports, regarding the subject matter of this litigation. 5. Copies of any and all expert reports prepared or submitted by experts which you intend to call at trial. 6. Copies of any and all documents identified by you in response to Interrogatories propounded by Defendant. 7. Copies of any and all reports, records or bills for medical treatment which you have received for the injuries alleged in the accident in question. 8. Copies of any and all medical bills which you contend the defendant did not pay when it was obligated to do so with respect to the accident in question. 9. Copies of any and all medical bills which you contend Defendant paid but did not pay in a timely fashion with respect to the accident in question. 10. Copies of any and exhibits which you intend to use or introduce at the time of trial. 11. A complete copy of the investigation file in your possession or the possession of your attorneys, representatives, or agents regarding the matters complained of in your Amended Complaint including, but not limited to, records, reports, documents, computer notes, logs, emails, faxes, photographs, diagrams, statements, or other writings. 12. Copies of all correspondence between you and each of the Healthcare Providers which you have identified in your Amended Complaint as being ones for which Defendant either did not pay medical expenses or did not timely pay medical expenses. 13. An itemization of all medical expenses paid by Defendant on your behalf for treatment received as a result of the accident in question. 14. Copies of any and all documents that you contend support your allegations that the Defendant acted in bad faith. These requests are deemed continuing requests and any documentation or information requested herein which is discovered, obtained or available subsequent to your first response hereto should be furnished immediately to Defendant's counsel. Respectfully submitted, NESTICO DRUBYY & ILDABRA D, L.L.P. c'C Cc ti (=?rC? cwt.-s By: Karl R. Hildabrand Attorney I.D. No. 30102 840 E. Chocolate Avenue Hershey, PA 17033 (717) 533-5406'I'elephone (717) 533-5717 Fax Attorney for Defendant CERTIFICATE OF SERVICE 1, Karl R. Hildabrand, of the law firm of Nestico, Druby & Hildabrand, L.L.P., hereby certify that on the - Jday of August 2004, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: William P. Douglas, Esquire Douglas Law Office 27 W. High Street P.O. Box 261 Carlisle, PA 17013 Karl R. Hildabrand H NESTICO, DR,UBY & HILDABRAND, LLP ATTORNEYS AT LAW 940 East Chocolate Avenue, Hershey, PA 17033 Phone(717)533-5406 Fax(717)533-5717 www.hersheypalaw.com January 11, 2005 William P. Douglas, Esquire DOUGLAS LAW OFFICE 27 W. High Street P.O. Box 261 Carlisle, PA 17013 Re: Corine A. Rickabaugh v. Goodville Mutual Casualty Company Cumberland County Docket No. 04-64 Civil Term Dear Bill: This will confirm the scheduling of the independent medical evaluation of Corinne Rickabaugh with John S. Rychak, M.D., at his office located at 99 November Drive, Camp Hill, Pennsylvania 17011, on Tuesday, March 1, 2005, at 10:00 a.m. Please have your client bring with her to the examination her x-ray films and other films of diagnostic testing which have been taken. If for any reason this date is not convenient for your client, please let me know immediately. Otherwise, we will be billed for the examination and expect her attendance. On or about August 19, 2004, 1 served Defendant's First Set of Interrogatories and First Request for Production of Documents Upon the Plaintiff. Your client's responses are now well overdue. Would you please provide full and complete answers within the next two (2) weeks. I would like to have all of this information, together with the requested documents, provided in advance of the independent medical evaluation by Dr. Rychak so that his examination can be complete and accurate. Thank you. Very truly yours, NESTIC9, DRUBY & HILDABRAND, LLP K3`?. ildabrand* :comb Enclosure *Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy 11 HSTIC01 DRUBY & HILDABBAND, LLP ATTORNEYS AT LAW 840 East Chocolate Avenue, Hershey, PA 17033 Phone(717)533-5406 Fax (717) 533-5717 w ww.hersheypal aw,eonn February 24, 2005 William P. Douglas, Esquire DOUGLAS LAW OFFICE 27 W. High Street P.O. Box 261 Carlisle, PA 17013 Re: Corine A. Rickabaugh v. Goodville Mutual Casualty Company Cumberland County Docket No. 04-64 Civil Term Dear Bill: On August 19, 2004, I served Defendant's First Set of Interrogatories and First Request for Production of Documents upon the Plaintiff. On January 11, 2005, I wrote to you and asked that you provide your client's responses within the following two (2) weeks. I have been asked to proceed with a Motion to Compel if the responses are not forwarded within the next seven (7) days. Please call me to discuss. Very truly yours, NESTICO, DRUBY & HILDABRAND, LLP K Mlciabrand* :mmb *Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy e'l I) ; CERTIFICATE OF SERVICE I, Karl R. Hildabrand, of the law firm of Nestico, Druby & Hildabrand, L.L.P., hereby certify that on the Il? _ day of August 2004, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: William P. Douglas, Esquire Douglas Law Office 27 West High Street PO Box 261 Carlisle, PA 17013 ell, 4arl R. Hildabrand CERTIFICATE OF SERVICE I, Karl R. Hildabrand, of the law firm of Nestico, Druby & Hildabrand, L.L.P., hereby certify that on the 1 ± day of March, 2005, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: William P. Douglas, Esquire Douglas Law Office 27 West High Street PO Box 261 Carlisle, PA 17013 Karl R. Hildabrand 3 . r- CONNIE A. RICKABAUGH, IN THE COURT OF COMMON MLEAS OF Plaintiff CUMBERLAND COUNTY, PENNSYLVANIA V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant NO. 04-64 CIVIL TERM CIVIL ACTION LAW JURY TRIAL DEMANDED RULE TO SHOW CAUSE AND NOW, this -73 day of March, 2005, upon the Defendant's Petition to Compel Discovery, a rule is hereby issued upon Corine A. Rickabaugh to show cause, if any she has, why the relief requested in Defendant's Petition should not be granted. Rule returnable within 2 o days after service. cc: illiam P. Douglas, Esquire , Hildabrand, Esquire BY THE COURT: of ?.,L?: y ??.?c, .. _ ?????? ?? '3: ,? ?R, »- _?.??, ?,f...? CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term CIVIL ACTION - AT LAW DEFENDANT'S PETITION TO MAKE RULE ABSOLUTE On or about March 16, 2005, Defendant filed a Petition to Compel Answers to its First of Interrogatories and First Request for Production of Documents served upon Plaintiff. 2. On March 23, 2005, this Court issued a Rule upon Plaintiff to Show Cause, if any she why the relief requested should not be granted. Attached hereto, marked as Exhibit "A" incorporated n by reference is a copy of the Rule to Show Cause returnable twenty (20) days after service. 3. On March 29, 2005, the undersigned served Plaintiffs counsel by First Class Mail, with a of the Rule to Show Cause. Attached hereto, marked as Exhibit "B" and incorporated herein by ence is copy of said correspondence. 4. Defendant has heard nothing from Plaintiff in response to the Rule to Show Cause, no rise has been filed, and no responses to discovery have been served. WHEREFORE, Defendant respectfully requests that this Honorable Court make the previously Rule to Show Cause absolute and direct Plaintiff Corinne A. Rickabaugh to provide full and to answers, without objection, to Defendant's First Set of Interrogatories and First Request for Lion of Documents within twenty (20) days of the date of this Court's Order or suffer sanctions. Respectfully submitted, NESTICO, DRUBY & HILDABRAND, L.L.P. 6 5" DS By: Karl R. Hildabrand Attorney I.D. No. 30102 840 E. Chocolate Avenue Hershey, PA 17033 (717) 533-5406 Telephone Attorney for Defendant COWS A. RICKABAUGH, : IN THE COURT OF COMMON PLEAS OF Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. ; NO. 04-64 CIVIL TERM GOODVILLE MUTUAL. CASUALTY COMPANY, : CIVIL ACTION LAW Defendant : JURY TRIAL DEMANDED RULE TO SHOW CAUSE AND NOW, this -),3 _day of March, 2005, upon consideration of the Defendant's Petition to Compel Discovery, a rule is hereby issued upon Plaintiff, Corine A. Rickabaugh to show cause, if any she has, why the relief requested in the Defendant's Petition should not be granted. Rule returnable within 2l J days after service. BY THE OURT: ?J. cc: William P. Douglas, Esquire Karl R. Hildabrand, Esquire T1 i 17 r.., In Tsru?r?? an. I ;;'cll Tl .....: ?1,...., ! ' .. + r v h;!nfd Y Pr;hh;ncl:?ry C??v it USTICO, DRUBY & HILDABRO, LLP A7TORNEYSAT LAW 840 East Chocolate Avenue, Hershey, PA 17033 Phone (717) 533-5406 Fax (717) 533-5717 www.hersheypalaw.com March 24, 2005 William P. Douglas, Esquire DOUGLAS LAW OFFICE 27 W. High Street P.O. Box 261 Carlisle, PA 17013 Re: Corine A. Rickabaugh v. Goodville Mutual Casualty Company Cumberland County Docket No. 04-64 Civil Term Dear Bill: Enclosed please find copy of the Rule to Show Cause issued by Judge [less on March 23, 2005 returnable within twenty days after service. Very truly yours, NESTICO, DRUBY & FIILDABRAND, LLP Kar . Hildabrand* losure *Board Certified in civil trial law and advocacy by the National Board of Trial Advocacy (t VS v CERTIFICATE OF SERVICE -14 1, Karl R. Hildabrand, Esquire, of the law firm Nestico, Druby& Hildabrand, LLP, on this day of May 2005, hereby certify that I served a true and exact copy of the foregoing document as follows: By First Class Mail, Postage Pre-paid: William P. Douglas, Esquire Douglas Law Office 27 W. High Street P.O. Box 261 Carlisle, PA 17013 NESTICO,,DRUBY & HILDABRAND, L.L.P. R. Hildabrand <'? ti '.'7 lJl 1 ?. J., ' G? ?) . ?. ?..? { ?) C? ? CORINE A. RICKABAUGH, Plaintiff V. GOODVILLE MUTUAL CASUALTY COMPANY, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA DOCKET NO. 04-64 Civil Term CIVIL ACTION-AT LAW ORDER OF COURT AND NOW, this 1Z day of May 2005, Defendant's Petition to Make Rule Absolute in respect to Defendant's Motion to Compel Discovery is hereby granted. Plaintiff Corinne A. Rickabaugh is hereby directed to provide full and complete answers to Defendant's First Set of Interrogatories and First Request for Production of Documents, +?l within twenty (20) days of the date of this Order or suffer sanctions. AV °. -]Hi ?;' JV Curtis R. Long Prothonotary office of the i9rotbonotarp Cumblerrarib Countp Renee K. Simpson Deputy Prothonotary John E. Slike Solicitor D41 - Io CIVIL TERM ORDER OF TERMINATION OF COURT CASES AND NOW THIS 29TH DAY OF OCTOBER 2008 AFTER MAILING NOTICE OF INTENTION TO PROCEED AND RECEIVING NO RESPONSE - THE ABOVE CASE IS HEREBY TERMINATED WITH PREJUDICE IN ACCORDANCE WITH PA R C P 230.2 BY THE COURT, CURTIS R. LONG PROTHONOTARY n„P r'n»rthnnce Snuare • Carlisle, Pennsylvania 17013 • (717) 240-6195 • Fax (717) 240-6573