IF AT FIRST YOU DONíT SUCCEED, BOARD SAYS DO NOT TRY AGAIN:
National Workers Compensation Defense Network (NWCDN)
Claimant was involved in a compensable 2003 work accident with an accepted L4-S1 fusion performed in 2005, by Dr. Eppley. Following the surgery, claimant was discharged by her surgeon and referred to pain management. Claimant remained in continuous pain management to the present, with narcotic medications, injections, and various other conservative care. In 2017, Claimant returned to Dr. Eppley, who recommended adding L2-4 to her original fusion, citing suspected adjacent segment disease. Claimant filed a Petition seeking approval of the surgery. Employer filed a Petition seeking to discontinue ongoing narcotic medications.The Board found that the recommended surgery was not reasonable and necessary treatment, accepting the opinion of defense expert Dr. Fedder over Dr. Eppley. The Board noted that contrary to the rosy picture painted by Dr. Eppley in his deposition as to the outcome of the first surgery, the medical records showed ďat bestĒ this procedure caused 30% improvement in claimantís subjective complaints only. The procedure did not allow claimant to return to work, or reduce her treatment, narcotic medications, and the like. To the contrary, pain management treatment increased and was uninterrupted for years following the surgery. The Board also noted that the proposed surgery would not fix claimantís multiple unrelated comorbid conditions that significantly impacted her function, such as the need for bilateral knee replacements, rheumatoid arthritis, and morbid obesity. The Board further opined, based upon the testimony of defense expert Dr. Nathan Schwartz, that claimantís narcotic medications should be discontinued due to lack of functional improvement. Should you have any questions regarding this Decision, please contact Greg Skolnik, or any other attorney in our Workersí Compensation Department.Carmen Kelley v. First Student, IAB Hrg. No. 1238448 (Apr. 6, 2020). 302-573-4800 www.hfddel.com.
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