In your Pennsylvania workers’ compensation case, it is important to be aware of which kinds of treatments may entitle you to an award of benefits, and which may not. Specifically, it is important to be aware that a treatment doesn’t necessarily have to cure or permanently improve your medical condition in order to be something that allows you to obtain an award of benefits. Simple management of pain can be enough, even if the positive effects of the treatment last only a couple of days. To make sure that you are getting the full award to which you are entitled, be sure to retain an experienced Pennsylvania workers’ compensation attorney.
The case of Anthony, an employee of the YMCA, was a recent example of how even short-term benefits could be the basis of a winning case. Anthony suffered a work-related disc herniation in his neck. The employee’s treating physician was a licensed doctor, board certified in “physical medicine and rehabilitation.” The doctor was also a licensed acupuncturist. The course of treatment that the doctor prescribed and carried out for Anthony included a muscle relaxant and also acupuncture.
Eventually, the employer and its insurer requested what’s called a “utilization review.” This type of review is a tool, provided within Pennsylvania’s workers’ compensation law, that allows an employer to request a review of medical treatment provided to an injured worker. Employers may often exert their option to request a utilization review as a means of trying to save money on a case.
The physician who did Anthony’s review concluded that acupuncture was neither reasonable nor medically necessary. The reviewing doctor determined that the acupuncture was giving the worker neither significant nor long-lasting pain relief.
Anthony testified that, in fact, the acupuncture did only eliminate the pain for one or two days, after which the pain returned. However, he also testified that the acupuncture treatments helped reduce his pain and keep it at manageable levels. In addition to Anthony’s own testimony, he also had the helpful testimony of his doctor. The doctor further bolstered the employee’s assertion that the acupuncture treatment helped keep Anthony’s pain at manageable levels.
The board ruled for Anthony, and the Commonwealth Court upheld that ruling on appeal, meaning that the worker was entitled to benefits that covered the cost of his acupuncture treatments. The court explained that even just the benefit of temporary, short-term pain elimination, along with additional pain reduction, could be enough to make a treatment reasonable and necessary under the law. The pain management benefit to which the employee testified could, by itself, be enough to warrant an award of benefits. In Anthony’s case, though, he had proof that he received additional benefits from his acupuncture treatments; namely, the acupuncture allowed him to stay off opioid drugs. Pennsylvania courts have previously noted the increased array of risks that opioids pose, so the benefit of avoiding them (which the acupuncture provided) was a tangible benefit further indicating that Anthony should receive benefits to cover his acupuncture.
There can be many different things that go into obtaining a full and complete award of workers’ compensation benefits. You may require a variety of treatments in order to address your work-related injury. Make sure that you are getting all of the workers’ compensation benefits that you should be receiving. Talk to the knowledgeable Pennsylvania workers’ compensation attorneys at Needle Law Firm. Our team can offer you the thoughtful advice and diligent advocacy your case needs to get you the award you deserve.
Contact us today for a free, no-obligation consultation by calling (570) 344-1266.
More blog posts:
Overcoming Your Employer’s Attempt to Terminate Your Pennsylvania Workers’ Compensation Benefits, Pennsylvania Accident Lawyer Blog, Feb. 5, 2018
Maintaining Your Pennsylvania Workers’ Compensation Benefits, Even After Returning to Work, Pennsylvania Accident Lawyer Blog, Jan. 28, 2018