Employer Ordered to Pay for Medications

The worker suffered a low back injury at work.  The parties subsequently agreed to a settlement that allowed the claimant to continue to receive medically reasonable and necessary treatment that was related to the work injury.  The employer filed for discontinuance of medications based on a records review that concluded the medications were not necessary for treatment of a work-related injury but rather for other personal medical conditions.  The doctor also questioned whether the use of some of the medications, which were being used in “an off-label context,” was medically appropriate.  Perry v. State of Vermont, Op. No. 13-13WC (2013).

The Department of Labor concluded that the employer is responsible only for those medical treatments that are reasonable and causally related to the injury.  Perry v. State of Vermont, Op. No. 13-13WC (2013) (citing 21 V.S.A. §640(a); Baraw v. F.R. Lafayette, Inc., Op. No. 01-10WC (2010); MacAskill v. Kelley Servs., Op. No. 04-09WC (2009)).  Utilizing the commonly cited five factor test, the Department concluded that the claimant’s treating doctor’s opinions as to causality and necessity were more credible than the employer’s doctor’s opinions. Perry v. State of Vermont, Op. No. 13-13WC (2013) (citing Geiger v. Hawk Mountain Inn, Op. No. 37-03 (2003)).  Specifically, the Department cited the fact that the claimant’s expert was a treating physician and that relationship allowed him to: differentiate between the work-related injury symptoms and the symptoms that resulted from personal medical issues; and use trial and error to create a successful pharmacology regime evidence by better pain control, fewer drugs and lower dosages.  Perry v. State of Vermont, Op. No. 13-13WC (2013).  The Department further concluded that the employer’s expert opinion was based on an assumption, rejected by the Department, that the claimant’s personal medical diagnosis excluded all other possible causes for the worker’s pain complaints.  Such reliance rendered his opinion unpersuasive.  Perry v. State of Vermont, Op. No. 13-13WC (2013).

Employer Ordered to Pay for Cervical Myelopathy

The worker, a short haul freight driver, hit his head while in the employ of the defendant when moving out from underneath a trailer.  He was dazed and suffered a cut to his head but completed his route that day.  He continued to work his regular shifts, “without incident” until he began experiencing symptoms in his lower extremities a number of days later.  Then while at the bank preparing for vacation, he described upper extremity symptoms.  His arms felt heavy and weak.  His hands were numb and unresponsive.  On his vacation, the claimant traveled via motorcycle to South Dakota.  While in South Dakota, his symptoms worsened, his balance was off, he could not walk well and he was unable to return on his motorcycle.  A neurosurgeon at Fletcher Allen Health Care diagnosed him with a disc herniation that was pressing on the spinal cord rather than a nerve root (cervical spondylotic myelopathy) and performed a disc excision and fusion.  He opined the claimant suffered a disc herniation when he hit his head on the underside of the trailer and over the subsequent three weeks he developed the progressive cervical myelopathy.  The employer denied the surgery utilizing a medical opinion that the disc herniation was the result of a natural degenerative process in the claimant’s cervical spine.  The employer’s expert relied on the radiographs of the claimant’s cervical spine taken on the date of the injury which showed an advanced degenerative process, in support of his position.  He also opined that the motorcycle trip was a more likely cause of an aggravation of the pre-existing condition due to the relationship between the trip and the worsening of symptoms. Cain v. New Penn Motor Express, Inc., Op. No. 12-13WC (2013).

The Department of Labor concluded that the treating doctor’s opinion was more credible than the employer’s expert, relying heavily on the “clarity, thoroughness and objective support underlying the opinion.” See Geiger v. Hawk Mountain Inn, Op. No. 37-03 (2003) (citing the five-part test for assessing physician credibility: (1) the nature of the treatment and the length of time there has been a patient-provider relationship; (2) whether the expert examined all the pertinent medical records; (3) the clarity, thoroughness and objective support underlying the opinion; (4) the comprehensiveness of the evaluation; and (5) the expert’s qualifications). The claimant’s doctor adequately explained how the progression of symptoms, though intermittent, explained the worsening of the myelopathy subsequent to the injury.  The defendant’s expert did not adequately address how the motorcycle trip was the cause of the injury when the symptoms began prior to the trip and could not explain what specific elements of the trip were responsible for the causal relationship.  Cain v. New Penn Motor Express, Inc., Op. No. 12-13WC (2013).

Department of Labor Announces Vermont Workers' Compensation Licensing Contact

Adjusters with questions about whether attendance at the final Vermont Department of Labor’s Workers’ Compensation Adjusters’ Continuing Education is required in order to meet continuing education requirements in Vermont should contact Sandra Fraser at the Department of Financial Regulation.  Her phone number is 802-828-5923 and her e-mail is Sandra.fraser@state.vt.us.

The Department of Financial Regulation website is www.dfr.vermont.gov.         

The seminar begins at 12:30pm on Thursday October 24th, and finishes at 5pm that day.  On Friday October 25th, the seminar runs from 8:30am until noon.  This is the last continuing education conference of the cycle.  Pursuant to 8 VSA §4791 any person (other than a licensed attorney) who investigates claims and negotiates settlement of claims arising under policies of workers’ compensation insurance in behalf of insurers under such policies, or who advertises or solicits business from insurers as an adjuster, is a workers’ compensation adjuster for purposes of the statute.  In order to renew a WC Adjusters license you must attend and satisfactorily participate in a continuing education seminar administered by the Vermont Department of Labor and Industry.

The link below takes you to the registration for the October 24 & 25 conference.

http://www.cvent.com/d/z4qnkd/4W

Department of Labor Updates Change of Vocational Provider Form

Today the Vermont Department of Labor has issued an update to the Change of Vocational Provider Form (VR-8).  The Department has asked that previous versions of the Form be discontinued as of this date.  

 

The new form is available at the following link:

http://labor.vermont.gov/FormsPublications/WCFormsandPublications/VRForms/tabid/185/Default.aspx

Vermont Workers' Compensation Conference To Be Held October 24 & 25

The Vermont Department of Labor’s Workers’ Compensation Adjusters’ Continuing Education is scheduled for October 24 and 25^th at the Hilton Hotel, Burlington, Vermont.   The seminar begins at 12:30pm on Thursday, finishing at 5pm and runs from 8:30am until noon on Friday.  This is the last continuing education conference of the cycle.  Pursuant to 8 VSA §4791 any person (other than a licensed attorney) who investigates claims and negotiates settlement of claims arising under policies of workers’ compensation insurance in behalf of insurers under such policies, or who advertises or solicits business from insurers as an adjuster, is a workers’ compensation adjuster for purposes of the statute.  In order to renew a WC Adjusters license you must attend and satisfactorily participate in a continuing education seminar administered by the Vermont Department of Labor and Industry.

The link below takes you to the registration for the October 24 & 25 conference.

http://www.cvent.com/d/z4qnkd/4W

 

The Hilton Hotel, Burlington, Vermont has a block of rooms has been secured for the conference. The link below will provide access to easy online reservations. Guests can also contact 1-800-Hiltons using the code: VTD for the discounted rate.

http://www.hilton.com/en/hi/groups/personalized/B/BTTVTHF-VTD-20131023/index.jhtml