Workers' Compensation

Chris T. Archer

The Industrial Commission will maintain jurisdiction over a claim and award of permanent total disability to resolve disputes over future medical treatment. Noel v. ABB Combustion Engineering, No. 98446 (Mo. App. E.D., November 13, 2012), Gaertner, Jr., C.J.

Claimant sustained a work-related back injury in 1997, for which she was awarded permanent total disability and future medical treatment for depression and pain management. A final award was issued by the commission in 2007.

In April 2011, Employer required Claimant to undergo an independent medical examination (IME), conducted by Dr. Michael Jarvis. He concluded that both Drs. Granberg and Robinson had “lost their respective ways” in terms of treatment and recommended several changes to Claimant’s medication. Later that year, Claimant was notified by Employer’s attorney that several of the medications she was taking would no longer be paid for by Employer.  

Claimant filed a motion with the commission to reopen her workers’ compensation claim, requesting that the commission prevent such a change in medication because it would endanger her life, health, or recovery. The commission ordered an evidentiary hearing, which was conducted by ALJ Carl Strange. The commission then reviewed the transcript of the hearing, the exhibits filed, and the briefs of the parties. The commission concluded that Claimant failed to meet her burden to show that all of the medications she was taking were necessary for the cure and relief of her work-related injuries. Thus, the commission did not reach the issue of whether a change in treatment would endanger Claimant’s life, health, or recovery. This appeal follows.

The court found that the evidence was undisputed that pain medication was reasonably necessary to cure and relieve claimant from the effects of her work-related injury, and that it is accordingly Employer’s obligation to provide such treatment. Therefore, the commission erred in failing to reach the issue of whether reasonable grounds existed to believe the manner in which Employer chose to provide this pain medication and treatment would endanger claimant’s life, health, or recovery, under § 287.140.2. The court reversed the commission's order as to the suspension of pain medication.

The court otherwise affirmed the commission’s decision as it pertained to the psychiatric treatment and other medication the Employer must supply based upon the opinion of Dr. Jarvis who they found more credible.

Not discussed in the case was the ability of the Employer to order an IME, or necessarily retain their right to direct medical treatment under § 287.140. Not challenged by the parties either was the commission’s retention of jurisdiction over a final award and specifically a dispute over the scope of an open or future medical award.

Tillotson v St. Joseph’s Medical Center, 347 S.W.3d 511 (Mo. App. 2011), stands for the proposition that once a compensable accident is found, a claimant needs only to prove that the need for treatment and medication flows from the work injury. Armstrong v. Tetra Park Inc., No. 31971 (Mo. App. S.D., December 7, 2012), Bates, J.

Claimant was found to have sustained a compensable accident to his right shoulder when at work he reached up over his head for a stack of cardboard and felt pain. Conservative treatment was tendered. The Claimant was referred to a number of orthopedic surgeons who all opined that the claimant’s medical condition was pre-existing and degenerative in nature. An MRI confirmed that there were no acute changes in the claimant’s right shoulder. Claimant obtained a contrary expert medical opinion. The commission found that the claimant sustained a compensable accident but affirmed the denial of benefits as claimant failed to prove that the accident was the prevailing factor for his right shoulder medical condition.

Claimant argued that Tillotson stands for the proposition that once a compensable accident has been sustained, the employer is responsible as a matter of law for all injuries and disabilities that flow from the accident. The court disagreed with this interpretation. “[T]here is a material distinction between determining whether a compensable injury has occurred and determining what medical treatment is required to treat a compensable injury.” Id. Tillotson involved the latter while this case involved a determination of the former.