Case Law Alerts
A claimant who refuses to undergo a drug detox program to be weaned off medications taken for a work injury is subject to suspension of benefits.
The Court upheld a suspension of benefits where the claimant refused to undergo a detoxification program that would wean her off toxic doses of medication taken for the work injury. The employer petitioned to terminate compensation benefits the claimant had been on for ten years following a work-related back injury. At the same time, the claimant filed a utilization review petition challenging a UR determination that the medications the claimant received were not reasonable and necessary. The medications included Methadone, Oxycodone, Neurontin, Alprazolam, Zanaflex, Effexor, Wellbutrin, Depakote and Etodolac. Although the workers' compensation judge denied the termination petition, he found credible the testimony of the IME physician that the claimant needed a detox program to help wean her off most of the medications prescribed to her. The doctor testified that such treatment would involve little risk, decrease toxic doses of opiates, and make it possible for her to "live, work and play," although not return to her pre-injury job. Following the workers' compensation judge's decision, the employer offered the claimant an opportunity to enter a detox program under the direction of any physician other than the doctor prescribing the challenged medication. The employer filed a suspension petition under § 306(f.1) (8) after the claimant refused the treatment, arguing that it was reasonable and necessary medical treatment. The court agreed with the workers' compensation judge and found that the medical evidence supported the conclusion that the detox program was reasonable treatment since it was highly probable it would wean the claimant from the toxic doses of medication, allowing her to return to normal functioning and enhancing her prospects of returning to normal functioning. The court's opinion does not include any discussion of testimony as to the nature of the program that would allow the claimant to be weaned off the high level of medications without adverse consequences to her.
Case Law Alert, 2nd Qtr 2010