BARBARA J. THAEMERT, Employee/Appellant,
v.
HONEYWELL INT'L, INC., SELF-INSURED, and SEDGWICK CLAIMS MGMT. SERVS., INC., Employer-Insurer/Respondents
and
INJURED WORKERS' PHARMACY, Intervenor.
No. WC18-6164
Minnesota Workers Compensation
Workers' Compensation Court of Appeals
December 20, 2018
MEDICAL
TREATMENT & EXPENSE - REASONABLE & NECESSARY.
Substantial evidence in the record does not support the
compensation judge's denial of claimed medical treatment
according to whether the claimed medical treatment was
reasonable and necessary.
EVIDENCE
- EXPERT MEDICAL OPINION. Where the report prepared by the
independent medical examiner relied on assumptions which are
contradictory to the facts as found by the compensation judge
and was otherwise unsupported by evidence in the record,
reliance on the opinion of the independent medical examiner
is error.
Charles M. Cochrane, Cochrane Law Office, Roseville,
Minnesota, for the Appellant.
Jeffrey G. Carlson, Brown & Carlson, P.A., St. Louis
Park, Minnesota, for the Respondents.
Determined by: Patricia J. Milun, Chief Judge, David A.
Stofferahn, Judge, Gary M. Hall, Judge, Deborah K. Sundquist,
Judge, Sean M. Quinn, Judge
Compensation Judge: James F. Cannon
Disposition:
Vacated in part and remanded.
OPINION
PATRICIA J. MILUN, Chief Judge.
The
employee appeals from the compensation judge's
determination, relying on the opinion of the self-insured
employer's independent medical examiner, that the
employee's current medical claim for narcotic medications
does not constitute medical treatment that was reasonable,
necessary, and causally related to the work-related injuries
on January 29, 1993, and June 17, 1998. We vacate Findings 17
and 19-23 and the denial of benefits, and remand to the
compensation judge for reconsideration.
BACKGROUND
The
employee, Barbara Thaemert, worked at Honeywell, the
self-insured employer, from 1977 until June 1998. The
employee suffered an admitted work injury on January 29,
1993, as a result of assembly work, largely consisting of
connecting parts and pinching wires. She began experiencing
headaches and pain in her neck, bilateral shoulders, and
bilateral arms. First seeking chiropractic treatment,
physical therapy, and massage therapy, she then began
treating with A.V. Anderson, M.D., in May 1993. Dr. Anderson
diagnosed the employee with degenerative disc and joint
disease in the cervical spine at C3 through C6, tendinitis of
the right shoulder, and lateral epicondylitis of the upper
right arm. In 1995, Dr. Anderson concluded the employee was
at maximum medical improvement (MMI) for the January 29,
1993, work injury; opined continuing conservative care was
appropriate to address the effects of that injury; and rated
the employee with a permanent partial disability (PPD) of
10.5 percent for the cervical spine and 3 percent for the
right shoulder.
In
December 1995, Dr. Anderson prescribed Tylenol #3, an opioid
medication, to be taken as needed for pain. The employee had
been taken off work for one week due to an aggravation of her
pain symptoms. Dr. Anderson noted the employee had a 50
percent reduction of her pain due to the use of Tylenol #3.
In June 1996, Dr. Anderson noted that the employee needed
Tylenol #3 for sufficient pain relief to be able to sleep. In
March 1997, Dr. Anderson noted the employee was unable to
continue working without the pain relief provided by Tylenol
#3, and the employee's use of that medication was reduced
when she was not working. On January 21, 1998, Dr. Anderson
began the employee on a trial of oxycodone as a replacement
for the Tylenol #3 pain medication. The employee credited her
ability to work full time to the pain relief she was
receiving from the medication.
The
employee suffered an alleged work injury on June 17, 1998,
which caused her to be taken off work by Dr. Anderson. The
claimed work injury was bilateral carpal tunnel syndrome,
which the employee attributed to her work duties. An EMG
study supported the diagnosis. The employee did not resume
working for the employer.
At a
follow-up appointment on July 15, 1998, Dr. Anderson noted
the employee's use of OxyContin (20 mg) to address her
ongoing pain symptoms and Oxycodone for breakthrough pain.
After the failure of conservative treatment, the employee
underwent carpal tunnel surgery on the right side in December
1998, and on the left side in February 1999. Both surgeries
were performed by David R. Olson, M.D. On May 5, 1999, Dr.
Anderson noted the employee's continued use of OxyContin
and Oxycodone, and indicated the employee was experiencing
ongoing pain symptoms resulting in other adverse effects,
such as sleep interruption. On June 16, 1999, Dr. Anderson
documented the employee's physical symptoms, including
muscle spasms, which he considered consistent with the
employee's complaints of pain.
On
December 15, 1998, the employee underwent an independent
medical examination (IME) by Joseph T. Teynor, M.D., on
behalf of the self-insured employer. Dr. Teynor opined the
employee did not suffer a Gillette[1] injury at work. Dr.
Teynor considered the employee's ongoing use of narcotic
medications to be unnecessary to treat any claimed work
injury with the employer.
On
December 17, 1999, Dr. Anderson provided a narrative letter
describing the employee's condition, including the
unsuccessful effort to address arm pain through carpal tunnel
surgery. Dr. Anderson attributed the employee's ongoing
pain syndrome to her 22 years of assembly work. Dr. Anderson
increased the employee's PPD rating, and considered the
employee to be permanently and totally disabled. Dr. Anderson
noted the ongoing opioid prescriptions were needed to give
the employee enough pain relief to sleep and perform ordinary
activities of daily living (hereinafter ADLs).
On
March 2, 2000, Dr. Anderson conducted a follow-up examination
and again opined the employee was permanently and totally
disabled. Dr. Anderson also noted the employee's
medications substantially reduced her pain and improved her
overall functioning.
On May
12, 2000, the employee underwent a second JJVIE by Dr.
Teynor, on behalf of the self-insured employer. Dr. Teynor
opined the employee's ongoing symptoms did not arise from
any work injury with the employer.
On July
12, 2000, Dr. Anderson conducted a follow-up examination and
noted the employee's ongoing prescription for opioids was
consistent with current medical practice and was needed to
provide sufficient functioning for ADLs.
On
April 4, 2001, Dr. Olson provided a narrative report
regarding the employee's carpal tunnel condition. Dr.
Olson discussed permanent restrictions and a permanent
partial disability rating which would be either zero percent
or three percent, depending on the outcome of a subsequent
EMG arising from that condition and the relative success of
the surgery. There was no discussion of chronic pain and no
discussion of the employee's opioid treatment.
The
parties reached a settlement and on July 19, 2001, an Award
on Stipulation was filed. The employee received $70,000, less
attorney fees of $14,200, for a close-out of claims including...
