DARWIN STATELY, Employee/Appellant,
v.
RED LAKE BUILDERS and GAB ROBINS N. AM., INC., Employer-Insurer,
and
MERITCARE HEALTH SYS., CENTRAL MINN. NEUROSCIENCES, LTD., and CENTER FOR PAIN MGMT., Intervenors.
No. WC10-5113
Minnesota Workers Compensation
Workers’ Compensation Court of Appeals
September 30, 2010
HEADNOTES
MEDICAL
TREATMENT & EXPENSE - REASONABLE & NECESSARY; MEDICAL
TREATMENT & EXPENSE - TREATMENT PARAMETERS. Substantial
evidence, including expert opinion, supported the
compensation judge’s conclusion that in-home use of a
hospital bed was not reasonably required to treat the
employee’s low back condition, and the judge did not
err in concluding that the employee’s claim did not
qualify for a departure from the treatment parameters or
application of the “rare case” exception to the
parameters pursuant to Jacka v. Coca Cola Bottling
Co., 580 N.W.2d 27, 58 W.C.D. 395 (Minn. 1998).
Affirmed.
Yuri
Jelokov, Rodgers, Garbow & Jelokov, Bemidji, MN, for the
Appellant.
Michael Forde and Andrew Grimsrud, Aafedt, Forde, Gray,
Monson & Hager, Minneapolis, MN, for the Respondents.
Determined by: Wilson, J., Rykken, J., and Johnson, C.J.
Compensation Judge: Adam Wolkoff
OPINION
DEBRA
A. WILSON, Judge
The
employee appeals from the judge’s decision denying the
employee’s claim for an in-home hospital bed for
treatment of his low back condition. We affirm.
BACKGROUND
The
employee sustained a work-related injury to his low back
while working for Red Lake Builders [the employer] on March
1, 2002. The employer and its workers’ compensation
insurer accepted liability for the injury and paid various
workers’ compensation benefits, including expenses
related to a low back fusion surgery performed on April 7,
2003, and benefits for a 20% permanent partial disability of
the whole body. The fusion surgery was performed by Dr.
Jeffrey Gerdes.
Upon
his discharge from the hospital, the employee was provided
with a hospital bed for use at home. For approximately six to
eight months, the employer and insurer paid the rental
charges associated with that bed. The bed was removed from
the employee’s home at the employer and insurer’s
direction.1 The employee subsequently continued to
receive care from Dr. Gerdes and from his primary care
doctor, Mark Cunningham.
In June
of 2004, the employee was referred to Dr. Michael Gonzales
for pain management. Dr. Gonzales treated the employee
primarily with pain medication, including opioids, and
exercise. Sacroiliac injections performed in January of 2005
were not effective in reducing the employee’s pain. The
employee eventually also came under the care of neurosurgeon
Dr. Alejandro Mendez.
At some
point between 2005 and 2007, the employee again began using a
hospital bed in his home, and he has continued to use it
since that time.
It was
eventually determined that the employee had a failed fusion.
Dr. Mendez evaluated the employee to determine whether
surgery would be effective. He indicated that a fusion
revision offered only a 30% chance of significantly improving
the employee’s low back pain.2
On
August 7, 2007, Dr. Mendez wrote a letter, indicating that
the employee had experienced no resolution of his low back
pain and that the employee’s diagnosis was chronic low
back pain with demonstrated pseudoarthrosis at L5-S1 and
possibly L4-5. Noting that the employee reported increased
back pain when he used a regular bed, Dr. Mendez recommended
that the employee continue using a hospital bed on a
permanent basis.
In late
2007, the parties entered into a stipulation for...
