LISA MIDDLETON-WHITE
v.
FIVE STAR QUALITY CARE INC SAFETY NATIONAL CASUALTY CORP, Insurance Carrier
BROADSPIRE SERVICES, INC, Claim Administrator
Jurisdiction Claim No. VA00001239700
Virginia in the Workers' Compensation Commission
May 17, 2021
Date
of Injury August 24, 2016
Claim
Administrator File No. 188330795001
Bradford Goodwin, Esquire For the claimant.
Jennifer Helsel, Esquire For the Defendants.
Opinion by MARSHALL Commissioner
REVIEW
on the record by Commissioner Marshall, Commissioner Newman,
and Commissioner Rapaport at Richmond, Virginia.
The
defendants request review of the Deputy Commissioner's
December 22, 2020 Opinion finding the claimant's ongoing
medical treatment reasonable, necessary, and causally related
to her August 24, 2016 injury. We AFFIRM.
I.
Material Proceedings
The
claimant suffered a compensable low back injury on August 24,
2016. A November 28, 2017 Opinion awarded medical benefits
and various periods of temporary partial disability. Claims
filed on February 12, 2020 and August 24, 2020 sought
reimbursement for medical treatment and out-of-pocket
expenses, approval of prescribed medications, and a panel of
pain management specialists in Boston, Massachusetts where
the claimant resides.
The
defendants disputed the claims on the basis that there was no
causal connection between the low back injury and medical
treatment. Based on Dr. Kirby's opinion, they asserted
that any treatment after October 26, 2017 was not reasonable,
necessary, or causally related to the work accident.
Following
an evidentiary hearing, the Deputy Commissioner issued a
December 22, 2020 Opinion. Weighing the evidence, she was
persuaded that the claimant's lower back pain radiating
into her left hip remains causally related, at least in part,
to the compensable August 24, 2016 injury by accident. She
explained:
We find it significant that the claimant's symptoms never
fully abated. She has continued to have pain in the same
place since the work accident; pain which has required
ongoing medical treatment. We considered Dr. Kirby's
opinion as a treating physician, but did not give it
controlling weight because Dr. Kirby failed to explain why he
accepted the onset of the claimant's pain as the work
accident but, by September 2017, believed that same, ongoing
pain could not be explained aside from the claimant's
non-related degenerative changes and weight. Instead, we
found treating physician Dr. Nazmi's repeated opinion
that the claimant's pain is from her work-related injury
convincing.
(Op.
7.) The Deputy Commissioner concluded that the treatment to
date was reasonable and necessary. Given the claimant's
relocation to the Boston, Massachusetts area in July 2020,
the defendants were ordered to provide a new panel of
physicians to the claimant.
The
defendants filed a timely request for review. They assert the
Deputy Commissioner erred in determining that medical
treatment beyond October 26, 2017 was reasonable, necessary...
