MATTIE J. WILLIAMS, Employee,
v.
HOLIDAY STATION STORES and RELIANCE GROUP/CRAWFORD & CO., Employer-Insurer/Appellants,
and
DOCTORS' DIAGNOSTICS CTR., Intervenor.
Minnesota Workers Compensation
Workers' Compensation Court of Appeals
March 12, 1999
HEADNOTES
MEDICAL
TREATMENT & EXPENSE - REASONABLE &
NECESSARY. Under the particular facts of this case,
substantial evidence, including the opinions of the
employee's family physician and treating surgeon,
supported the compensation judge's conclusion that
gastric bypass surgery was reasonable and necessary to treat
the employee's work-related low back strain.
MAXIMUM
MEDICAL IMPROVEMENT - SUBSTANTIAL EVIDENCE. Substantial
evidence supported the compensation judge's conclusion
that further significant improvement in the employee's
work-related low back condition could be reasonably
anticipated through the employee's expected continued
weight loss, following gastric bypass surgery, and her
resulting ability to participate in rehabilitative exercises.
Affirmed.
Determined by Wilson, J., Wheeler, C.J., and Pederson, J.
Compensation Judge: Bradley J. Behr.
OPINION
DEBRA
A. WILSON, Judge
The
employer and insurer appeal from the compensation judge's
findings as to maximum medical improvement and the
reasonableness and necessity of gastric bypass
surgery. We affirm.
BACKGROUND
The
employee began working as a cashier for Holiday Station
Stores [the employer]1 in October of 1990. Between 1992
and 1994, the employee sought occasional treatment for low
back symptoms, but she apparently missed little or no time
from work as a result of her back condition until September
8, 1995, when she sustained a work-related low back injury
while unloading or scanning a bag of cat
litter.2 Following that injury, the
employee sought treatment for low back symptoms from Dr.
Robert Johnson, her usual family physician, who diagnosed
sprain/strain and tried various conservative treatment
measures, including physical therapy, aquatic therapy, and
medication. The employee's symptoms continued,
however, and she began to have difficulty performing her job.
In
addition to the other treatment directed toward her back
symptoms, Dr. Johnson advised the employee to lose
weight. The employee, who is 4§ 10" or 4§ 11",
has been obese virtually all of her adult life, with her
weight ranging from 260 to nearly 350 pounds. At some
point prior to her work injury, the employee tried the Weight
Watchers diet program, and she apparently lost 30 or 40
pounds before quitting the program due to
cost. Following her work injury, Dr. Johnson gave the
employee a prescription for Redux, which also resulted in a
40-pound weight loss, but the employee had to discontinue the
medication due to health concerns. Neither Weight
Watchers nor Redux produced permanent weight control; the
employee regained the weight she had lost, and more. As
Dr. Johnson explained in his deposition, the employee's
severe obesity both contributed to her back symptoms and
prevented her from engaging in the kind of exercise program
necessary to strengthen her back and allow the sprain/strain
to heal.
In
August of 1997, after Dr. Johnson recommended a 10-pound
lifting restriction for the employee, the employer placed the
employee on a temporary leave of absence "pending
improvement of [her] condition."
On
December 3, 1997, the employee filed a claim petition seeking
authorization for gastric bypass surgery, which Dr. Johnson
had advised her to investigate to treat her
obesity. About a month later...
