Additional medical care may be awarded after employee reaches MMI

In Indiana, an employee may be entitled to continued medical care after reaching maximum medical improvement.

Case name: Perkins v. Jayco, No. 93A02-0812-EX-1155 (Ind. Ct. App. 05/14/09).

Ruling: The Indiana Court of Appeals remanded the case to the Workers' Compensation Board to determine whether and to what extent future noncurative medical care would benefit the claimant's permanent impairment.

Lack of fixed work site makes car crash compensable (02/25/13)
Failure to tell doctor pain was work-related doesn't curb benefits (02/25/13)
Employer liable for medical care related to latent, progressive injury (02/25/13)
Claim timely filed within 2 years of fatal heart attack (11/01/12)
Late payments, denial of treatment entitle worker to attorney's fees (09/30/11)

What it means: In Indiana, an employee may be entitled to continued medical care after reaching maximum medical improvement if the Workers' Compensation Board determines that such care would limit or reduce the amount and extent of the pain or impairment so that the employee can work within his restrictions, even if the treatment is not intended to cure the impairment.

Summary: The employee suffered a compensable work-related accident and received temporary total disability benefits and medical expenses. He was placed at maximum medical improvement by a number of doctors. One doctor opined that he needed continuing treatment on an intermittent basis for the rest of his life to decrease his pain. The employee filed for an adjustment of his claim to provide additional future medical treatment. The board denied his application for future medical treatment, finding he had reached MMI and therefore was not entitled. The employee argued that a MMI finding is not determinative of whether the injured person is entitled to additional medical treatment that is palliative and reduces the amount and extent of the impairment. The Indiana Court of Appeals agreed, finding that the state allows for palliative treatment for work-related impairments for a time period which the board deems necessary to limit or reduce the amount of the impairment.

The Court of Appeals reasoned that the board could have awarded the employee palliative care upon a finding that it would reduce his pain and limit the extent of his impairment. The court found that since the board failed to make a finding as to whether the proposed care would reduce his pain so that he could function from day-to-day, the case was remanded for the board to make a determination.

June 25, 2009

Newsletter Sign-up