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Carrier must authorize treatment for preexisting diabetes
In Florida, a carrier must provide treatment for a condition that may not be related to the work accident if treatment or stabilization of the condition is necessary to assist the employee in recovering from the compensable injury.
Case name: Perez v. Miami-Dade County Water & Sewer Dept., 16 FLWCLB 218 (Fla. JCC, Miami 2009). Ruling: A Judge of Compensation Claims ordered the carrier to authorize medical treatment to stabilize the employee's preexisting, noncompensable diabetes in order to medically clear the employee to undergo pain treatments for his work-related back condition.
Summary: A utilities and supplies specialist suffered two work accidents. The carrier accepted the claims as compensable and provided medical and indemnity benefits. The specialist's doctor later recommended a series of injections with sedation anesthesia to relieve the specialist's back pain. However, the doctor found that the specialist's blood glucose level was too high due to diabetes. The carrier authorized the injections but argued that because the employee had already reached maximum medical improvement, it was no longer its duty to stabilize the underlying diabetic condition. The JCC disagreed and authorized treatment for the employee's diabetes, reasoning that the carrier had a duty to furnish treatment for the underlying diabetic condition. The JCC relied on the treating doctor's testimony that unless the specialist's blood sugar was under control, he could not go ahead with the epidural steroid and lumbar facet injections that would aid in the employee's recovery from the compensable accident. The JCC found the employee's diabetic condition was an underlying condition that must be controlled before he could receive the proper treatment recommended by the authorized provider. The JCC further explained that the fact that the employee had reached MMI did not affect the outcome of this case. It rejected the carrier's argument that the employee failed to take reasonable measures to treat his diabetic condition by not seeking medical treatment. The JCC relied on the doctor's statements that the injections could not be performed until the diabetes was controlled because the employee could fall into a diabetic coma. However, the JCC pointed out that the employee had to fully cooperate with the diabetes treatment, including avoidance of certain foods and beverages, without deviation. Read more at the WORKERSCOMP ForumTM homepage. March 4, 2010 Copyright 2010© LRP Publications |
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