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Worker swims away with compensation for pool therapy

In Virginia, if an injured worker's treating physician prescribed specific medical treatment, the employer must show that the treatment is unreasonable or unnecessary in order to deny compensation.

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Case name: American Armoured Foundation, Inc. v. Lettery, No. 1968-11-2 (Va. Ct. App. 05/01/12, unpublished).

Ruling: In an unpublished decision, the Virginia Court of Appeals held that a worker was entitled to compensation for a YMCA membership and mileage reimbursement so he could continue independent pool therapy.

What it means: In Virginia, if an injured worker's treating physician prescribed specific medical treatment, the employer must show that the treatment is unreasonable or unnecessary in order to deny compensation.

Summary: A worker suffered a compensable workplace accident that injured his right hip, groin, femur, and knee. His orthopedic surgeon prescribed physical therapy, including aquatic therapy. He underwent formal, supervised pool therapy for eight months. His physician instructed him to perform independent pool therapy and wrote him a prescription for six months. In a follow-up visit, the worker notified his physician that his employer did not authorize the independent pool therapy. The worker also saw the orthopedic surgeon and told him his pain increased after he stopped the pool therapy. The surgeon recommended that he restart his pool therapy. The worker sought compensation for a YMCA membership and a mileage reimbursement so he could continue his pool therapy. The Virginia Court of Appeals held that he was entitled to compensation.

The court found that the worker showed that his independent pool therapy was "necessary medical attention." Both of his treating physicians indicated that his independent pool therapy was part of a continuing course of treatment for his compensable injury. The worker's pain and mobility worsened after the employer ceased payments for his YMCA membership and mileage.

The court noted that when the employer complained about the cost of supervised pool therapy the worker and his treating physician accommodated the concern by pursuing independent pool therapy. The court rejected the employer's argument that the pool therapy was not compensable because it was not "medically supervised."

Read more at the WorkersComp Forum homepage.

June 11, 2012

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