Curative or Palliative” Care — The Statute require the court compel on treatment that will ‘probably relieve petitioner’s symptoms and improve ability to function.
Martin v. Newark Pub. Sch., N.J. Super. App. Div. Decided December 12, 2019 (Approved for Publication)
Submitted by New Jersey Workers Compensation Lawyer, Jeffrey Hark.
- Procedural History:
Petitioner Samuel Martin, III appeals from an August 13, 2018 order of the Workers’ Compensation Court denying his application for medical and temporary disability benefits (Also know as Motions for Med & Temp). Petitioner requested reimbursement for continued prescription opioid medication to treat a lower back injury suffered during his employment with respondent Newark Public Schools. The compensation judge conducted hearings to determine whether respondent should be compelled to pay for Martin’s prescription opioid medication in accordance with the Workers’ Compensation Act (Act), N.J.S.A. 34:15-1 to -142, specifically N.J.S.A. 34:15-15.
In May 2011, Martin injured his back in an employment-related car accident. In November 2014, Martin received a fifteen percent partial disability award for the orthopedic injury to his lower back as a result of the work-related accident and aggravation of a pre-existing lumbar disc herniation and bulge. After receipt of the partial disability award, Martin filed a motion based on respondent’s refusal to pay for Percocet prescriptions after September 2017. Martin claimed he required Percocet to relieve ongoing and recurrent pain subsequent to the car accident. Respondent opposed the motion, and the matter was scheduled before a judge of the Workers’ Compensation Court.
The compensation judge conducted hearings to determine whether respondent should be compelled to pay for Martin’s prescription opioid medication in accordance with the Workers’ Compensation Act (Act), N.J.S.A. 34:15-1 to -142, specifically N.J.S.A. 34:15-15. The judge heard testimony from Martin; Martin’s treating doctor, Patricio Grob, D.O.; and Martin’s medical expert, Harris Bram, M.D..Dr. Grob, an orthopedic surgeon, testified he began treating Martin in June 2011 and continued treating him through September 2017. In September 2017, Dr. Grob released petitioner, finding Martin reached maximum medical improvement. In discharging him, the doctor wrote a final prescription for Percocet as a courtesy to Martin.
III. Issue — “Curative or Palliative” Care — The Statyte require treatment that will ‘probably relieve petitioner’s symptoms and improve ability to function” Definition.
We next consider petitioner’s argument that the judge misapplied the law concerning the application for continued palliative care treatment. The Act (New Jersey’s Workers Compensation Statute) requires employers to provide treatment to injured employees when the treatment is “necessary to cure and relieve the worker of the effects of the injury and to restore the functions of the injured member or organ where such restoration is possible . . . .” N.J.S.A. 34:15-15.
Whether the treatment is characterized as curative or palliative, the treatment is compensable if competent medical testimony shows that it is “reasonably necessary to cure or relieve the effects of the injury.” Hanrahan v. Twp. of Sparta, 284 N.J. Super. 327, 336 (App. Div. 1995). A claimant must show the treatment would “probably relieve petitioner’s symptoms and thereby improve his ability to function.” Ibid. “[I]n determining what is reasonable and necessary, the touchstone is not the injured worker’s desires or what he thinks to be most beneficial. Rather, it is what is shown by sufficient competent evidence to be reasonable and necessary to cure and relieve him.” Squeo v. Comfort Control Corp., 99 N.J. 588, 606 (1985). “A mere showing that the injured worker would benefit from the added treatment is not enough.” Raso v. Ross Steel Erectors, Inc., 319 N.J. Super. 373, 383 (App. Div. 1999). There may be a point at which “the pain or disability experienced by the worker is insufficient to warrant the expense of active treatment.” Hanrahan, 284 N.J. Super. at 336 (citing Squeo, 99 N.J. at 606).