West Virginia Record

Thursday, November 21, 2019

Court says steroid injections are allowed for bus driver's pain management

State Supreme Court

By Kyla Asbury | Sep 30, 2019

Wvschero

CHARLESTON — The West Virginia Supreme Court of Appeals sided with a bus driver in an appeal, affirming that the West Virginia Workers' Compensation Board of Review rightfully reversed an earlier decision and allowed steroid injections for pain.

The claims administrator involved in Lester Howell's workers' compensation claim denied a request for repeat thoracic epidural steroid injections on May 11, 2017.

The claims administrator also denied a request to add herniated discs at T1-2 and T9-10 to the claim one week later, according to the Sept. 13 memorandum decision.

The Office of Judges reversed the May 11, 2017, decision and authorized the injections in January 2018 and also modified the later decision to allow for the T1-2 disc herniation to be added to the claim, according to the decision.

"The Court has carefully reviewed the records, written arguments, and appendices contained in the briefs, and the case is mature for consideration," the decision states. "The facts and legal arguments are adequately presented, and the decisional process would not be significantly aided by oral argument."

Howell, a bus driver for the county, was injured on Aug. 26, 2015, when the bus he was driving was rear-ended by another vehicle. He sought treatment with Dr. Stephen Mascio and returned to work several weeks later, despite still having pain. Howell went to physical therapy and was given a referral for pain management.

Mascio requested authorization for thoracic epidural steroid injections in 2016 and the claims administrator granted them for injections between Feb. 23, 2016, and May 31, 2016. However, the claims administrator denied them after that date and then denied the thoracic disc herniations being added to the claim.

The Office of Judges reversed the claims administrator’s denial of repeat thoracic epidural steroid injections and authorized the treatment

"In regard to the T1-2 herniated disc, the Office of Judges found that a preponderance of the evidence shows the condition should be added to the claim," the decision states. "An MRI taken six months after the compensable injury showed a herniated disc at T1-2. The Office of Judges found no evidence in the record of a herniation at that level prior to the compensable injury."

After review, the Supreme Court found it agreed with the reasoning and conclusions of the Office of Judges as affirmed by the Board of Review.

"An additional condition may be added to a claim if a claimant can show that it was a personal injury, received in the course of employment, and resulting from that employment," the decision states. "In this case, Mr. Howell presented sufficient evidence to show that his T1-2 disc herniation was the result of his motor vehicle accident which occurred in the course of and resulted from his employment."

Regarding the requested treatment, West Virginia code provides that the claims administrator "must provide medically related and reasonably required sums for healthcare services, rehabilitation services, durable medical and other goods, and other supplies."

"For the foregoing reasons, we find that the decision of the Board of Review is not in clear violation of any constitutional or statutory provision, nor is it clearly the result of erroneous conclusions of law, nor is it based upon a material misstatement or mischaracterization of the evidentiary record," the decision states.

West Virginia Supreme Court of Appeals Case number: 18-0767

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