Louisiana Record

Monday, October 21, 2019

Work-comp claimant who wanted non-narcotic treatment gets favorable ruling from high court

By Sam Knef | Mar 31, 2017

NEW ORLEANS — After finding that the workers' compensation system and its medical director misinterpreted language of state administrative code, the Louisiana Supreme Court has reversed a lower-court ruling that denied a claimant's request for a trial of a spinal-cord stimulator.

The issue decided by the high court, according to the opinion released on March 15, was whether the Office of Workers' Compensation erred by affirming the system's medical director who denied claimant Byron Gulley's physician's request.

Judges with the 3rd Circuit Court of Appeals, Parish of Rapides, had affirmed the findings of the OWC.

The high court’s opinion noted that the state Legislature in 2009 enacted a statute establishing a medical-treatment schedule that was ultimately used by the OWC. The statute allows an aggrieved party to file an appeal with the medical director, and the decision of the medical director can be “overturned when it is shown, by clear and convincing evidence” that the decision “was not in accordance with the provisions” of the statute.

Gulley had sued Hope Youth Ranch and others after he had been hit by a golf cart in June 2009 while working at the Winnfield, Louisiana ranch. He claimed injuries to his head, shoulder, wrist, back, knee, hip, foot and ankle, court documents said.

His pain-management specialist had recommended a trial of the spinal-cord stimulator because medications, conservative therapy and injections did not deal with pain in his lower back, left hip and leg.

"To deny this claimant the non-narcotic alternative he seeks not only departs from the appropriate interpretation of the Medical Treatment Guidelines addressed by the majority, but would also leave this claimant, who has exhausted all other options, with the unavoidable use of dangerous and addictive opioids for pain relief," Justice Scott Crichton wrote in the court's opinion. "Surely this is not what the Louisiana Workers’ Compensation Act seeks to accomplish."

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