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COA reverses worker's comp board on prescription drug denial

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The Indiana Court of Appeals reversed a finding by the state Worker’s Compensation Board that a woman’s employer isn’t responsible for providing a specific prescription drug to her, noting that the board only focused on one possible reason why the drug is prescribed.

In Yvette Albright v. Four Winds International, No. 93A02-1010-EX-1324, Four Winds International employee Yvette Albright appealed the decision by the full Indiana Worker’s Compensation Board that affirmed her employer doesn’t have to provide prescription Cymbalta to Albright. Albright developed neck pain and numbness as a result of her work wiring recreational vehicles and was given an 18 percent permanent partial impairment of the body. Four Seasons agreed to compensate her for the injury.

Albright’s doctor prescribed Cymbalta to help control Albrights’ paresthesias, which causes skin sensations and is usually associated with injury or irritation of a nerve. Her doctor later increased the dosage and found the increase helped Albright deal with the pain caused by the condition. She later filed an application for adjustment of claim and her medical records were reviewed by Dr. David Poder. He found the prescription drug to be an appropriate treatment for her condition.

The single hearing member denied Albright’s claim, finding her doctor didn’t submit a detailed report about how much pain relief Albright had with the drug, and that Albright isn’t entitled to payment for indefinite ongoing medication for depression and anxiety.

The Court of Appeals found the full board erred in denying Albright’s claim for Cymbalta. The board made no finding that the drug isn’t properly prescribed for pain generally or to treat Albright’s neuropathic pain, wrote Judge Edward Najam. There isn’t even evidence in the record from which the board could conclude that Cymbalta is only used to treat depression.

The judges also found that Albright’s attorney and personal doctor did submit detailed reports on Albright’s condition and how much pain relief Albright had while taking Cymbalta.

“There is evidence in the record to support findings that Cymbalta was helping Albright’s psychological issues as well as her paresthesias. In light of the broadly stated issue presented to the Board in the Stipulation, the Board should have separately considered each reason for the treatment in determining whether Four Winds is responsible to provide that medication,” wrote Judge Najam.

He wrote there is also evidence that her paresthesias is related to her neck injury. Based on all the evidence, the board should have entered an award in favor of Albright. The judges remanded to the board to determine how long Four Winds should be required to provide the drug and request and consider additional evidence on that issue if necessary.

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  1. Indianapolis employers harassment among minorities AFRICAN Americans needs to be discussed the metro Indianapolis area is horrible when it comes to harassing African American employees especially in the local healthcare facilities. Racially profiling in the workplace is an major issue. Please make it better because I'm many civil rights leaders would come here and justify that Indiana is a state the WORKS only applies to Caucasian Americans especially in Hamilton county. Indiana targets African Americans in the workplace so when governor pence is trying to convince people to vote for him this would be awesome publicity for the Presidency Elections.

  2. Wishing Mary Willis only God's best, and superhuman strength, as she attempts to right a ship that too often strays far off course. May she never suffer this personal affect, as some do who attempt to change a broken system: https://www.youtube.com/watch?v=QojajMsd2nE

  3. Indiana's seatbelt law is not punishable as a crime. It is an infraction. Apparently some of our Circuit judges have deemed settled law inapplicable if it fails to fit their litmus test of political correctness. Extrapolating to redefine terms of behavior in a violation of immigration law to the entire body of criminal law leaves a smorgasbord of opportunity for judicial mischief.

  4. I wonder if $10 diversions for failure to wear seat belts are considered moral turpitude in federal immigration law like they are under Indiana law? Anyone know?

  5. What a fine article, thank you! I can testify firsthand and by detailed legal reports (at end of this note) as to the dire consequences of rejecting this truth from the fine article above: "The inclusion and expansion of this right [to jury] in Indiana’s Constitution is a clear reflection of our state’s intention to emphasize the importance of every Hoosier’s right to make their case in front of a jury of their peers." Over $20? Every Hoosier? Well then how about when your very vocation is on the line? How about instead of a jury of peers, one faces a bevy of political appointees, mini-czars, who care less about due process of the law than the real czars did? Instead of trial by jury, trial by ideological ordeal run by Orwellian agents? Well that is built into more than a few administrative law committees of the Ind S.Ct., and it is now being weaponized, as is revealed in articles posted at this ezine, to root out post moderns heresies like refusal to stand and pledge allegiance to all things politically correct. My career was burned at the stake for not so saluting, but I think I was just one of the early logs. Due, at least in part, to the removal of the jury from bar admission and bar discipline cases, many more fires will soon be lit. Perhaps one awaits you, dear heretic? Oh, at that Ind. article 12 plank about a remedy at law for every damage done ... ah, well, the founders evidently meant only for those damages done not by the government itself, rabid statists that they were. (Yes, that was sarcasm.) My written reports available here: Denied petition for cert (this time around): http://tinyurl.com/zdmawmw Denied petition for cert (from the 2009 denial and five year banishment): http://tinyurl.com/zcypybh Related, not written by me: Amicus brief: http://tinyurl.com/hvh7qgp

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