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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. "So we broke with England for the right to "off" our preborn progeny at will, and allow the processing plant doing the dirty deeds (dirt cheap) to profit on the marketing of those "products of conception." I was completely maleducated on our nation's founding, it would seem. (But I know the ACLU is hard at work to remedy that, too.)" Well, you know, we're just following in the footsteps of our founders who raped women, raped slaves, raped children, maimed immigrants, sold children, stole property, broke promises, broke apart families, killed natives... You know, good God fearing down home Christian folk! :/

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  3. Whilst it may be true that Judges and Justices enjoy such freedom of time and effort, it certainly does not hold true for the average working person. To say that one must 1) take a day or a half day off work every 3 months, 2) gather a list of information including recent photographs, and 3) set up a time that is convenient for the local sheriff or other such office to complete the registry is more than a bit near-sighted. This may be procedural, and hence, in the near-sighted minds of the court, not 'punishment,' but it is in fact 'punishment.' The local sheriffs probably feel a little punished too by the overwork. Registries serve to punish the offender whilst simultaneously providing the public at large with a false sense of security. The false sense of security is dangerous to the public who may not exercise due diligence by thinking there are no offenders in their locale. In fact, the registry only informs them of those who have been convicted.

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  5. A common refrain in the comments on this website comes from people who cannot locate attorneys willing put justice over retainers. At the same time the judiciary threatens to make pro bono work mandatory, seemingly noting the same concern. But what happens to attorneys who have the chumptzah to threatened the legal status quo in Indiana? Ask Gary Welch, ask Paul Ogden, ask me. Speak truth to power, suffer horrendously accordingly. No wonder Hoosier attorneys who want to keep in good graces merely chase the dollars ... the powers that be have no concerns as to those who are ever for sale to the highest bidder ... for those even willing to compromise for $$$ never allow either justice or constitutionality to cause them to stand up to injustice or unconstitutionality. And the bad apples in the Hoosier barrel, like this one, just keep rotting.

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