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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. A traditional parade of attorneys? Really Evansville? Y'all need to get out more. When is the traditional parade of notaries? Nurses? Sanitation workers? Pole dancers? I gotta wonder, do throngs of admiring citizens gather to laud these marching servants of the constitution? "Show us your billing records!!!" Hoping some video gets posted. Ours is not a narcissistic profession by any chance, is it? Nah .....

  2. My previous comment not an aside at court. I agree with smith. Good call. Just thought posting here a bit on the if it bleeds it leads side. Most attorneys need to think of last lines of story above.

  3. Hello everyone I'm Gina and I'm here for the exact same thing you are. I have the wonderful joy of waking up every morning to my heart being pulled out and sheer terror of what DCS is going to Throw at me and my family today.Let me start from the !bebeginning.My daughter lost all rights to her 3beautiful children due to Severe mental issues she no longer lives in our state and has cut all ties.DCS led her to belive that once she done signed over her right the babies would be with their family. We have faught screamed begged and anything else we could possibly due I hired a lawyer five grand down the drain.You know all I want is my babies home.I've done everything they have even asked me to do.Now their saying I can't see my grandchildren cause I'M on a prescription for paipain.I have a very rare blood disease it causes cellulitis a form of blood poisoning to stay dormant in my tissues and nervous system it also causes a ,blood clotting disorder.even with the two blood thinners I'm on I still Continue to develop them them also.DCS knows about my illness and still they refuse to let me see my grandchildren. I Love and miss them so much Please can anyone help Us my grandchildren and I they should be worrying about what toy there going to play with but instead there worrying about if there ever coming home again.THANK YOU DCS FOR ALL YOU'VE DONE. ( And if anyone at all has any ideals or knows who can help. Please contact (765)960~5096.only serious callers

  4. He must be a Rethuglican, for if from the other side of the aisle such acts would be merely personal and thus not something that attaches to his professional life. AND ... gotta love this ... oh, and on top of talking dirty on the phone, he also, as an aside, guess we should mention, might be important, not sure, but .... "In addition to these allegations, Keaton was accused of failing to file an appeal after he collected advance payment from a client seeking to challenge a ruling that the client repay benefits because of unreported income." rimshot

  5. I am not a fan of some of the 8.4 discipline we have seen for private conduct-- but this was so egregious and abusive and had so many points of bad conduct relates to the law and the lawyer's status as a lawyer that it is clearly a proper and just disbarment. A truly despicable account of bad acts showing unfit character to practice law. I applaud the outcome.

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