House v. Heartland Homecare, WC12-5474 (W.C.C.A. Jan. 28, 2013)
In this case, the W.C.C.A. affirmed the compensation judge’s findings that the
Employee’s medical treatment was reasonable, necessary, and causally related to her
specific work injury, and that the prescribed medications were both effective and cost
effective. The W.C.C.A. also held that the compensation judge did not err when she
wrote that the Employee was suffering from “overuse syndrome,” and that this did not
constitute a finding of a Gillette injury that had never been claimed by the Employee, but
was instead just a description or explanation of the Employee’s ongoing symptoms.
The Employee worked full-time in the records department at the Employer, performing
a variety of clerical tasks. While putting a chart on a shelf on February 10, 2010, she felt
pain between the index and middle fingers of her left hand. Her pain radiated up the hand
and occasionally into the dorsum of the forearm. She was initially diagnosed with acute
hand strain, but she continued to report symptoms through the spring and summer despite
various medications, and her treating doctors had difficulty making a diagnosis. She had
a normal EMG. The Employer and Insurer had the Employee examined by Dr. Husband,
who felt she had reached maximum medical improvement without any permanency,
restrictions, or need for further treatment, and that the employee’s subjective complaints
were not supported by objective findings. Even her treating doctor could not find an
organic cause of her complaints.
The Employee continued to work in her full-duty capacity through 2010, 2011, and into
2012. She continued to treat and various medications were tried. In March of 2012,
the employee’s attorney had her evaluated by Dr. Kenneth Britton, who found that her
symptoms were consistent with “overuse syndrome” related to her work, and her work
activities were a substantial contributing factor to her condition. Dr. Britton believed
that the Employee had reached MMI on November 30, 2010, and recommended that
her Lyrica be continued and even increased in order to maintain her current level of
The Employee had filed a medical request, and a hearing was held on May 31, 2012. The
compensation judge found that the claimed medical expenses and treatment, including
doctor visits from late 2010 and prescriptions including Lyrica and Lidocaine patches,
were reasonable, necessary, and related to the work injury. The treatments were not
inappropriate under the treatment parameters. The judge also wrote that the Employee’s
continued work activities following the original injury had aggravated her initial injury,
and that the continued repetitive work activities resulted in the need for continuing
medical treatment. The Employer and Insurer appealed.
The W.C.C.A. agreed with the Compensation Judge that the claimed treatment was
reasonable, necessary, and causally related to the work injury. The Employer and Insurer
argued that because the Employee was not getting better with medication, the continued
use of medication was not appropriate under Minn. R. 5221.6300, subp. 10, which
states that the treating physician must determine that ongoing medication is effective
treatment for the patient’s condition and that the most cost-effective regimen is used.
The W.C.C.A. noted that several treating physicians had prescribed medications, that
Dr. Britton had recommended increasing her dosage of Lyrica in order to maintain her
functional level, and that the Employee had not required a lot of medical treatment since
going on medications. The court held that this was substantial evidence to support the
compensation judge’s determination that the Employee’s treatment had been reasonable
and necessary and had not been inappropriate under the treatment parameters.
The Employer and Insurer also argued that the compensation judge’s finding that the
Employee suffered from “overuse syndrome” and that her ongoing work activities
aggravated her initial injury, constituted an improper finding of a new Gillette injury. The
W.C.C.A. acknowledged that a compensation judge may not resolve matters that are not
at issue. However, the compensation judge’s finding that the Employee’s “initial injury
of February 10, 2010 was aggravated by continuing repetitive work activities with her left
hand that resulted in the need for continuing medical treatment of her overuse syndrome”
did not constitute a finding of a new Gillette injury that had never been claimed by
the Employee. Instead, the compensation judge was simply explaining the nature of
the Employee’s condition, symptoms, and ongoing need for treatment. The W.C.C.A.
affirmed the decision of the compensation judge.