Mach v. Wells Concrete Prods. Co.

Mach v. Wells Concrete Prods. Co., No. WC14-5710 (Nov. 4, 2014)

In Mach, the employee appealed the compensation judge’s Order dismissing his  Medical Request.

The employee suffered a left leg injury at work on August 6, 2008, which was admitted by the employer and insurer.  He later alleged to have developed RSD as a result of this admitted injury and filed a Claim Petition seeking the surgical placement of a spinal cord stimulator.  At hearing, the compensation judge found that treatment was not reasonable or necessary, as the employee failed to show he suffered from RSD.

Two years later, the employee filed a Medical Request seeking removal and replacement of his spinal cord stimulator.  The employee submitted records from his new physician, Dr. Vollmar, containing a diagnosis of RSD and a causation opinion.  The employer and insurer filed a Motion to Dismiss which was heard in a special term conference by the original compensation judge on this matter.  The judge issued Findings and Order concluding that the employee’s request was barred by collateral estoppel and res judicata, dismissing the medical request with prejudice.

The workers’ compensation court of appeals reviewed these findings as a matter of law, de novo.  It concluded that there was no determination in the prior findings regarding the new bills by Dr. Vollmar.  In addition, the WCCA notes there was no determination that the employee’s injury was temporary and that the compensation judge simply found that the employee had failed to establish that he suffered from RSD at the time of the hearing.  The Findings and Order was reversed as the Medical Request should be determined on its merits.