Is Massage Therapy “Medical Treatment” in PA Workers’ Compensation?

What is “medical treatment”?  Though most folks know that medical treatment for a work injury is covered under the Pennsylvania Workers’ Compensation Act (Act), even the courts seem confused as to what constitutes “medical treatment.”  In some ways, this issue was recently clarified by the Commonwealth Court of Pennsylvania.

In Schriver v. Workers’ Compensation Appeal Board (Commonwealth of Pennsylvania, Department of Transportation), the injured worker suffered an injury to his low back.  For relief, the injured worker began treating with a chiropractor.  The chiropractor, in turn, referred the injured worker to a massage therapist in his office.  When presented with bills for the massage therapy, the workers’ compensation insurance carrier refused payment, denying that “massage therapy” falls under the category of “medical treatment.”

The injured worker filed a Petition for Review of Medical Treatment/Billing, and a Petition for Penalties.  After hearing the evidence, the Workers’ Compensation Judge (WCJ) granted both Petitions and ordered payment of the massage therapy bills, in addition to penalties.

However, on appeal, this was reversed by the Workers’ Compensation Appeal Board (WCAB).  According to the WCAB, there is a difference between massage therapy “which is utilized to ‘enhance health and wellbeing’ and medical treatment, which is designed to diagnose and treat impairment, illness, disease and disability.”  The WCAB went on to conclude that “Health care providers, unlike massage therapists, go beyond the promotion of health and wellbeing to treat and diagnose injured workers.”

This was appealed further, to the Commonwealth Court of Pennsylvania.  Despite the fact that massage therapists are now licensed by the State of Pennsylvania, this did not solve the issue.  The Court found that the mere licensing did not make the therapy the responsibility of the workers’ compensation insurance carrier.

On the other hand, the Court found the distinction made by the WCAB erroneous and contrary to the Act.  Said the Court:

“Section 109 and Section 306(f.1)(1)(i) of the Act do not expressly limit health care providers to medical treatment, to the exclusion of methodologies intended to enhance an injured worker’s health and well-being.  Moreover, because there has been no challenge that Hurd’s massage therapy was prescribed for any reason other than to afford Claimant relief from pain caused by his accepted work injury, the record supports that the therapy would not have been undertaken but for Claimant’s work injury.”

Finding the existence, or not, of licensing to be immaterial, the Court concluded, “if they are supervised or have an employment or agency relationship with a licensed health care provider, an employer is liable for expenses related to the health care services rendered.”  As such, the WCJ correctly concluded that the bills for the massage therapy are in fact payable by the workers’ compensation insurance carrier.