Holistic Medical Treatment Provided in India Not Compensable for PA Workers’ Compensation
We have often discussed the right of an injured worker in Pennsylvania to have medical treatment for his or her work injury. The general rule is that medical treatment is covered by the Pennsylvania Workers’ Compensation Act if such treatment is not only reasonable and necessary, but is also related to the work injury. Sometimes, this comes down to who prescribed or provided the treatment, rather than the treatment itself.
For example, the Commonwealth Court of Pennsylvania recently issued a decision in the matter of Babu v. Workers’ Compensation Appeal Board (Temple Continuing Care Center). Here, a licensed Pennsylvania nurse hurt her neck and shoulders. She obtained some “Ayurvedic” treatment in her native India (the Court described this as a form of holistic alternative medicine traditional in India). The case was settled, expect for whether the bills for this treatment should be paid.
After hearing the evidence, the Workers’ Compensation Judge (WCJ), citing the case of Boleratz v. Workers’ Compensation Appeal Board (Airgas Inc.), determined the Ayurvedic treatment in this case was not compensable. Specifically, the WCJ found that the injured worker failed to prove the treatment was rendered, prescribed or supervised by a licensed practitioner. Additionally, the records offered by the injured worker did not show what treatment was provided, or to what part of the body the treatment was given (making it impossible to see if the treatment was actually even related to the injury). This decision was affirmed by the Workers’ Compensation Appeal Board (WCAB).
On appeal to the Commonwealth Court of Pennsylvania, the decision was again affirmed. In fact, had the Court simply shown that the treatment failed the requirements under Boleratz, this case would not be especially troubling at all (the evidence does not really support that the treatment should be paid by the workers’ comp insurance carrier on these facts). After all, we already know leaving the Country can be devastating for a PA workers’ comp case.
But, instead, the Court took this opportunity to focus on the fact that medical treatment must be provided, prescribed or supervised by a Pennsylvania licensed physician. Indeed, the Court did not sound like it was referring to treatment outside the United States, as in the facts before it, but to anywhere outside PA, including another State. Having represented injured workers who reside all across the United States in Pennsylvania workers’ compensation cases, this is incredibly troubling. Could a PA workers’ compensation insurance carrier actually refuse to pay for medical treatment for a work injury for, say, a tractor trailer driver injured in PA who lives in Texas (and thus treats in Texas) because the treatment is neither provided, prescribed or supervised by a Pennsylvania licensed physician? We tend to doubt a WCJ would look kindly on this practice, and the insurance carrier could then invite an obligation to fly the injured worker to PA for any required medical treatment, but we fear another obstacle could be placed to an injured worker trying to get the treatment he or she needs to recover from a work injury in Pennsylvania.