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PA Injured Worker’s Refusal to Enter Detox for Work-Related Prescription Drugs Leads to Suspension of Workers’ Compensation Benefits

This being a free Country, a workers’ compensation insurance company in PA cannot “force” an injured worker to get any medical treatment. However, the Pennsylvania Workers’ Compensation Act permits the suspension of workers’ comp benefits if an injured worker refuses “reasonable” medical treatment (Known as a “Forfeiture” Petition). Often in those cases, the issue is whether the treatment at issue (anything from carpal tunnel release, to lumbar fusion, to total knee replacement, to epidural steroid injections) is actually “reasonable” in any particular case.

An interesting aspect of this issue was recently examined by the Commonwealth Court of Pennsylvania in Bereznicki v. Workers’ Compensation Appeal Board (Eat ‘N Park Hospitality Group). In that case, the question was whether the proposed treatment had to actually be intended to return the injured worker to gainful employment. In a decision surprising to many, the Court held that the treatment did NOT have to be designed to return the injured worker to gainful employment to lead to a suspension of benefits.

The concept of a “Forfeiture Petition” makes sense; it is designed to keep an injured worker from refusing treatment which would put the injured worker back on the job (in reality, however, I doubt many folks would truly refuse treatment that would make them better, but the insurance industry seems to disagree with me). But, to me, that is the point – the fact the injured worker could return to work.

The treatment at issue in Bereznicki was a detox program for prescription medications. There was no evidence the detox program would enable the injured worker to become employable (which makes sense, since the program would provide no treatment for the disabling injury itself).

In holding that the Workers’ Compensation Judge correctly granted the Forfeiture Petition and suspended workers’ comp benefits, the Court stated, “Although such a program would not return Claimant to her pre-injury job, her refusal of such treatment certainly increases her incapacity.”

Personally, I find that to be an odd standard to use, in what amounts to forcing a person into medical treatment. If the treatment is designed simply to cure a problem and improve function and quality of life, why is that the role of the workers’ comp insurance carrier? Should that not be the decision of the injured worker, and his or her treating doctors? Once a person is “totally” disabled, I am not aware of any math that would allow the person to become more disabled.

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