Harborth v. State, ex rel., Department of Workforce Services, Workers’ Compensation Division

The Supreme Court affirmed the decision of the Medical Commission upholding the decision of the Department of Workforce Services, Workers’ Compensation Division (the Division) denying benefits for Appellant’s back surgery, holding that substantial evidence supported the Medical Commission’s (the Commission) determination that the procedure was “alternative medicine” for which benefits were properly denied.Appellant underwent artificial disc replacement to treat her work-related back injury. The Division denied compensation for the jury, finding that it was not reasonable and necessary medical treatment because the artificial disc and surgical procedure had not been approved by the FDA and because Appellant had not presented sufficient objective medical support for their use. The Commission affirmed the Division’s denial of compensation, determining that the procedure was an “off-label” use of medical services and “alternative medicine” for which Appellant did not prove adequate support. The Supreme Court affirmed, holding (1) the Commission erred in determining that implantation of non-FDA-approved artificial discs at adjacent levels of the lumbar spine was an “off-label” use of medical services; but (2) substantial evidence supported the Commission’s determination that Appellant failed to provide sufficient documentation of the procedure’s safety and effectiveness, rending it “alternative medicine” for which benefits were properly denied. View "Harborth v. State, ex rel., Department of Workforce Services, Workers’ Compensation Division" on Justia Law