Medical Benefits – Prolonged Chronic Pain Treatment In Excess of Medical Treatment Guides No Longer Compensable

Administrative Law Judge (ALJ) denied claimant’s continued access to opioid pain medications three to four times the recommended dosages as unreasonable and unnecessary treatment for the work related injury.

Claimant sustained a compensable injury in 2007 to her lower back. Claimant underwent several lower back surgeries and was ultimately diagnosed with failed back syndrome. She was first placed on opioid medications for pain in 2008. At times her morphine equivalent score exceeded seven times the recommended score. Claimant’s authorized treating physician attempted to justify her extraordinarily high dosages of medications by stating that she had functional gains and would otherwise not be able to function. Claimant had never returned to work after her injury. Respondents’ obtained a records review that opined that claimant’s reporting of functional gains actually correlated with her decrease in pain medications – including beginning to work part time and seasonally. The ALJ determined that claimant’s treatment and excessive dosages were no longer in accordance with the Medical Treatment Guidelines and was, therefore, no longer reasonable or necessary treatment for the work related injury. Claimant was ordered to taper her medications.

Lippert v. United Airlines, W.C. No. 4-709-708 (November 21, 2019).

Would you like to know more? Contact Brad Miller or Hayleigh Lidbury at or or (720) 542-6125.


From the December 2019 Newsletter