A woman who became ill as a result of exposure to toxic heavy metals while working to restore furniture for a large chain store was recently awarded compensation for necessary treatments at her doctor’s office.
In Moore v. K-Mart Corp., the West Virginia Supreme Court took the unusual step of declaring a law invalid for its direct contravention to the underlying purpose of state workers’ compensation benefits law.
The primary issue was not whether the illness was work-related. No one disputed it. The issue was not the extent of injury. All agreed it was severe. In fact, no one even argued the treatment she was receiving wasn’t medically necessary or reasonable. The core of the dispute was the place in which she was receiving this particular type of treatment.
A state law specifically precluded workers’ compensation beneficiaries from being reimbursed for intravenous chelation therapy conducted in a physician’s office, as opposed to a hospital.
Our work injury attorneys know chelation therapy is a form of treatment that is used to treat heavy metal poisoning. The treatment involves an injection of a series of binding agents, which attract the metals in the blood (namely, lead, iron, zinc, mercury, cadmium and a few others). The chemicals are then flushed from the body.
Petitioner in this case worked for the same employer for more than 30 years. During this time, she routinely worked with belt sanders and grinders in order to refurbish furniture. Her work space was small, with little to no ventilation. The result was metal and furniture dust were routinely breathed.
Over time, she began to develop feelings of numbness and tingling in her feet. The symptoms continued to worsen, and her physician diagnosed her with peripheral neuropathy, a condition resulting from exposure to heavy metals at work.
She filed a claim for workers’ compensation. Perhaps unsurprisingly, the employer fought the claim, but petitioner eventually prevailed.
While litigation was pending, her doctor started treating her with the aforementioned therapy. Her symptoms began to improve. She underwent 30 such treatments, and her doctor recommended she undergo at least four annually. And yet, her employer refused to compensate her for medical bills related to this treatment. This was despite the fact her doctor had extensive experience in performing the treatments, there was no other nearby provider for them and the doctor provided them at nearly a quarter of the going rate.
Workers’ compensation law in West Virginia – similar to that in Georgia – requires companies to cover the cost of necessary and reasonable medical treatments related to compensable injuries.
However, W.B. Code 23-5-15 stated the insured employer would not be required to reimburse for IV chelation therapy performed in a doctor’s office. Plaintiff countered denial of reimbursement essentially amounted to a denial of medical treatment under state workers’ compensation law which provides employees are entitled to reimbursement for health care treatment that is reasonably required for various types of occupational injuries and diseases.
While the commission sided with employer, the state high court reversed and invalidated the statute barring such in-office treatments. The high court noted that respondents cited no medical justification for not allowing such treatments to be conducted in-office. Secondly, there was no assertion that doing so was a cost-saving measure. Finally, the court pointed out there was no regulation that prohibited the procedure from being performed in an office setting – only regulation regarding reimbursement.
Because of the arbitrary nature of the statute and its contradiction with the purpose of workers’ compensation law – to provide swift and fair coverage for work-related injuries – the law was deemed invalid.
For information on Atlanta work injury compensation, contact J. Franklin Burns, P.C., at 1-404-920-4708 .