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Unrelated Medical Expenses at Times Compensable.

On Behalf of | Sep 23, 2016 | Workers' Compensation |

Our client suffers from severe asthma caused by a work-related exposure to mold. As a result, client requires a lifetime of treatment consisting of medications, home filtrations systems and inhalers. Some of client’s symptoms include heavy coughing, shortness of breath and chest pain.

Our client has had multiple office visits and emergency room treatment for shortness of breath and chest pain. The defendant requested client to see their own cardiologist to determine whether these symptoms were related to client’s heart as opposed to lungs. Given the workers compensation injury was asthma, if the symptoms were found to be related to the heart, they would no longer owe further benefits.

The cardiologist requested a stress test which results were abnormal. This led to a heart catheterization which revealed the cardiac condition was not the cause of client’s coughing, shortness of breath and chest pain. Despite the defendant’s own doctor requesting the testing to “rule out” cardiac involvement, the defendant refused to pay for the treatment. Trial was held and the court found as follows:

The issue is whether or not the treatment the employee receives and the tests that the employee undergoes is to determine the cause of the employee’s medical condition. In this case, the employee had shortness of breath and chest pain which can be due to asthma, other lung problems, or cardiac problems. The physician retained by defendant recommended the cardiac work up which started with the stress test, which was mildly positive, and ended with the catheterization which found that plaintiff has no cardiac problem. The cardiac work up was to determine the cause of the shortness of breath and the chest pains. These two problems can be caused by different medical diagnoses. The reason for the cardiac work up was to determine whether or not cardiac was a cause for the shortness of breath and chest pains. It is not.

When medical treatment is undergone to eliminate as well as to determine the cause of client symptoms, the treatment is compensable.


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