The West Virginia Supreme Court on Thursday upheld the denial of opioids and related medication to treat an injury in a workers compensation claim filed by a laborer who was hurt on the job in 2014.
The high court ruled that the West Virginia Workers’ Compensation Board of Review correctly determined that opioids and drugs used to reverse an opioid overdose were not warranted in a claim by Terri Becca.
Ms. Becca, who worked for Eagle Manufacturing, was injured when a block of material fell and caused her to hyperextend her left wrist.
In October 2020, a physician requested authorization for the drugs relating to diagnoses of chronic low back pain and chronic pain syndrome, but a claims administrator denied the request, a decision upheld by the Workers’ Compensation Office of Judges, and later affirmed by the board.
The judges found the treatment inappropriate because Ms. Becca failed to submit evidence showing she met state requirements relating to opioid use.
The Supreme Court agreed with the lower determinations that Ms. Becca failed to prove the course of treatment was related to her compensable injury.
The court said that the authorization of such medication requires “extensive documentation” including a treatment plan, a weaning plan, regular drug screenings and physician statements, and that Ms. Becca provided no such documentation before seeking the opioids and related drugs.