MWCC NO. 99-07533
BOBBIE DICKERSON CLAIMANT
vs.
STEPHEN
LAFRANCE/LAFRANCE PHARMACY, INC.
EMPLOYER
AND
CENTRE
INSURANCE COMPANY
CARRIER
REPRESENTING
CLAIMANT:
Robert L. Spotswood, Esquire, Jackson, MS
REPRESENTING
EMPLOYER/CARRIER:
L. Pepper
Cossar, Esquire, Jackson, MS
This matter
was heard by the Commission on December 18, 2000 pursuant to the Employer's
and Carrier's Petition for Review of Decision of Administrative Judge.
At issue is whether the Administrative Judge effed when she entered an
Order Compelling Payment of Medical Expenses on October 23, 2000. This
Order directs the Employer and Carrier to pay for all reasonable and necessary
expenses associated with a knee replacement surgery that has been recommended
for the Claimant.
Bobbie Dickerson sustained a compensable injury to her knee on or about February 2, 1998, and was first released at maximum medical improvement by her treating physician on September 21, 1999.1 Sometime subsequent to this, Ms. Dickerson returned to her doctor for additional treatment and she has now been advised that a total knee replacement is in order.
By Motion filed May 23, 2000 and again on October 4, 2000, the Claimant asked the Administrative Judge to order the Employer and Carrier to pay for this procedure because the Employer and Carrier had previously refuse to authorize payment. In a response filed October 6, 2000, the Employer and Carrier questioned whether the Claimant's need for knee replacement surgery bore any causal relation to her original injury. They objected to any order compelling payment therefor, at least until a deposition of Dr. Gene Barrett and Dr. William Geissler could be completed. Apparently, Dr. Barrett had previously questioned whether Ms. Dickerson's need for knee replacement surgery bore any relation to her original injury, and Dr. Geissler had not rendered a final opinion because he had not yet completed a review of Ms. Dickerson's prior medical records.
Based on
these pleadings and a review of the file, as well as arguments presented
by counsel, the Administrative Judge issued her Order on October 23, 2000
finding the Employer and Carrier liable for the costs to be associated
with knee replacement surgery for Ms. Dickerson. In arguments before the
Commission, counsel for the Employer and Carrier pointed out that the deposition
of Dr. Geissler was just completed on the morning of December 18, 2000,
and they further argued that a decision regarding liability for knee replacement
surgery should not be made until after an evidentiary hearing could be
held and testimony and other evidence presented on the question of whether
such a procedure was necessitated in sufficient degree by Ms. Dickerson's
original injury.
Under the circumstances, we agree with the Employer and Carrier that an evidentiary hearing should be convened to consider the issue of whether Ms. Dickerson's need for knee replacement surgery is in any way causally related to her original injury. This hearing should be held post haste and both parties should be allowed to present whatever relevant testimony or other evidence they have at their disposal so that a ciornplete record can be made to support the decision of the Judge, and our possible review thereof.
We therefore vacate the Order Compelling Payment of Medical Expenses entered on October 23, 2000 and hereby remand this claim to. the Administrative Judge for further proceedings consistent with this Order.
SO ORDERED this the 8th day of January, 2001.
MISSISSIPPI
WORKERS' COMPENSATION COMMISSION
BARRETT
SMITH
BARNEY
SCHOBY
ATTEST:
Joann McDonald, Secretary
___________________________
MWCC NO. 99 07533
BOBBIE DICKERSON CLAIMANT
vs.
STEPHAN LAFRANCE/LAFRANCE PHARMACY (SUPER D) EMPLOYER
SUPERIOR
NATIONAL INSURANCE GROUP
CARRIER
CAME ON THIS DAY to be heard Claimant, BOBBIE DICKERSON'S Motion For An Emergency Hearmg Compelling Payment of Medical Services By Employer and Carriler and after review of the Commission's file on this matter and hearing argument of counsel, this Administrative Law Court is of the opinion and hereby finds that said Motion is well taken and the relief requested therein is granted. Specifically, this Administrative Law Court finds that the Independent Medical Exammier, DR. WILLIAM GEISSLER, opines that the, pre-existing condition of the Claimant was aggravated by a work-related injury and that the surgery recommmded by Claimant's treating physician is medically necessary.
IT IS, THREFORE, ORDERED AND ADJUDGED that the Employer/Carrier in this claim shall pay all medical expenses associated with Claimant's knee replacement surgery and all related thereto.
SO ORDERED AND ADJUDGED, this the 23rd day of October, 2000.
VIRGINIA
WILSON MOUNGER
1.
The Employer and Carrier alleges that the compensability
of this original injury "is totally in dispute." However, the Employer
and Carrier
has not previously questioned the compensability of this original injury,
has paid benefits therefor, and did not timely challenge an Order issued
by the Judge on February 11, 2000 which found this original injury to be
compensable. It appears to us that the Employer and Carrier are instead
questioning whether Ms. Dickerson's need for knee replacement surgery is
the result of any work related injury and the Notice of Controversion filed
by them on May 16, 2000 clearly supports this view.
ADMINISTRATIVE
JUDGE
ATTEST:
Joann
McDonald, Secretary
___________________________