Laser Spine Surgery Evaluation by Dr. Vernon Morris at Laser Spine Institute is Reasonable
On January 19, 2010 the Claimant requested a referral for laser back surgery from Dr. Adebajo, who agreed and asked the Claimant to provide the name of the surgeon and the facility. The Claimant provided the name of Dr. Vernon Morris at the Laser Spine Institute.
On May 26, 2010, the Claimant treated with Dr. Joytish Grover, a pain management specialist, who diagnosed failed back surgery syndrome, lumbar cervical radiculopathy and chronic neuropathic pain. Dr. Grover recommended bilateral epidural steroid injections and a spinal cord stimulator if the injections didn’t work. Dr. Grover also ordered an MRI and CT of the lumbar spine. Dr. Portner felt it was highly unlikely that additional surgical intervention would improve the Claimant’s condition and found such intervention to be unreasonable and unnecessary.
On October 12, 2010 the Claimant filed a Petition to Review the Utilization Review Determination of Dr. Portner. Dr. Adebajo noted in a December 16, 2010 report that the Claimant was still in persistent pain and had numbness, tingling and bladder problems in spite of his operation. Dr. Adebajo noted that a surgical consult would be reasonable in the Claimant’s circumstances.
The Claimant’s Petition to Review the Utilization Review Determination was assigned to Workers Compensation Judge Robert Vonada in Altoona, Centre County, PA. The Judge found the findings and opinions of Dr. Adebajo to be more credible and persuasive than those of Dr. Portner. Dr. Portner stated he felt a surgeon could not help the Claimant, but he did note Dr. Grover may recommend a surgical evaluation for placement of a spinal stimulator. Dr. Adebajo testified the next step following Dr. Grover’s evaluation was to be evaluated by a surgeon. Therefore the Judge found Dr. Adebajo’s referral for a surgical evaluation was reasonable and necessary.
The Judge found the Employer did not meet its burden to establish that a surgical consultation at the office of Dr. Vernon Morris was unreasonable and unnecessary. The Claimant’s Petition to Review the Utilization Review Determination was granted. The Employer and Delhaize America, LLC were ordered to reimburse the medical expense of the consultation with Dr. Vernon Morris at the Laser Spine Institute.


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