On April 21, 2006, the plaintiff was employed as a certified nursing assistant at a nursing home when she fell and injured her back while assisting a patient. The injury consisted of a bulging cervical disc. Before the accident, the plaintiff had complained of neck pain, but had been doing all her work without restrictions.
The Lauderdale County Circuit Court found that the nursing home should provide pain-management treatment for the plaintiff even though her treating physician believed that the pain was not caused by the work-related injury. After the nursing home contested this decision, the plaintiff was referred to another physician who also concluded that the pain was not caused by the work-related injury.
The nursing home once again sought to be relieved of paying for the plaintiff’s pain management, arguing that the circuit court was usurping the role of the treating physicians. The plaintiff disagreed, pointing out that the physicians were expressing an opinion about medical causation, not making a medical treatment decision. (Both physicians had recommended that plaintiff was not a good candidate for surgery and should be treated with pain medication.)
In response to the nursing home’s appeal, the Alabama Court of Civil Appeals affirmed the circuit court’s decision. The appeals court pointed out that when medical causation is disputed (as it was in this case), the cause is determined by the court, not by the treating physicians. The circuit court had settled that issue in favor of the plaintiff. Any prior and later opinions about the cause of the medical condition expressed by treating physicians is not relevant once that decision has been made by the court. In its ruling on the matter, the circuit court had noted that 11 days before she fell, the plaintiff’s doctor had completed a series of spinal examinations that revealed no fractures, dislocations, tumors, or lytic lesions. The circuit court had noted that, before she fell, the plaintiff was able to do her job functions, including heavy lifting, with no restrictions. The appeals court noted that the Workers’ Compensation Act does not require that an accident be the sole cause of injury, but may be a contributory cause of an injury in order for the injury to be compensable under the act.
The nursing home was therefore ordered to pay for pain management for the plaintiff. See Ex parte El Reposo Nursing Home Group, Inc., decided on September 16, 2011.
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