Jeffrey B. Sprouse v. John L. Briggs & Co., Inc., (IAB Hearing No. 1272196 – Decided Apr. 26, 2017)
Board finds chronic pain management treatment non-compliant; orders claimant to be weaned from opioid medications.
The claimant commuted all benefits with the exception of medicals, for which he continued to receive pain management care. The employer challenged this treatment through the Utilization Review process and, specifically, the continued use of opioid pain medication. The UR Determination found that the continued use of opioids was not in compliance with the Guidelines. In response, the claimant filed a petition appealing the UR Determination. The Board agreed with the defendant’s medical expert that efforts should be made to wean the claimant from his current high level of opioid usage. They reasoned that this was in accordance with the current treatment plan, which even the claimant’s pain management expert had professed to follow, as well as being reasonable in light of the admitted danger of the claimant remaining on such a high dosage of opioid medication. A weaning process was required to safely detoxify the claimant. The Board agreed that the claimant’s pain management expert could do the weaning if he was willing.
