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The Supreme Court finds the worker’s narcotic painkillers no longer reimbursable



The Supreme Court of Delaware on Thursday upheld a decision that an injured worker’s prescribed narcotic painkillers were no longer eligible for reimbursement.

Zelda Sheppard worked for Allen Family Foods in 2011 when she slipped and fell. She received total disability benefits and received opiate and non-opiate medications, according to Sheppard v. Allen Family Foods.

In August 2012, Sheppard filed a request for additional benefits, claiming that she had suffered a permanent disability. The Occupational Accident Board determined that she was entitled to permanent compensation for a 10% deterioration of the cervical spine and a 7% deterioration of the right upper extremity.

In 201

6, Allen requested a review of the treatment / service for medications prescribed to Sheppard. After two unsuccessful attempts to contact his doctor, the examiner determined that some prescribed opioid medications did not comply with state medical guidelines.

IAB upheld the usufructuary’s decision.

In December 2019, Allen filed a request to discontinue the replacement of Sheppard’s narcotic drugs and injection therapy.

The petition was supported by the opinion of a physician who recommended complete detoxification of all addictive drugs, including opiates, benzodiazepines, muscle relaxants and marijuana. He recommended reducing Sheppard’s medication over the course of three months and continuing treatment with “non-opioid medication and occasional rounds of physical therapy.”

The IAB found the doctor’s opinion convincing and agreed with his conclusion that Sheppard should be weaned off the drug.

Sheppard appealed to the Superior Court, which upheld the IAB’s decision and stated that substantial evidence supported the decision.

By confirming, the state Supreme Court found that Allen had a good faith basis for questioning Sheppard’s ongoing treatment, given a physician’s opinion, the AIB’s conclusion about Sheppard’s lack of credibility, and the evidence that she had lied to her doctors about her use of marijuana.

WorkCompCentral is a sister magazine to Business Insurance. More stories here.


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