A school district in New Jersey will not have to reimburse further opioid prescription costs for a district employee injured in a work-related car accident in 2011, a New Jersey appellate court ruled on Friday.
In 2014, Newark Public Schools employee Samuel Martin was deemed 15% partially disabled as after his accident, which resulted in an injury to his lower back and aggravated a pre-existing disc herniation. From 2016 to 2017, a doctor prescribed an opioid for pain but advised in 2017 that the pain medication “was poorly controlling (his) pain and that ‘prolonged narcotic use [would] not manage his radicular complaints ... and can complicate his recovery,’” as stated in documents pertaining to Samuel Martin III v. Newark Public Schools, filed in the Superior Court of New Jersey, Appellate Division in Jersey City, New Jersey.
In a final note in 2017, when Mr. Martin had reached maximum medical improvement, the doctor wrote: "I would recommend to attempt to wean from (the opioid Percocet) and if we are unsuccessful, (Mr. Martin) would then need to consider having a discussion with (a) pain management specialist to see if there is any palliative standpoint that may be needed from a chronic management of (his) discomfort."
Mr. Martin was examined by a second physician in 2018. That physician testified that Mr. Martin “self-reported that Percocet abated his pain symptoms by approximately sixty percent, and he was more active on the medication. However, in taking petitioner's history, (the second doctor) noted (that Mr. Martin) reported opioid medication provided only ‘small pain relief.’” The second doctor opined: "It was reasonable that (Mr. Martin) be on opioid medication on a long term basis for his pain. I thought that was reasonable for him."
Later that year, a Workers Compensation Court judge denied Mr. Martin's motion seeking reimbursement for the prescription, holding that the “petitioner failed to prove continued treatment with opioid medication would reduce Martin's pain or permit him to function better. The judge found (the primary doctor’s) testimony, having treated Martin for six years, to be more credible than the testimony of the one-time evaluating physician.”
Mr. Martin appealed, arguing that the judge misapplied the law concerning the application for “continued palliative care treatment,” citing that state workers compensation law “requires employers to provide treatment to injured employees when the treatment is ‘necessary to cure and relieve the worker of the effects of the injury and to restore the functions of the injured member or organ where such restoration is possible,’” documents state.
The first doctor, meanwhile, testified that the only treatment that would “cure” Mr. Martin would be surgery, which the worker refused, according to the record.
The appellate court affirmed the earlier ruling, writing that the judge “properly exercised his discretion” in not awarding Mr. Martin reimbursements for opioids, citing “credible evidence in the record” that opioids would not cure his pain.
The attorneys involved could not immediately be reached for comment.