West Palm Beach Workers’ Compensation Judge Orders Insurance Company to Pay for Injured Utility Worker’s Low Back Surgery

A West Palm Beach judge recently ruled in favor of an injured utility worker who suffered extensive injuries to his low back after lifting a pallet at work. The employee initially obtained treatment with various doctors until ultimately coming under the care of a pain management physician and a spine surgeon. These two doctors provided several different courses of treatment including facet injections and epidural steroid injections. After exhausting all non-invasive care, the spine surgeon performed an L4-5 microdiscectomy on the injured worker’s low back.

Following the surgery, the injured utility worker continued to experience low back pain consistent with facet joint related pain. Facet joint disorders are some of the most common recurrent disabling low back problems and can cause serious symptoms and disability. The authorized pain management physician recommended a course of post-surgical facet injections which were authorized and paid for by the workers’ compensation insurance company. The injured worker was able to enjoy 48 hours of relief before the pain returned. Based on the failed course of care up to that point, the pain management doctor recommended a Radio Frequency Ablation (RFA).

The RFA, or rhizotomy, is a minimally invasive procedure where the patient remains awake throughout the process. RFAs are used by pain management doctors to treat severe chronic pain in the lower back and neck. A device is used to create radio frequency waves which produce heat that is directed to the nerves surrounding the facet joints on either side of the lumbar spine. The heat destroys the nerves ability to transmit pain signals to the brain.

However, the workers’ compensation insurance company denied the RFA stating that the test was not medically necessary and the need for the procedure was not related to the workplace accident. The insurance company obtained a medical expert who questioned the injured worker’s truthfulness and mistakenly testified that the injured employee did not need the RFA because he did not have pain relief after the facet injections notwithstanding the fact that the evidence demonstrated he did have pain relief.