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Follow up treatment for work accident denied.

Byline: Virginia Lawyers Weekly

A Lowe's employee who failed to produce evidence that the treatment he sought for crying spells was causally related to his work accident has his claim denied.

Background

Claimant suffered from epilepsy as a child and had a temporal lobectomy in 1994. In March 2013, while working at Lowe's, claimant was injured when a cart fell on his head at the site of his lobectomy. Claimant then began to experience auras, accompanied by a flushing sensation in his face and a ringing in his ears, but he did not have convulsions or lose consciousness. The commission awarded claimant various periods of temporary partial disability benefits and reasonable, necessary and causally related medical treatment for his compensable head injury beginning March 16, 2013.

During an evaluation at VCU on Feb. 2, 2015, claimant reported that he was having spells of "sudden crying for no reason," which had "disrupted his daily activities." On March 25, 2015, a doctor at VCU noted that claimant was experiencing crying spells almost daily and that the spells had an "unclear etiology," but appeared "susp[i]cious for seizure." On May 13, 2015, another doctor at VCU recommended that claimant seek a second opinion because VCU was unable to determine the cause of the crying spells.

Claimant was evaluated at the Cleveland Clinic Hospital in July 2015. The medical notes reflect that after a head injury, claimant had experienced "recurrence of seizures in the 1st year mostly 'auras'" and "after the first year started to have his crying seizures." Claimant was diagnosed with focal epilepsy. On May 5, 2017, a neurologist at the Cleveland Clinic opined that the crying spells were epileptic, but their relation to claimant's 2013 head injury was "not clear . . . at all." A second doctor agreed that the crying episodes were "highly suspicious of being epileptic in nature." Claimant underwent surgery on June 15, 2017, to implant a vagus nerve stimulator for his "intractable epilepsy."

Claimant filed a claim for benefits on May 31, 2017, requesting payment and authorization of a vagus nerve stimulation with subsequent follow-up treatment as recommended by the Cleveland Clinic. Lowe's responded that there were no medical reports causally relating the requested treatment to the work accident or showing that the treatment was necessary and reasonably related to the accident. A deputy commissioner conducted an on-the-record hearing and denied the claim. Claimant appealed to the full commission, which affirmed the deputy's decision. Claimant then appealed to this court.

Analysis

Claimant argues that the commission erred in denying his claim because his crying spells began after he hit his head at work and thus are causally related. However, the medical evidence presented to the commission did not show the requisite connection. Claimant experienced auras soon after he hit his head at work, but the crying spells began later. Claimant's doctors at VCU noted that the crying episodes were "susp[i]cious for seizure," but their examinations "thus far ha[d] not revealed an underlying objective abnormality associated with these spells and the[re]fore the exact etiology of these remain[ed] elusive." Similarly, claimant's doctors at the Cleveland Clinic determined that the crying spells were "highly suspicious of being epileptic in nature," but their relation to claimant's traumatic head injury was "not clear . . . at all." Accordingly, the record supports the commission's ruling that claimant did not meet his burden to prove that the need for surgery and ongoing treatment at the Cleveland Clinic was causally related to his 2013 work injury.

Claimant further contends that he should not be denied further treatment simply because his doctors could not determine a causal connection between his crying spells and his work injury. However, it was claimant's burden to provide evidence that established a connection. Further, when medical issues are complex, as in this case, causation must be determined by a medical expert.

Affirmed.

Williams v. Lowe's Home Centers Inc., Record No. 0120-18-2, Oct. 2, 2018. CAV (Clements), from Va. Workers Comm'n. William C. Carr Jr. for Appellant; Ciara Wren Malone for Appellee. VLW No. 018-7-238, 4 pp.

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Title Annotation:Williams v. Lowe's Home Centers Inc., Virginia Court of Appeals
Publication:Virginia Lawyers Weekly
Date:Oct 28, 2018
Words:686
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