Illinois nurse unable to secure medical benefits for disc replacement surgery
The Illinois Workers' Compensation Commission denied a claimant's request for surgery involving an artificial disc replacement.
Case name: Warner v. Kewanee Hospital, 17 ILWCLB 175 (Ill.W.C.Comm.2009).
Warner, a nurse at the defendant's hospital, injured her back while helping to lift an unresponsive patient froma a vehicle. She underwent a course of injections for discogenic pain. However, because she reported only minimal relief from the injections, her doctor recommended an artificial disc replacement, which if denied by insurance coud be substituted with a fusion.
The arbitrator denied Warner's request for surgery. Based on Warner's lack of credibility, in addition to an opioid dependence, insignificant MRI findings, and lack of other objective findings to support her objective complaints, the arbitrator concluded that Warner was not a surgical candidate and denied any additional treatment. Upon review, the Illinois Workers' Compensation Commisison affirmed and adopted the decision of the arbitrator.
