Does Alabama Workers Compensation Have to Pay for Palliative Medical Care?

Does Alabama Workers Compensation Have to Pay for Palliative Medical Care?

Many injured workers assume that once they reach Maximum Medical Improvement (MMI), their workers’ compensation medical treatment comes to an end, but that is not always true.

In fact, a common dispute in Alabama workers’ compensation claims involves what is known as palliative care.

What Is Palliative Care?

Palliative medical treatment is treatment that is intended to:

• reduce pain;
• improve function;
• maintain a worker’s current condition; or
• prevent symptoms from worsening.

Unlike curative treatment, palliative care is not necessarily expected to “fix” or “cure” the injury.  Palliative care comes into play when a worker suffers a serious injury that likely will require medical care for an extended time into the future.  Its purpose is to help the injured worker manage the long-term effects of a workplace injury.

Examples of palliative treatment may include:

• pain management treatment;
• prescription medication;
• periodic injections;
• physical therapy;
• follow-up medical evaluations;
• durable medical equipment; or
• other treatment designed to control symptoms.

Doesn’t Workers’ Compensation End at MMI?

NO-and this is one of the biggest misconceptions in workers’ compensation law injured workers have with regards to Alabama law.  Maximum Medical Improvement simply means the worker’s condition has improved as much as the authorized treating physician reasonably expects it to improve.  It does not mean the worker is pain free; treatment is no longer necessary; or that future medical care automatically ends.

Many injured workers continue to require medical treatment for years after reaching MMI.

If the Treatment Doesn’t Cure Me, Why Should Workers’ Compensation Pay for It?

This is where disputes frequently arise.  Insurance carriers sometimes argue that treatment should not be authorized because it will not improve the worker’s underlying condition.  We have had to take cases before the Alabama Court of Civil Appeals in the past in situations where after the resolution of a claim, the workers’ compensation insurance carrier later believes they should no longer be responsible for paying for the injured workers’ medical care since treatment will not “heal” the medical problem; however, the purpose of medical treatment is not always to cure.

For many serious injuries, there may be no cure. The question often becomes “Is the treatment reasonably necessary to relieve the effects of the work injury?”

For example, a worker who suffers a serious back injury may never fully recover. Nevertheless, periodic treatment may allow that worker to function, remain active, and avoid a significant increase in symptoms.

Common Examples of Palliative Care

Palliative treatment is particularly common in cases involving:

Back and Neck Injuries

Workers with herniated discs, failed back surgery syndrome, spinal stenosis, or chronic pain frequently require ongoing treatment long after MMI has been reached.

Joint Injuries

Shoulder, knee, and hip injuries often require periodic treatment to control pain and maintain mobility.

Chronic Pain Conditions

Some work injuries result in long-term pain that cannot be completely eliminated but can be managed through ongoing medical care.

Nerve Injuries

Workers suffering from nerve damage may require continued treatment to help control symptoms and maintain function.

Black Lung

A disease such as black lung is not curable and will continue damaging the workers’ lungs, but that does not mean that he is not entitled to medical treatment to better  manage the long-term effects of this workplace injury.

Why Is This Issue Important?

For many injured workers, future medical benefits are more valuable than any settlement check. A worker may live with the effects of a serious injury for decades after a case concludes; the ability to continue receiving necessary medical treatment can have a significant impact on quality of life, pain control, and overall functioning.

That is why disputes concerning future medical treatment and palliative care often become some of the most important issues in a workers’ compensation claim.

One of the most important things injured workers should understand is that medical treatment does not have to cure an injury to be considered necessary. Many work injuries result in permanent conditions that require ongoing medical care. When treatment helps control pain, maintain function, or prevent worsening symptoms, it may still qualify as reasonably necessary medical treatment under Alabama’s Workers’ Compensation Act.

Simply reaching Maximum Medical Improvement does not automatically end an employer’s responsibility to provide medical care related to a compensable work injury.

If your workers’ compensation carrier has denied pain management treatment, refused to authorize ongoing medical care after MMI, or disputed whether treatment is reasonably necessary, it may be helpful to speak with an attorney experienced in Alabama workers’ compensation law.

At Powell and Denny, we have spent decades helping injured workers protect their rights to medical treatment and future medical benefits under Alabama’s Workers’ Compensation Act.

If you have suffered a job injury and you have questions about your rights and benefits under Alabama’s workers compensation laws -don’t hesitate to contact and speak with one of the experienced Alabama Workers Compensation and Social Security Disability attorneys at Powell and Denny today for a free consultation. Appointments are available in person, or virtually via Zoom if more convenient.  Powell and Denny would appreciate the opportunity to help.  And remember, there is no fee unless you win.

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