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In PA, Workers’ Comp Benefits Can Be Suspended If Worker Refuses Detox

According to a recent ruling by the Commonwealth Court of Pennsylvania, a workers’ compensation insurer can suspend benefits when an injured worker refuses to enter a detox program… even if the program will not treat the worker’s medical condition or help him or her return to employment.

The ruling arose from a case involving an employee who had been receiving workers’ compensation benefits for 10 years for a lumbar spine injury when her former employer tried to end her benefits. The workers’ comp judge denied the employer’s request to terminate the benefits, but instead said that the injured employee should enter a detoxification program to help wean her off the prescription pain medication she had been taking for her injury.

When the injured employee refused the detox treatment, the employer filed a petition to suspend her workers’ comp benefits on the grounds that she was refusing reasonable medical treatment.

At the hearing, the physician who would oversee the injured employee’s detox program testified that although the treatment would not allow her to return to her pre-injury job, it would allow her to return to normal functioning and enhance her prospects for gainful employment. The judge agreed with the physician’s opinion, ruling that the detox program was reasonable medical treatment.

While this “forfeiture” provision of the Workers Compensation Act is rarely used, injured workers should be aware of its existence. Often a treating physician will offer surgery, however the patient is reluctant because the surgeon advises that the procedure has many risks and may not improve the patient’s condition and could actually worsen the injury and disability. In those instances it is usually considered reasonable to refuse the treatment, however every case is unique and therefore an injured worker should always consult with his or her attorney before making the decision to refuse treatment.