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Boudreaux v. GLI Holding Company5/3/2000
NOT DESIGNATED FOR PUBLICATION
REVERSED IN PART; AFFIRMED IN PART
Appellant, Wilson Boudreaux, appeals from the decision of the Workers' Compensation Commission which held that he failed to prove by a preponderance of the evidence that additional chiropractic treatments are reasonable and necessary treatment for his compensable injury .
Appellant is a sixty-one-year-old former bus driver who lives in Columbia, Louisiana, and who has been before the Commission several times regarding a back injury he received in 1991, while in the employ of appellee GLI Holding Company (GLI). Appellant also suffered an injury to his back in 1986, which injury required surgery, and in June 1990, he received an injury to his upper spine which resulted in medical treatment and several weeks of total incapacitation. On January 12, 1991, appellant sustained the compensable injury to his lower back which is the subject of this claim for additional benefits.
Appellant has been treated since January 14, 1991, by Dr. Walter Creel, a chiropractor who is appellant's authorized treating physician. Dr. Creel referred appellant to Drs. John Patton and Lawrence Drerup, neurosurgeons, and Dr. Drerup referred appellant to the Comprehensive Spine Program where, as a part of his treatment, he was evaluated by Dr. James Quillin, a psychiatrist. In addition, appellant was seen by his family physician, Dr. Terry Thompson, who referred him to Dr. Raeburn Llewellyn, a New Orleans neurosurgeon. Appellant's treatment by Drs. Thompson and Llewellyn was ruled unauthorized medical treatment, and Dr. Creel continued to be appellant's authorized treating physician. Appellant has also been evaluated by Dr. Phillip Osborne, a Louisiana neurosurgeon. Appellant has seen no other medical doctor since 1995, when he saw Dr. Jim Moore relative to his compensable injury at the Commission's request. Dr. Creel has continued to treat appellant since he was discharged from the Comprehensive Spine Program in March 1992. GLI's carrier, appellee Cigna Insurance (Cigna), paid Dr. Creel's bills for several years, but then abruptly stopped paying.
At the hearing before an administrative law judge on his claim for additional benefits, appellant contended that he is entitled to the continuation of pharmacy and physician benefits to include treatment by Dr. Creel. Appellees contended that appellant had received all appropriate medical treatment to which he is entitled and that his continued weekly visits to Dr. Creel are not reasonably necessary. There was also an issue regarding an outstanding balance due Dr. Creel in the amount of approximately $4,000.
At the hearing on his claim, appellant testified that he has been seeing Dr. Creel once a week for the last seven or eight years, that he has gotten along well under Dr. Creel's care, that Dr. Creel keeps him going, and that nothing else has helped him. Appellant testified that after Cigna withheld its permission for him to see Dr. Creel, he stayed away for approximately three weeks but had to return to Dr. Creel because he could not stand the pain. During a treatment, Dr. Creel adjusts appellant's low back and neck. Appellant testified that part of the reason he sees Dr. Creel is for a neck adjustment. Dr. Creel's adjustments give him relief for a few days, and he can sleep at night. His pain progressively returns, and he visits Dr. Creel again to keep going. Appellant testified that Dr. Creel probably won't be able to cure his condition, but he gives him relief. Appellant testified further that Cigna has authorized orthopaedic care in El Dorado, Arkansas, but that is 120 miles from his home. Appellant has no problem with this, but said that he has no place
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