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Papco Oil Co. v. Farr11/18/1997
Argued at Norfolk, Virginia
FROM THE VIRGINIA WORKERS' COMPENSATION COMMISSION
Papco Oil Company and its insurer (hereinafter referred to as "employer") appeal a decision of the Workers' Compensation Commission (commission) holding employer responsible for the cost of certain medical expenses incurred by William Farr (claimant). Employer contends that the commission erred in finding it responsible for the cost of claimant's (1) June 26, 1994 through July 5, 1994 and September 19, 1994 through September 27, 1994 medical treatment related to claimant's idiopathic thrombocytopenia (ITP); (2) January 30, 1995 through February 8, 1995 medical treatment related to his deep venous thrombophlebitis (DVT) and pulmonary embolism; (3) May 16, 1995 through May 24, 1995 medical treatment related to his DVT and pulmonary embolism; and (4) coumadin therapy. Finding no error, we affirm the commission's decision.
Facts
On March 7, 1994, claimant sustained a compensable back injury . On April 1, 1994, claimant underwent lumbar disc surgery causally related to his compensable injury. In June, 1994, claimant was scheduled for a second back surgery. During a routine work-up prior to that surgery, claimant's physicians found that he suffered from ITP. On June 22, 1994, Dr. Robert L. Burger examined claimant with regard to his ITP. On June 30, 1994, Dr. Burger admitted claimant to the hospital to undergo treatment for his ITP. On claimant's history and physical form, Dr. Burger noted that "claimant had been told by Dr. Messer, the orthopedic surgeon, that the platelet situation needed to be clarified before surgery." In a July 5, 1994 discharge summary, Dr. Burger noted that claimant's platelet count had increased from 15,000 to 210,000 after infusion of intravenous gammaglobulin. Dr. Burger opined that claimant could proceed with surgery.
On July 23, 1994, claimant underwent his second back surgery. Claimant was discharged from the hospital on July 24, 1994. Three to four days after discharge, claimant developed right-sided chest pain.
On August 19, 1994, claimant was again admitted to the hospital for treatment of pleural effusion and ITP. He remained in the hospital until August 27, 1994. On August 19, 1994, Dr. Chantal Brooks became claimant's treating physician.
On September 19, 1994, claimant was admitted to the hospital for treatment of his ITP before his third back surgery. After physicians corrected claimant's platelet count, he underwent his third back surgery in September, 1994.
After claimant's third back surgery, he developed DVT, which required hospital treatment from January 30, 1995 through February 8, 1995. While in the hospital, claimant developed a pulmonary embolism, a complication of his DVT.
On May 8, 1995, claimant underwent an elective splenectomy to treat his ITP. Shortly after discharge from the hospital, claimant was readmitted due to recurrent left lower extremity DVT and pulmonary embolus.
In a letter dated June 12, 1995, Dr. Brooks summarized claimant's medical treatment beginning August 19, 1994. Dr. Brooks opined that the May, 1995 splenectomy markedly improved claimant's platelet count. Dr. Brooks also noted the following:
[Claimant] returned to the office in follow-up thereafter and was noted to become again increasing thrombocytopenic. It was elected therefore to start him on steroid therapy in November of 1994 at which time his platelet count was 20,000. In February of 1995, as a result of inactivity secondary to the multiple lumbar surgeries and residual low back pain and leg pain as well as the Prednisone therapy, the patient had to be admitted to
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