An injured worker must be weaned off narcotics before it can be determined whether he is entitled to workers compensation medical treatment for erectile dysfunction, a low libido and other problems, Louisiana's 1st Circuit Court of Appeal has ruled.

The court's ruling in John Morgan vs. Barber Brothers Contracting Co. follows from a 1997 neck injury Mr. Morgan suffered while working as a heavy equipment operator. The accident led to a cervical fusion and 14 years of consuming narcotic pain medications, the court opinion shows.

Despite treatment, Mr. Morgan continued to complain of difficulty sleeping, chronic neck pain, and headaches. A pain management physician recommended that he undergo a sleep apnea test to ascertain whether Mr. Morgan's narcotic pain medications worsened such issues.

The doctor also said that narcotic pain medications increase liver function, causing it to metabolize not only pain medications but also testosterone. To combat problems stemming from low testosterone levels—such as erectile dysfunction, low libido, lethargy, fatigue and depression—the physician prescribed a combination of Cialis and testosterone replacement therapy. In addition, the doctor recommended that Mr. Morgan enter an inpatient pain treatment program that would include weaning him off of pain drugs.

But Barber Brothers refused to authorize the sleep apnea test and treatments for low testosterone issues. Then in 2011, a workers comp judge ordered Mr. Morgan to submit to an inpatient pain treatment program as recommended by the doctor. The judge denied Mr. Morgan's claims for sleep apnea testing, erectile dysfunction treatment, and testosterone replacement therapy as premature until he had completed the pain treatment program.

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On appeal, the 1st Circuit Court ruled that the workers comp judge did not err in finding “that Mr. Morgan's assertion of claims for sleep apnea testing, Cialis prescription, and testosterone replacement therapy are premature until such time as he has submitted to and completed an inpatient pain treatment program” as recommended by the doctor.

But the court let stand a ruling by the workers comp judge that Mr. Morgan is entitled to at least $7,000 in tooth extraction and denture work related to damage caused by the pain medications.

For in-depth coverage of this topic and related issues, visit our Solution Arc on Opioid Abuse and Workers Compensation: Tackling a Growing Problem.