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Injured man's treatments by subsequent doctors ruled uncompensable

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Certain medical treatments provided by doctors other than an injured worker’s original treating physician weren’t “reasonable and necessary” for a man who was struck in the head nearly 18 years ago, the Connecticut Appellate Court ruled Tuesday.

Heyward Sellers sustained a compensable injury when he was struck in the head by a falling automobile part while working for Sellers Garage Inc. on March 21, 1997, court records show.

Mr. Sellers was diagnosed with central pain syndrome, myofascial pain syndrome and tension headaches, according to records. He was awarded a 10% permanent partial disability to the cervical spine with a maximum medical improvement date of Dec. 11, 1997.

In October 2010, a neurosurgeon examined Mr. Sellers and found that he reached maximum medical improvement with a 2% permanent partial disability rating, records show. The report also states that no additional treatment would be beneficial for Mr. Sellers, but he should refrain from overhead work and continuous use of his neck.

The treating physician testified in May 2011 that he continued to treat Mr. Sellers with medications that assist in the activities of daily living, but that don’t help him to continue to work, according to records.

Another physician, who first examined Mr. Sellers in 2000, performed an examination in September 2011, finding that Mr. Sellers never underwent recommended neuropsychological testing, according to records. The physician again recommended the testing to differentiate between cognitive impairment related to possible depression or from side effects related to medications.

The Connecticut Workers’ Compensation Review Board found that that certain medical treatments were not “reasonable and necessary” after May 2011, and that medical treatment provided by physicians other than Mr. Sellers’ original treating physician was not subject to compensation by Sellers Garage.

Mr. Sellers appealed, records show.

The Connecticut Appellate Court affirmed the board’s ruling on Tuesday, noting that treatments were palliative rather than curative and that any treatment by additional physicians was “outside the chain of authorization.”

“Reasonable or necessary” medical care must be curative or remedial, which means it “seeks to repair the damage to health caused by the job even if not enough health is restored to enable the employee to return to work,” the ruling states.

Palliative treatment, on the other hand, aims to reduce the effects or symptoms of a medical condition without curing it, according to Merriam-Webster.