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Drug overdose death puts onus on workers comp payers

Drug overdose death puts onus on workers comp payers

Workers compensation payers should monitor the drugs injured workers take as a result of a California Supreme Court ruling that an injury needs only to be a contributing cause in a compensable death.

Brandon Clark, a carpenter at Costa Mesa, California-based South Coast Framing Inc., died in July 2009, about 10 months after falling off a roof and suffering back, head, neck and chest injuries, according to court records.

An autopsy attributed his death “to the combined toxic effects of the four sedating drugs (Elavil, Neurontin, Xanax and Ambien) detected in his blood” and “associated early pneumonia.” While Mr. Clark's workers comp physician prescribed Elavil, Neurontin and Vicodin, his personal physician prescribed Xanax and Ambien in January 2009 for anxiety and sleep problems, records show.

A medical examiner opined that the drugs prescribed by his personal physician alone “caused sedation significant enough to result in the events leading to (his) death.”

In its ruling last month, the California Supreme Court said Mr. Clark's surviving family was due compensation since an “industrial injury need only be a contributing cause to the disability.”

“The legislature has not articulated a more stringent standard for death claims than disability claims,” the court ruled. “Similarly, we may not break from longstanding precedent to apply a higher proximate cause standard to death cases when the legislature has not seen fit to do so.”

Experts were divided on the impact of the case.

“This could be a turning point for more death benefits claims in California and possibly around the country,” said Mark Pew, senior vice president of product development at Prium, a Duluth, Georgia-based medical management company.

While drug overdoses have been ruled compensable in other states, such as Pennsylvania and Tennessee, California tends to set trends and precedents in the workers comp industry, Mr. Pew said.

It's likely that anytime a death occurs from prescription drugs, survivors will pursue death benefits, he said.

Don Powelson, senior partner at Hanna, Brophy, MacLean, McAleer & Jensen L.L.P. in Bakersfield, California, said the ruling is in line with previous decisions in California.

“What I always tell my clients is that in a death case, if there's 1% contribution from the job, it's compensable,” Mr. Powelson said

There's little that can be done to prevent drug overdoses beyond monitoring treatment through utilization reviews and independent medical reviews, he said.

Payers should ensure that physicians use best practices, such as assessing injured workers to see if there's a history of substance abuse, checking prescription drug monitoring programs that most states have and conducting urine drug screenings, sources said.

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