Submitted: January 10, 2014
On Appeal from Decision of the Industrial Accident Board.
Gary S. Nitsche, P.A., Nicholas M. Krayer, Esq., Weik, Nitsche & Dougherty, Attorney for Claimant-Below Appellant, Cross-Appellee.
John Gilbert, Esq., Heckler & Frabizzio, Attorney for Employer-Below Appellee/ Cross-Appellant.
ANDREA L. ROCANELLI, JUDGE
Claimant was injured at work on March 27, 2006 when he was working for Employer. Claimant received worker's compensation benefits. This is an appeal by Claimant-Below, Juan Torres ("Claimant") from the July 11, 2013 decision of the Industrial Accident Board ("Board").
On October 1, 2012, Reybold Homes, Inc. ("Employer") filed a Petition to Terminate Benefits, alleging Claimant was capable of returning to work and, therefore, should have his total disability benefits terminated. On December 12, 2012, Employer filed an Appeal of a Utilization Review Decision to dispute the reasonableness and necessity of ongoing medical treatment that commenced on June 5, 2012. A consolidated hearing on the merits was held before the Board on April 29, 2013. The Board issued a decision on July 11, 2013 terminating total disability benefits and finding that the disputed medical treatment was reasonable and necessary ("Board's Decision").
Claimant filed this appeal regarding the Board's Decision to terminate his total disability benefits. Employer filed this cross-appeal of the Board's Decision regarding the reasonable and necessary nature of the disputed medical treatment. For the reasons set forth below, the Board's Decision is affirmed.
Board's Factual Findings
On March 27, 2006, Claimant was employed as a construction worker for Employer when he suffered an injury to his right knee on a job site. As a result of his work injury, Claimant was placed on total disability and underwent substantial medical treatment.
Claimant had three arthroscopic surgeries on his right knee from April 2006-2009. Despite these surgeries, Claimant's knee pain persisted. From 2010-2012, Claimant continued to see various doctors for pain management and physical therapy. After multiple examinations, three different doctors suspected Claimant's knee pain was due to damaged nerves. Eventually, Claimant was referred to Dr. Patrick Swier.
Dr. Swier first examined Claimant on March 27, 2012. Dr. Swier confirmed the other doctor's suspicions and diagnosed Claimant with an injury to part of the saphenous nerve. Dr. Swier soon determined that Claimant's nerve damage required "denervation" surgery, which involves removing smaller nerves from the body and covering bigger nerves with muscle tissue to numb the nerves in exchange for pain relief.
On June 5, 2012, Dr. Swier performed the denervation surgery, Claimant's fourth surgery since the work accident. Claimant experienced complications after surgery and Claimant eventually required a pain management specialist. As Claimant's medical treatment has progressed, he has continued to experience multiple complications. Claimant walks with a cane, and complains of constant shooting pain and numbness. Pain medication allows ...