Excessive court docket orders reconsideration of employee’s nixed prescriptions

The Ohio Supreme Court on Wednesday ordered the Ohio Industrial Commission to reconsider its previous decision allowing an employer to suspend payment of prescriptions for an injured worker.

In 2006, Robert Batina suffered an injury while working for TS Trim Industries Inc., a self-insured auto parts manufacturer in Winchester, Ohio. As part of his employee compensation claim, he was prescribed an opioid for pain relief and a muscle relaxant. In 2016, TS Trim ordered a drug use review by a doctor, according to State documents. “Did not find enough credible evidence to support the need for continuous anesthesia, taking into account Mr Batina’s story, medical record review and physical examination”. Ex-Rel. TS Trim Industries, Inc. v Indus. Come from Ohio, filed in Columbus.

Based on this review, TS Trim informed Mr. Batina that his use of the two drugs would be reduced, after which the company would no longer pay for the prescriptions. Mr. Batina filed a petition with the state’s industrial commission, and a district hearing officer issued an order in which he concluded that “medical evidence was inconclusive” in support of Mr. Batina’s continued use of the pain reliever, however sufficient to support its continued use of a. to support muscle relaxers.

The commission denied TS Trim’s request to reconsider that order to continue the drug, and the company petitioned the State 10th District Court of Appeals to order the commission to overturn its order and refuse further reimbursement for both drugs.

The Court of Appeal then instructed the Commission to investigate the reasons for refusing the re-examination. The commission later appealed this judgment, which was overturned by the state’s highest court, but ordered the commission to terminate Mr Batina’s request to force his employer to cover his pharmaceutical costs in the light of state law, the insurer and the employer obliged to refer to the regulations, re-examines a drug inventory introduced in 2017 when drugs are denied or approved for injured workers.