Under the Pennsylvania Workers' Compensation Act (WCA), the general rule is that medical treatment is compensable if reasonable, necessary and causally related to the accepted work injury. Less than a year ago, the Commonwealth Court in Babu v. WCAB (Temple Continuing Care Center), 2014 Pa. Commonwealth, Lexis 448, assessed the compensability of holistic medical treatment administered outside of the United States and, in the process, used an interesting rational, which may create controversial precedent.
In that matter, the employee, a nurse, sustained a compensable work injury to her neck and shoulders. She obtained some "Ayurvedic" treatment in India, which the Court described as a form of holistic alternative medicine traditional in India. The matter eventually settled via Compromise and Release, however, the parties agreed that the Workers' Compensation Judge (WCJ) would make a determination as to the compensability of the "Ayurvedic" treatment. The WCJ cited the Boleratz v. WCAB (Airgas Inc.) matter and found the treatment was not compensable and determined that the employee failed to prove the treatment was rendered, prescribed or supervised by a licensed practitioner. Additionally, it was noted the records offered to the WCJ by the employee did not show what treatment was provided, or to what part of the body the treatment was given, making it impossible to see if the treatment was actually even related to the injury. The employee appealed the decision to the Workers' Compensation Appeals Board (WCAB), which affirmed the WCJ's determination. On appeal to the Commonwealth Court of Pennsylvania, the decision was again affirmed. Interestingly, instead of focusing on the actual evidence presented by the employee, the Court focused on the fact that medical treatment must be provided, prescribed or supervised by a Pennsylvania licensed healthcare practitioner. The employee's Petition for Allowance of Appeal from the Order of the Commonwealth Court was denied by the Supreme Court of Pennsylvania in April 2015.
The Commonwealth Court's decision in Babu, is somewhat surprising, although favorable from a defense perspective, as, on its face, limits exposure for treatment in certain circumstances, especially in cases where the treatment may be unverifiable and provided by a provider unlicensed by the Commonwealth of Pennsylvania. At the present time, there are not any published decisions which cite the Babu determination, however, going forward, it is certainly a possibility the Court may have to again revisit and clarify this issue.
By Ross J.Ventre II