Worker establishes need for dental implants after assault

An Arkansas appeals court upheld the finding that a worker’s injury was causally linked to her tooth decay and subsequent need for dental implants.

However, the court ruled that she was not entitled to recoup the cost of the surgery to extract her upper teeth, as she had not requested prior authorization.

Tara Rowland was working for the Evangelical Lutheran Society of Good Samaritans at a nursing home when a patient punched her in the face in 2014, chipping one of her teeth, according to Evangelical Lutheran Society of Good Samaritans c. Rowland.

A medical analysis showed conditions requiring surgery, which was unsuccessful. Two doctors then recommended braces and other surgeries after the braces were removed. Evangelical Lutheran argued that there was no causal connection between the compensable injury and the recommended treatment.

An administrative law judge disagreed. After further treatment, she developed dental caries and her upper jaw became infected.

A doctor determined it was necessary to extract all of Ms Rowland’s upper teeth and did so without seeking prior permission. This doctor recommended dental implants.

The doctor also felt that Ms Rowland’s remaining lower teeth would also require extraction and dental implants, and he attributed her condition to delays in treatment caused by Evangelical Lutheran’s denial of the claim.

The ALJ also concluded that Ms. Rowland’s tooth decay was causally related to her original injury and that the implants were reasonably necessary. However, the judge concluded that Ms Rowland was not entitled to recover the cost of the extraction because she had not obtained prior authorization. The Workers Compensation Board confirmed.

The Arkansas Court of Appeals said there was substantial evidence to support the finding that Ms Rowland was entitled to further treatment because her doctor described dental and jaw problems that were the direct result of processing delays due to the rejection of the application by Evangelical Lutheran.

However, the court said the commission duly relied on the doctor’s testimony that Ms Rowland’s condition was not a ‘life or death’ situation and concluded that it had not the right to have the cost of extraction covered.

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