Employee LD, a resident of Lebanon, Lebanon County, suffered a work injury on June 6, 200 while employed by Mack Employment Services. Claimant was injured when she fell on her hands and knees, rupturing a disc in her back. Claimant has treated with Dr. Stuart Hartman, MD, Dr. Dinello, DMD and Dr. Rick Yazinski, DMD.
Claimant underwent treatment for the injury including surgery in the nature of lumbar spinal fusion, however the surgery wasn’t successful and the Claimant continues to be in pain. In addition to physical therapy, Claimant takes various medications for pain, including approximately eight to ten Actiq lollipops per day, since 2002.
On or about August 27, 2009, Claimant filed a request for Utilization Review because the Workers’ Compensation carrier refused to accept payment for the proposed treatment. Over the years, Claimant had presented to Dr. Rick Yazinski, DMD, as needed for treatment of rapid tooth decay due to the Actiq lollipops, which contain sugar and can lead to tooth decay without proper oral hygiene; it is recommended patients brush their teeth after each lollipop used.
Claimant LD filed a Petition for Review of Utilization Review Determination on or about November 25, 2009 for prospective pre-approval of dental treatment by Dr. Rick Yazinski, DMD that would include four implants, four abutments, anesthesia and seven crowns. A Utilization Review Determination was made by Robert D. Clements, Jr., DDS, who was asked to determine the reasonableness and necessity for the treatment.
A Petition for Review of Utlization Review was also filed by claimant on or about May 19, 2010 for treatments by Stuart A. Hartman, D.O., that would include the medications Axert and Protonix and bursa injections to assist in management of Claimant’s pain, which went before Judge James Deeley in Harrisburg. The Judge found the testimony of Dr. Yazinski & Dr. Hartman to be credible. The Judge found the testimony of Dr. Krassen and Dr. Clements not to be credible because their opinion that dentures would suffice ignores the claimant’s age and the detrimental effect long term use of dentures would have on the claimant’s jawbone.
