EDWARD W. JENSEN, III, Employee/Appellant, v. NORTHERN STATES POWER d/b/a XCEL ENERGY, SELF-INSURED/CCMSI, Employer.
WORKERS’ COMPENSATION COURT OF APPEALS
JULY 26, 2012
STIPULATION FOR SETTLEMENT - INTERPRETATION. Substantial evidence supported the compensation judge’s decision that the employee had been prescribed Wellbutrin to treat depressive symptoms and that the drug was therefore not compensable pursuant to a stipulation for settlement that closed out claims for psychological or psychiatric treatment expenses.
Determined by: Johnson, J., Hall, J., and Milun, J.
Compensation Judge: Jeanne E. Knight
Attorneys: Joseph T. Herbulock, Minneapolis, MN, for the Appellant. Mary M. Dienhart, Minneapolis, MN, for the Respondent.
THOMAS L. JOHNSON, Judge
The employee appeals from the compensation judge’s denial of his claim for reimbursement for medication. We affirm.
Edward W. Jensen, III, the employee, sustained a personal injury on November 2, 2000, arising out of his employment with Northern States Power, then self-insured. The employer accepted liability for the employee’s injury and made payment of various workers’ compensation benefits.
The employee ultimately sought permanent total disability benefits. The parties resolved their disputes and entered into a settlement agreement. In exchange for a lump sum payment, the employee settled his claims, with the exception of future reasonable and necessary medical expenses that were not specifically closed out. The Stipulation for Settlement provided that the “employee stipulates and agrees that the following services, treatment modalities and related expenses are not reasonable and necessary to cure and relieve him from the effects of the November 2, 2000 personal injury, including psychological or psychiatric expenses.” An Award on Stipulation was served and filed on September 29, 2010.
Since his personal injury, the employee has taken certain medications prescribed by Dr. Daniel R. Kurtti. One of the medications prescribed by Dr. Kurtti is Wellbutrin. The employer reimbursed the employee for his Wellbutrin prescriptions until the parties entered into the 2010 settlement, after which it ceased paying for the drug. The employee then filed a Medical Request.
At a hearing before a compensation judge, the employee testified that when the employer stopped paying for Wellbutrin, he stopped taking the medication for seven or eight days. When he did so, the employee stated, he experienced “lack of sleep, consistent headaches daily, sometimes two days straight, just pounding headaches, pain in my neck and back tension.” (T. 13.). The employee also testified that, when he stopped the Wellbutrin, his depressed mood, difficulty with concentration, and paranoid thinking also returned. According to the employee, when he recommenced Wellbutrin, the severity of his headaches decreased, his ability to sleep improved, and his pain was better managed. Received into evidence at the hearing was a note from Dr. Kurtti, dated April 5, 2011, which stated, “It is medically necessary to use Wellbutrin XL 300 mg tables, 1 tablet daily, to control chronic depression related to his chronic pain syndrome from his workers comp. injury 11/2/2000.” (Pet. Ex. A.)
In a Findings and Order, served and filed January 31, 2012, the compensation judge determined that Wellbutrin had been prescribed to treat chronic depression. While finding the medication reasonable and necessary, the compensation judge nevertheless denied reimbursement on grounds that Wellbutrin was a psychiatric expense that had been closed out by the Stipulation for Settlement. The employee appeals.
The employee concedes that Wellbutrin may be prescribed solely for treatment of depression, but he argues that he takes the drug for other purposes as well. The employee contends that his pain, headaches, and sleeplessness increased dramatically during the seven or eight days he did not take Wellbutrin and that those problems improved when he resumed taking the drug. The employee therefore asserts that Wellbutrin provides pain relief and aides his sleep and that such treatment does not constitute psychological or psychiatric treatment foreclosed under the terms of the stipulation. We are not persuaded.
There is no medical evidence that Wellbutrin was prescribed for any reason other than the employee’s depression. Dr. Kurtti’s note stated that “the employee needed Wellbutrin to control chronic depression related to his chronic pain syndrome.” Based upon this evidence, the compensation judge could reasonably conclude that Wellbutrin was prescribed solely to treat the employee’s depressive symptoms and was not compensable under the terms of the Stipulation for Settlement. Accordingly, the compensation judge’s decision must be affirmed.