Virginia: Specialized “Running Blade” Prosthesis Found Not to be Medically Necessary

The Virginia Workers’ Compensation Commission did not commit error when it determined that the running blade prosthetic device requested by claimant was not medically necessary under Va. Code Ann. § 65.2-603. Claimant had suffered a work-related accident, which resulted in a below-the-knee amputation of his left foot. He was given a prosthesis to replace his left foot and awarded lifetime medical benefits as well as temporary partial disability benefits. Claimant subsequently sought benefits for two separate prosthetics: an “Elan Boot” for day-to-day activities and a special “Endolite Blade XT” for sporting endeavors. The employer agreed to supply the former, but not the latter. Citing Larson’s Workers’ Compensation Law, the court acknowledged that the employer had a mandatory duty to compensate an injured employee for medical expenses causally related to the injury. Any recommended treatment must, however, be reasonable, necessary, and related to the industrial accident. Here claimant had failed to prove that the running blade was medically necessary. While the medical experts indicated provision of the blade would be “beneficial” in improving claimant’s quality of life, they did not opine that the blade was medically necessary. The court concluded that providing a running blade to enable claimant to participate in sporting activities fell outside the range of benefits provided in the workers' compensation statutes.

Thomas A. Robinson, J.D., the Feature National Columnist for the LexisNexis Workers’ Compensation eNewsletter, is the co-author of Larson’s Workers’ Compensation Law (LexisNexis).

LexisNexis Online Subscribers: Citations below link to Lexis Advance.

See Pacheco v. J.P. Masonry, Inc., 2017 Va. App. LEXIS 294 (Nov. 28, 2017)

See generally Larson’s Workers’ Compensation Law, § 94.03.

Source: Larson’s Workers’ Compensation Law, the nation’s leading authority on workers’ compensation law

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