The case of Martin v. Newark Public Schools was the subject of an earlier blog (Oct. 7). At the time of that blog, the case had not been approved for publication. 

John H. Geaney

On Dec. 13, the Committee on Publications decided to approve Martin for publication. It is now the only published decision in New Jersey workers’ compensation on this specific issue and, therefore, the leading case on requests for continued opioid use. 

The case involved a not uncommon situation where two physicians disagreed on the need for long-term opioid use. The treating physician, Dr. Patricio Grob, treated the petitioner from 2011 to 2017 but then released the petitioner in September 2017, writing one final prescription of Percocet as a courtesy to Samuel Martin.

Grob felt that Percocet was poorly controlling Martin’s pain. He also said continued Percocet would “not manage petitioner’s radicular complaints ... and could complicate his recovery.” After six years of treating the petitioner with Percocet, Grob concluded that prescription pain medication would never improve Martin’s condition. Grob recommended surgery but the petitioner declined due to an unrelated blood condition.

Martin next saw Dr. Harris Bram, an expert in pain medication, for a one-time evaluation. Bram noted that the petitioner had disk desiccation at L4-5 and L5-S1 and disk herniation at L5-S1. Bram recorded somewhat contradictory statements from the petitioner. 

In taking the petitioner’s history, Bram said Martin reported opioid medication provided only “small pain relief.” But he also self-reported in other records that Percocet abated his pain symptoms by approximately 60%. Bram concluded that long-term use of opioids would be reasonable.

Administrative Supervisory Judge Philip Tornetta found that the petitioner failed to prove continued Percocet treatment would reduce his pain or permit him to function better. He commented that Bram did not provide medical evidence that long-term Percocet use would permit Martin to function better.

The Appellate Division affirmed the dismissal of the petitioner’s motion, first citing an older case involving a motion for physical therapy. In Hanrahan v. Twp. Of Sparta, the court found that the claimant who was seeking further physical therapy was required to show the treatment would “probably relieve petitioner’s symptoms and thereby improve his ability to function.”

The court applied this logic to the Martin case with respect to the request for long-term opioids:

Here, the judge found credible the testimony of Dr. Grob that continued prescribing of pain medication did not, and would never, heal petitioner or relieve his condition. During the six years he treated petitioner, Dr. Grob concluded Martin’s pain had not been alleviated with therapy or medication.

The court concluded:

We are satisfied there was sufficient, credible evidence in the record to support the compensation judge’s determination that further treatment with opioid medication would not cure or relieve Martin’s injury.

The emphasis on this case at both the trial level and appellate level was on improvement of function. The fact that the treating doctor had observed poor pain control from Percocet over six years posed serious problems for the petitioner to overcome at trial. 

The case must be seen in the context of the opioid epidemic in the United States. It demonstrates that employers can actually do something about long-term opioid use under certain situations. Just testifying in court that opioid medication makes one feel good will not suffice. There must be medical evidence of improvement of function under this significant decision.

John H. Geaney is an attorney, executive committee member and shareholder with Capehart Scatchard, a defense law firm in New Jersey. This post appears with permission from Geaney's New Jersey Workers' Comp Blog.