Call or email us anytime
(805) 484-0333
Search Guide
Today is Thursday, March 28, 2024 -

Industry Insights

Moore: Court Says Rx OK Even if Not FDA-Approved

  • State: North Carolina
  • -  0 shares

A North Carolina Appeals Court rendered a very interesting decision earlier this month that was a shocker. I am not saying whether or not I agree with the decision. Those kinds of decisions are best left to the courts.  

James Moore

James Moore

The case was Davis v. Craven County ABC Board

One of the bedrock decisions in North Carolina (I was the claims adjuster on this one) was Simon v. Triangle Materials. The Simon decision brought “effect a cure and give relief” to light and strengthened the phrase in our state. 

Davis’ claim was accepted as compensable. The treating physician prescribed a non-Food and Drug Administration-approved cream for the injured employee to use. The carrier denied the prescription. The North Carolina Industrial Commission approved its use by Davis at both deputy commissioner and full commission levels.   

The insurance carrier appealed to the NC Court of Appeals. The appellate court summarized their decision very well in one paragraph:

As explained below, we reject defendants’ argument that non-FDA-approved drugs should be categorically excluded from medical compensation under the workers’ compensation system. The text of the Workers’ Compensation Act does not limit drug treatment solely to FDA-approved drugs. Defendants assert a number of persuasive policy arguments concerning the risks of non-FDA-approved drugs, but
this court has no authority to rewrite the law on policy grounds. That is a task for the legislative branch.

Take notice of that last sentence. Very interesting. 

I was involved in an offshore captive insurer’s decision to deny a cream that contained fentanyl.  The treating physician in Florida changed the cream from fentanyl-based to a non-FDA approved cream. I provided the captive with a large amount of documentation on fentanyl. The non-FDA approved cream was OK’d by the captive owners as a better alternative than what was considered a dangerous drug a few years ago.  

Why did I write up this article? Many workers' comp adjusters, not only in North Carolina, need to know when an unusual decision or circumstance occurs in work comp. 

Even if you do not have claims in the Tar Heel State, this type of decision may be coming, to or already has happened, in your state. The reach of a decision sometimes is much longer than this North Carolina Appeals Court decision.

This blog post is provided by James Moore, AIC, MBA, ChFC, ARM, and is republished with permission from J&L Risk Management Consultants. Visit the full website at www.cutcompcosts.com.

No Comments

Log in to post a comment

Close


Do not post libelous remarks. You are solely responsible for the postings you input. By posting here you agree to hold harmless and indemnify WorkCompCentral for any damages and actions your post may cause.

Advertisements

Upcoming Events

  • May 13-15, 2024

    NCCI's Annual Insights Symposi

    Join us May 13–15, 2024, for NCCI's Annual Insights Symposium (AIS) 2024, the industry’s premier e …

  • Jul 29 – Aug 2, 2024

    76th Annual SAWCA Convention

    SAVE THE DATE! 76th Annual SAWCA Convention July 29 – August 2, 2024 Hotel Effie Sandestin 1 Grand …

  • Aug 14-17, 2024

    CSIMS 2024 Annual Dual Track C

    California Society of Industrial Medicine and Surgery (CSIMS) is combining its two conferences, PI …

Workers' Compensation Events

Social Media Links


WorkCompCentral
c/o Business Insurance Holdings, Inc.
PO Box 1010
Greenwich, CT 06836
(805) 484-0333