Monday, November 5, 2007

Epidural Steroid Injection Is "Surgical"

Claimant alleged an epidural steroid injection (ESI) was a surgical procedure in the case of Boyce Manor Nursing Home v. Kaylor, COCA, Div IV, Case No. 104,035 (unpublished). The COCA cited with approval, Hartford Accident & Indemnity Co. v. Barfield, 80 S.E.2d 84 (Ga. Ct. App. 1954), in which the Georgia Court of Appeals concluded a myelogram constituted "surgery" in the context of Georgia workers' compensation law.

In Boyce Manor, the Court stated, "An epidural steroid injection is clearly a manual and instrumental operation for relief of suffering. It involves the same type of invasive 'penetration of living tissue,' as the myelogram in the Hartford Accident & Indemnity case. Accordingly, we believe an ordinary person would understand that this invasive procedure is 'surgery' because it is 'performed manually by a surgeon . . . in a sterile aseptic surgical room.' We also believe that an ordinary person would understand that this procedure is 'corrective' because it provides relief from pain, albeit temporarily."

If the reasoning of this case is followed, then it appears that procedures such as ESIs, myelograms, and discograms will be considered "surgical," thus removing the statutory soft tissue limitation on temporary total and permanent partial disability benefits.

Caveat: this is an unpublished opinion of the Court of Civil Appeals, and it is therefore not to be treated as authority or precedent for the proposition. However, it may be an indication of the thinking that might be followed if the question is addressed by the Oklahoma Supreme Court.

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