The employee, Ruth Chase, appeals an order of the compensation appeals board (board) finding that she failed to meet her burden that her prescription drug regimen was reasonable, necessary and causally related to her 1994 work injury. She argues that the board made factual rulings not supported by the evidence and committed legal error in finding that the medical treatment was not reasonable, necessary and causally related to her 1994 work injury. We affirm.
We will affirm the board's decision absent an error of law or unless by a clear preponderance of the evidence, we conclude that it is unjust or unreasonable. Appeal of Fay, 150 N.H. 321, 324 (2003). We consider the board's factual findings to be prima facie lawful and reasonable. Id. This presumption can only be overcome by a showing that there was no competent evidence from which the board could conclude as it did. Appeal of Newcomb, 141 N.H. 664, 667 (1997). The appealing party bears the burden of demonstrating that the board's decision was erroneous. Appeal of Fay, 150 N.H. at 324.
The employee argues that the board made factual findings not supported by competent evidence in the record. Specifically, she cites: (1) a finding that her treating physician failed to relate her prescription regimen to the 1994 injury; and (2) findings based upon the medical reports of Dr. Jacobs, Dr. Tromanhauser and Dr. Nagel. With respect to the three cited reports, the employee does not argue that the board's findings concerning those reports are inaccurate, but rather that they are incomplete. She also argues that the board failed to consider the palliative benefits that she received from the continued prescription of the requested medication. See Appeal of Lalime, 141 N.H. 534, 538 (1996) (under workers' compensation statutes, reimbursable medical care may include treatments that are either curative or palliative in nature).
The record before us includes two documents from the employee's treating physician labeled "letter of medical necessity" and dated February 23, 2006. Neither of those documents cites the August 13, 1994 Pizza Hut injury; moreover, in one of the documents, her physician states that the employee's chronic pain and disc disease are "presumably related to a work injury sustained in the early 1990's. I have been her provider since 1/5/04 and do not have records directly related to her injury."
The employee argues that the opinion of her treating physician is entitled to great deference. We disagree. In this case, the physician's statements concerning lack of familiarity with the employee's medical records related to the 1994 injury and admitted presumption that the treated condition is related to that injury do not support such deference.
The reports cited by the employee and authored by Dr. Jacobs and Dr. Tromanhauser address the efficacy of surgical treatment; they do not address her need for a continued drug regimen that specifically includes Demerol. Therefore, while they may have some relevance to the cause of the employee's symptoms, they are of less relevance on the issue of the requested drug regimen. The board therefore did not err in citing only the relevant portions of the reports. To the extent that the employee argues that the board erred in citing only one portion of Dr. Nagel's reports, we note first, Dr. Nagel ceased treating the employee in 2003 and second, the board was free to accept or disregard his report, in whole or in part, given the other expert evidence. See Appeal of Newcomb, 141 N.H. at 668-69.
As the parties noted, the record before the board and on appeal is extensive and contains reports from multiple medical providers detailing the employee's extensive medical history, not all of which was related to the 1994 work injury. It was the employee's burden to demonstrate that her requested drug regimen was the result of her 1994 Pizza Hut injury. See Appeal of Fay, 150 N.H. 321, 325 (2003). Our task on appeal is not to determine whether we would have found differently from the board nor to reweigh the evidence, but rather to determine whether the board's findings are supported by competent evidence in the record. Id. In this case, the board correctly noted that the threshold question before it was whether the medication continued to be causally related to the occupational injury. The record supports the findings made by the board that the employee failed to carry her burden of proof that the treatment was reasonable, necessary and causally related to the work injury.
DUGGAN, GALWAY and HICKS, JJ., ...