Abbott v. Mainsource Financial Group

931 N.E.2d 909, 2010 Ind. App. LEXIS 1449, 2010 WL 3075201
CourtIndiana Court of Appeals
DecidedAugust 6, 2010
Docket93A02-0912-EX-1261
StatusPublished

This text of 931 N.E.2d 909 (Abbott v. Mainsource Financial Group) is published on Counsel Stack Legal Research, covering Indiana Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Abbott v. Mainsource Financial Group, 931 N.E.2d 909, 2010 Ind. App. LEXIS 1449, 2010 WL 3075201 (Ind. Ct. App. 2010).

Opinion

OPINION

NAJAM, Judge.

STATEMENT OF THE CASE

Rebecea Abbott filed an application for adjustment of claim with the Worker's Compensation Board of Indiana (the "Board") against her employer, Main-Source Financial Group ("MainSource"). In particular, Abbott sought compensation for two prescription medications she alleges she must take indefinitely as a result of her work-related injury. A Single Hearing Judge denied her claim, concluding that the evidence did not support Abbott's contention that the prescriptions were necessitated by her work-related injury. Abbott petitioned the full Board, which affirmed the Single Hearing Judge's decision following a hearing. Abbott presents two issues for our review:

1. Whether the Board erred when it concluded that Abbott is not entitled to compensation for the prospective use of two preseription medications.
2. Whether the Board erred when it concluded that MainSource did not commit bad faith in denying compensation for the prescription medications.

We affirm.

FACTS AND PROCEDURAL HISTORY

On December 28, 2006, Abbott was working for MainSource as a bank teller when an armed man robbed the bank. The robber held Abbott at gunpoint and threatened to kill her and others before fleeing. The extreme stress of that incident led to Abbott sustaining a heart attack, for which she underwent extensive medical treatment.

(On December 29, Dr. Zachary Hodes performed a heart catheterization on Abbott, which revealed that Abbott's heart attack was caused by a condition called Takotsubo syndrome. Dr. John Bates, a cardiologist, described the syndrome as follows:

[Blasically it's a syndrome, it's something that people discover when patients would present with signs or symptoms of a heart attack, very often after a very stressful, emotional or stressful physical event. The death of a loved one, severe *911 exacerbation of a breathing problem. They couldn't get their breath, you know, or something like a bank robbery or something else that is a severe emotional stress. And basically it has all the signs and symptoms of a traditional heart attack but when the diagnostic evaluation is done the patient is often found to have no coronary artery disease or no blockages in the arteries that would typically cause a heart attack. And the thought is that the outpouring of catecholamines or hormones that occur with the very stressful event is actually somewhat toxic to the heart and so the heart is stunned and parts of the heart muscle don't move and it changes on EKG elevation of cardiac enzymes as you would have with a heart attack, but there's no blockage in the arteries, so that's really the distinction.

Appellant's Supp.App. at 5-6. Abbott was hospitalized for two days. After she was discharged, Abbott was prescribed Lipitor and Coreg, among other medications.

Abbott remained under the care of Dr. Bates until July 2, 2007, when a stress echocardiogram showed "normal resting left ventricular function, good exercise tolerance, and no evidence of inducible myocardial ischemia." Id. at 35. At that time, Dr. Bates concluded that Abbott had "recovered from the acute illness." Id. But, Dr. Bates noted that Abbott "is certainly at risk for a recurrence of that condition if she is again put under similar emotional stress." Id.

Abbott also underwent several months of psychological treatment for posttrau-matic stress disorder as a result of the emotional stress she experienced during the bank robbery. Dr. Gregory Hale, Ph. D., ultimately determined that Abbott sustained a 5% permanent impairment of the whole person as a result of her psychological injuries. But both Dr. Bates and Dr. John McLimore assessed that Abbott had sustained no impairment from a physical injury standpoint.

Pursuant to an interim agreement submitted to and approved by the Board, MainSource, through its worker's compensation provider, "paid [Abbott's] 5% whole person combined permanent partial impairment rating [.]" Appellant's App. at 5. After Abbott had attained maximum medical improvement, however, MainSource stopped paying for her prescriptions for Lipitor and Coreg, which had been pre-seribed for her by Dr. Bates. As Dr. Bates explained, Lipitor is a lipid-lowering drug that is usually given to patients after a heart attack to reduce the likely recurrence of a second heart attack. And Co-reg is a beta blocker that protects the heart from excesses of physical activity and emotional stress. Dr. Bates explained that the Coreg is "treating [Abbott's hypertension]" and that it would protect her against a future heart attack. Appellant's Supp.App. at 10.

Abbott contacted MainSource on four occasions in October and November 2007 to request that MainSource reinstate the compensation for her prescriptions for Lipitor and Coreg, but those requests were denied. Accordingly, on February 21, 2008, Abbott filed her application for adjustment of claim with the Board and, on March 7, she filed a Petition for Bad Faith Penalties Against MainSource. Following a hearing, the Single Hearing Member found and concluded in relevant part as follows:

3. [MainSource] accepted [Abbott]'s injury as compensable under the Act.
* * *#
11. Upon [Abbott]'s release from treatment for her physical injuries, the physician recommended that [Abbott] take Coreg and Lipitor.
*912 12. On August 26, 2008, Dr. Bates testified in his deposition that [Abbott] had suffered from Takotsubo syndrome but that her heart had returned to normal as of the date of his last evaluation.
13. Dr. Bates testified that [Abbott] had been placed on Coreg because she exhibited signs of exertional dyspnea, or shortness of breath upon exercise. Dr. Bates testified that Coreg can be used to treat high blood pressure. [Abbott] had shown elevated blood pressure at times during the course of her treatment with Dr. Bates.
14. Dr. Bates testified that he likes to keep heart attack patients on medications such as Coreg because the medications are protective against excesses of physical activity and emotional stress.
15. Dr. Bates testified that after a heart attack it is common to place patients on lipid lowering drugs such as Lipitor because they have been shown to reduce the likelihood of another heart attack.
16. Dr. Bates testified that based on [Abbott]'s constitution, and history of a cardiac event, she has an elevated risk for experiencing repeat cardiac events if she experiences extreme emotional distress.
17. Dr. Bates testified that the Coreg is intended to protect [Abbott] from any future stressful events and that the Lipitor is intended to keep her cholesterol low to prevent the development of arth-erosclerotic disease.
18. Dr. Bates testified that Lipitor has very little effect on [Abbott]'s everyday functioning. He testified that the Coreg seemed to help [Abbott]'s exertional dyspnea.
19. Dr. Bates testified that he was uncertain as to the length of time that [Abbott] might be kept on Coreg and Lipitor.

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931 N.E.2d 909, 2010 Ind. App. LEXIS 1449, 2010 WL 3075201, Counsel Stack Legal Research, https://law.counselstack.com/opinion/abbott-v-mainsource-financial-group-indctapp-2010.