Workers Compensation and Medication Side Effects

If you have an adverse reaction to the medication you are taking for a work injury, Adelaide injury lawyer and former pharmacist Mal Byrne says you may be entitled to workers compensation for that reaction.

In the Ice Age, when I was a pharmacist, I remember that part of the ritual when filling a prescription was to make sure that each dispensed medication was not only properly labelled, but that suitable warning stickers were applied. There were about ten stickers. No. 1 was the red sticker warning of the risk of drowsiness and operating machinery while taking the medication, No.2 was the don’t drink alcohol sticker, No. 4 the avoid milk sticker (for Tetracycline antibiotics), No. 8 the don’t expose yourself to the sun sticker (Phenothiazine based antipsychotics), and so on. Times have changed. The stickers have changed. The blue pharmacist’s coat that gathers moths in my wardrobe might have fitted Ice Age Mal, but not the current model; and do pharmacist’s even wear coats anymore? 

Some medications that I dispensed are still around and some have disappeared. What hasn’t changed is that medication old or new has side effects. Sometimes, the cure can come at a cost.  Some medications not only act on receptor sites that relate to the injury/illness, but on receptors in otherwise healthy parts of the body leading to physiological changes that are called side effects.  Side effects are a form of collateral loss or damage in the drug’s war against the disease.  Not all patients experience side effects. Some side effects are common, some rare.  Some are experienced as soon as you start taking the medication and some are caused by chronic use. Some side effects can be a simple nuisance, such as constipation from taking opiate analgesics. Other side effects can be debilitating and permanent. 

If you have an accepted claim for workers compensation, the reasonable cost of medication prescribed on prescription by your doctor to treat your work injury is covered by Return to Work SA (formerly WorkCover).  If it is essential that you take this medication and you suffer side effects, you can submit a claim for workers compensation for the side effects on the basis that they are a sequel to your work injury. 

The medications most commonly prescribed for work injuries are analgesics (painkillers) and anti-inflammatories. Depending on the drug type, analgesics and anti-inflammatories can cause side effects that you need to look out for and for which you can claim if they occur. Many workers with significant work injuries are forced to take strong analgesics for long periods of time.  A majority of those stronger analgesics will contain opiates.  Opiates are drugs derived from morphine.  They are strong, potentially addictive and have a number of side effects.  Examples of these drugs are: 

– Codeine (Panadeine, Panadeine Forte, Mersyndol, Mersyndol Forte)
– Tramadol hydrochloride (Tramal)
– Oxycodone (Endone, Oxycontin) 

The most common short term side effect of opiate analgesics is constipation. If you experience constipation from taking opiate medication and you are forced to take laxatives or other medication to deal with that side effect, you should be entitled to have the cost of that additional medication reimbursed by Return to Work SA. 

Injured workers with serious long term injuries such as discogenic injuries of the spine will have to take opiate medication for pain on a regular basis for years.  One of the side effects of opiates is dry mouth which of itself is a nuisance. However, patients who take opiate medication long term are at risk of dental decay caused by dry mouth and gums.  If you have been taking opiate medication on a long term basis, you should have your teeth checked regularly by your dentist or doctor and you should be able to claim any treatment required from Retrun to Work SA. You will need to prove that the tooth decay was caused substantially by the medication and not by general neglect and it’s likely that the claims agent will want to see your full dental records before determining the claim. If the dental decay caused by opiate medication is advanced to the point where teeth have to be extracted and there is therefore a permanent loss, you may be entitled to a Section 58 (formerly Section 43) lump sum payment for permanent impairment. 

Anti-inflammatories are prescribed by doctors to reduce inflammation due to injury. They are also useful in treating arthritic pain.  Common examples of anti-inflammatories include : 

– Ibuprofen (Brufen, Advil, Nurofen, Nurofen Plus)
– Celecoxib (Celebrex)
– Diclofenac (Voltaren)
– Meloxicam (Mobic) 

The main side effect is gastrointestinal irritation and in particular gastrointestinal  bleeding, including ulcer.  Some patients who must take anti-inflammatories will be prescribed tablets that will assist with preventing ulcers in the stomach or intestine, such as Esomeprazole (Nexium). In that circumstance, the cost of the Nexium would be claimable. Another dangerous side effect of anti-inflammatories is fluid retention or hypertension. 

Side effects are not the only potential adverse drug reaction that can occur when taking medication. Some people are allergic to certain medications. An allergy is different to a side effect. A side effect is caused by the drug’s collateral effects on a healthy part of the body. If someone is allergic to a drug, taking that drug triggers a physiological rejection which can range from a rash to severe anaphylactic shock that requires immediate hospitalisation. Another potential adverse reaction is drug incompatibility, where a person takes a drug that is incompatible with another drug prescribed at the same time or that the person already takes for another condition. 

So, if you have an adverse reaction to any medication prescribed by your doctor to treat your work injury, you should lodge a Return to Work SA claim and consult a lawyer if that adverse reaction was serious, and particularly if you have suffered permanent damage.

Author: Mal Byrne

For a free initial interview about your WorkCover matter in Adelaide or Perth, contact Mal on (08) 8250 6668.