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DISTRICT OF COLUMBIA COURT OF APPEALS

No. 14-AA-695

HELEN WHITE, PETITIONER,

V.

DISTRICT OF COLUMBIA DEPARTMENT OF EMPLOYMENT SERVICES, RESPONDENT,

and

WASHINGTON METROPOLITAN AREA TRANSIT AUTHORITY, INTERVENOR.

Petition for Review of an Order of the District of

Columbia Department of Employment Services

Compensation Review Board

(CRB-165-13)

(Submitted April 21, 2015 Decided July 23, 2015)

Krista N. DeSmyter was on the brief for petitioner.

Eugene A. Adams, Interim Attorney General for the District of Columbia at 

the time the brief was filed, Todd S. Kim, Solicitor General, Loren L. AliKhan, 

Deputy Solicitor General, and Richard S. Love, Senior Assistant Attorney General, 

filed a statement in lieu of brief for respondent.

Kathryn H.S. Pett, Sarah O. Rollman, and Donna J. Henderson were on the 

brief for intervenor.

Before BECKWITH and MCLEESE, Associate Judges, and NEBEKER, Senior 

Judge.
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MCLEESE, Associate Judge: Petitioner Helen White seeks review of an 

order denying her workers’ compensation benefits. The Compensation Review 

Board (CRB) concluded that Ms. White was not entitled to compensation for 

proposed medical treatments, because Ms. White could not show that the proposed 

treatments were reasonable and necessary. We affirm in part and reverse in part.

I.

The following facts are undisputed in this court. Ms. White worked as a bus 

operator for the Washington Metropolitan Area Transit Authority (WMATA) for 

twenty years. She injured her neck and lower back in a work-related accident in 

2006. She has not returned to work since August 2006. Dr. Eric G. Dawson 

treated her with intramuscular injections, muscle relaxants, pain medication, antiinflammatory medication, sleep medication, and physical therapy. 

In 2008, the parties agreed that WMATA would be liable for all reasonable 

and necessary medical expenses that were causally related to the accident. In 

2012, WMATA denied approval for additional treatment by Dr. Dawson. At 

WMATA’s request, Dr. Louis Levitt performed an independent medical 

examination (IME) of Ms. White in early 2013. Dr. Levitt determined that Ms. 
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White did not need further medical treatment. A utilization review was then 

conducted to determine if further treatment by Dr. Dawson was reasonable and 

medically necessary. See D.C. Code § 32-1501 (18A) (2012 Repl.) (“‘Utilization 

review’ means the evaluation of the necessity, character, and sufficiency of both 

the level and [the] quality of medically related services provided an injured 

employee . . . .”). The reviewer determined that further treatment was not

reasonable and necessary. 

Ms. White contested that determination, seeking an award ordering 

WMATA to pay for the treatments proposed by Dr. Dawson. After an evidentiary 

hearing, an ALJ denied Ms. White’s claim. Focusing on Dr. Dawson’s 

recommendation that Ms. White continue to receive intramuscular injections, the 

ALJ found that such injections were not reasonable and necessary. The ALJ did 

not make a finding as to whether the other recommended treatments -- muscle 

relaxants, pain medication, anti-inflammatory medication, sleep medication, and 

physical therapy -- were reasonable and necessary. The ALJ did find -- without 

explanation -- that continued office visits with Dr. Dawson would not be 

reasonable and necessary. The CRB affirmed without explicitly addressing 

recommended medical treatments other than injections and continued office visits. 
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II.

Ms. White argues that there was substantial evidence that all of the 

proposed medical treatments were reasonable and necessary. “Our limited role in 

reviewing the decision of the CRB permits us to reverse only if we conclude that 

the decision was arbitrary, capricious, or otherwise an abuse of discretion and not 

in accordance with the law.” Washington Hosp. Ctr. v. District of Columbia Dep’t 

of Emp’t Servs., 983 A.2d 961, 965 (D.C. 2009) (internal quotation marks omitted). 

“Our principal function in reviewing administrative action is to assure that the 

agency has given full and reasoned consideration to all material facts and issues.” 

Georgetown Univ. Hosp. v. District of Columbia Dep’t of Emp’t Servs., 916 A.2d 

149, 151 (D.C. 2007) (internal quotation marks omitted). We will affirm an 

agency’s factual determinations if the determinations are supported by substantial 

evidence in the record. Washington Times v. District of Columbia Dep’t of Emp’t 

Servs., 724 A.2d 1212, 1216 (D.C. 1999).

A.

There was substantial evidence to support a finding that the proposed 

injections were not reasonable and necessary. Although Dr. Dawson’s report 
5

explained why Dr. Dawson thought such injections were medically appropriate, 

Dr. Levitt’s report concluded that there was “no clinical basis whatsoever” for the 

proposed injections. Ms. White argues that the ALJ could only consider the 

utilization-review report and Dr. Dawson’s report. We concluded otherwise, 

however, in Placido v. District of Columbia Dep’t of Emp’t Servs., 92 A.3d 323, 

327 (D.C. 2014) (“[W]e defer to the CRB’s conclusion that an ALJ may consider 

an IME physician’s opinion when determining the reasonableness and necessity of 

medical services.”). 

B.

Ms. White also argues that the utilization-review report rested on the 

conclusion that Ms. White in fact was no longer suffering a work-related injury, 

which is contrary to the requirement that utilization review must “accept[] as a 

given the diagnosis of injury.” 7 DCMR § 232.2 (2015). The CRB acknowledged 

that the language in the utilization-review report was ambiguous, but reasonably 

concluded that the report in any event concluded that further injections were not 

reasonable and necessary because injections had already been tried for a lengthy 

period and had failed. We see no basis for reversal on this point.
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III.

Finally, Ms. White challenges the CRB’s ruling with respect to the 

reasonableness and necessity of treatments other than injections. WMATA 

defends the CRB’s ruling solely on the ground that Ms. White did not properly 

raise before the agency a claim involving such additional treatments. We disagree. 

First, Ms. White’s application for a formal hearing stated that Ms. White was

seeking authorization not only for injections but also for “follow up care and 

medication.” Second, when the ALJ asked at the evidentiary hearing if Ms. White 

sought payment specifically for the injections, Ms. White’s attorney responded, 

“[t]hat’s correct,” but stated further that “[t]he treatment has also consisted of 

treatment for the cervical spine as well and recommendations for continued antiinflammatory care with medication and then also follow-up orthopedic care.” In 

seeking review of the ALJ’s order, Ms. White made clear that she was seeking 

reimbursement not only for injections but also for other proposed treatments, 

including physical therapy, pain medication, muscle relaxants, and sleep 

medication. We view these consistent references to the other proposed treatments 

as sufficient to preserve the issue before the agency. WMATA does not argue that 

the ALJ or the CRB actually decided on the merits whether the other proposed 
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treatments were reasonable and necessary, and it is not apparent to us that the 

agency resolved that issue on the merits. Under the circumstances, we must 

remand the matter for further consideration of that issue. See, e.g., ButlerTruesdale v. AIMCO Props., LLC, 945 A.2d 1170, 1171 (D.C. 2008) (“When an 

agency has failed to consider and resolve each contested issue of material fact, we 

have remanded the case back to the agency for further proceedings.”).

The CRB's decision is affirmed in part and reversed in part, and the matter is 

remanded to the CRB to direct the ALJ to determine whether the additional 

proposed treatments were reasonable and necessary.

So ordered.