Opinion ID: 1859184
Heading Depth: 1
Heading Rank: 6

Heading: gastric bypass surgery

Text: Rodriguez' final assignment of error is that the single judge erred in denying his request for gastric bypass surgery. The single judge concluded that there was insufficient evidence in the record to prove that gastric bypass surgery was medically necessary. Rodriguez argues that such surgery was medically necessary, because his weight precluded him from obtaining surgery to correct injuries resulting from his accident. He bases this argument primarily on the opinion of one of his physicians, who concluded there was no perfect solution for Rodriguez' back problems, but that it would be [the physician's] opinion [that Rodriguez obtain] a gastric stapling so that he may at some point undergo surgical correction. Rodriguez' psychologist also opined that weight loss surgery may be a consideration, because traditional weight control programs are not very successful in individuals with this degree of obesity. However, the single judge denied this request. The judge noted that the medical evidence established several medical conditions that contraindicated surgery, including coronary artery disease and diabetes, placing Rodriguez at risk of emboli syndrome, pulmonary embolism, and deep vein thrombosis. But the single judge also noted that future medical benefits had been awarded and that the record at this point did not establish that the surgery was necessary to treat the claimant's work-related injuries. We recognize the generally accepted principle that in some circumstances, a medically necessary weight loss program may be compensable. See, e.g., State ex rel. Miller v. Indus. Comm., 71 Ohio St.3d 229, 643 N.E.2d 113 (1994). See, also, Hopp v. Grist Mill, 499 N.W.2d 812 (Minn. 1993) (finding sufficient evidence to support trial court's determination that gastric bypass surgery was necessary to relieve effects of claimant's compensable injury). But here, what little evidence is present in the record suggests that to the extent gastric bypass surgery would be therapeutic, it would not be to directly relieve the effects of Rodriguez' injury. Rather, an additional level of speculation is present, since the surgery is simply intended to make Rodriguez more amenable to more surgery that, in turn, might better his condition. Compare State ex rel. Williams v. Cincinnati Country Club, 83 Ohio St.3d 284, 699 N.E.2d 505 (1998). Cf. Castro v. Gillette Group, Inc., 239 Neb. 895, 479 N.W.2d 460 (1992) (affirming denial of medical treatment where physician's testimony was couched in terms of possibility and hopefulness). Given the sparseness of the record concerning whether gastric bypass surgery was medically reasonable and necessary to treat Rodriguez' compensable injuries, and whether gastric bypass surgery would even suffice to make Rodriguez a candidate for further surgery to treat his compensable injuries, we cannot say the single judge was clearly wrong in determining that there was not sufficient evidence at this time to establish that gastric bypass surgery was necessary to the treatment of Rodriguez' work-related injuries. Rodriguez' final assignment of error is without merit.