In Ex parte El Reposo Nursing Home Group, Inc., [Ms. 2100745, Sept. 16, 2011] __ So. 3d __(Ala. Civ. App. 2011), the Alabama Court of Civil Appeals held that an employer cannot escape its obligation to provide an injured worker with medical treatment by relying on a medical opinion that directly conflicts with a trial court's determination of medical causation. Plaintiff was injured at work in April 2006. Plaintiff filed a worker's compensation claim against her employer, El Reposo, in May 2007. In May 2009, the trial court conducted a trial on the issue of legal and medical causation and determined that Plaintiff's injuries were related to her April 2006 accident. In October 2009, a physician selected by El Reposo as Plaintiff's authorized treating physician, concluded that Plaintiff's pain-management treatment was not related to her April 2006 injury. El Reposo therefore refused to authorize Plaintiff's pain management treatment. The trial court then ordered El Reposo to provide another orthopedic physician to examine Plaintiff to determine the necessity of surgical intervention or provide Plaintiff with pain management treatment. The new physician agreed with the previous physician that the pain management treatment was not related to the April 2006 work injury. Plaintiff sought an order compelling medical treatment, which was granted in September 2010. The trial court amended its order to include detailed findings of fact and conclusions of law in March 2011. El Reposo argued on appeal that the "trial court has improperly usurped the role of the authorized treating physicians and has itself made a medical decision regarding the proper medical treatment to be provided to [Plaintiff]." The Alabama Court of Civil Appeals disagreed, holding that "the trial court had resolved the medical-causation issue in [Plaintiff's] favor before El Reposo authorized treatment by Dr. Jones and Dr. Morris. Regardless of whether Dr. Jones and Dr. Morris have formed the medical opinion that [Plaintiff's] pain is not related to her work-related injury, El Reposo has the duty to provide treatment for [Plaintiff's] pain because the trial court has concluded that medical causation exists."
