Jerome Lawlor of Paradise is an injured worker who's received special authorization from the workers' compensation commission to have more than its limit of six massage therapy sessions.
But he's facing other roadblocks because of new regulations adopted by the Workplace Health, Safety and Compensation Commission (WHSCC) in June 2010 that limit the number of treatments to six half-hour sessions with coverage capped at $25 per session.
Lawlor's approval for 15 sessions was based on "extenuating circumstances." Since 2008, he says, regular massage therapy has enabled him to deal with his chronic back pain without taking narcotics.
But Lawlor says he can't find a massage therapist who will treat him for only $25 a session. Most charge $45 and injured workers can't pay anything above the WHSCC limit because of another regulation that prohibits therapists from charging injured workers the difference.
Leslie Galway, chief executive officer of the WHSCC, said last week the latter regulation is to protect injured workers from being charged amounts above its set rate.
Lawlor, who worked as a school board maintenance employee/janitor, sustained his first back injury during renovations to a school in Paradise almost 23 years ago, and was injured a second time while clearing snow around the school. He's had three back surgeries and is now waiting to have another operation.
In his first workplace incident, Lawlor said, he was asked to help another man move a piano that was left in a corner of a room when new carpet was being installed.
"We rolled it over to the carpet and picked it up and lifted it probably 10 feet or so and laid it down," he said.
The following day, he felt a bit stiff, but didn't think much of it. The next morning, he couldn't even put his socks on.
Lawlor had back surgery, was off work for about two months and then returned to his job.
"I was working for probably two to three months with a pocketful of Atasol 30s and did more damage," he said.
Lawlor said part of his job was clearing snow on sidewalks and walkways around the school.
He brought his own snowblower there at first to make the job a bit easier, but said he was told the school board wouldn't pay to have it repaired or replaced if anything happened to it, so he had to resort to clearing snow with a large metal scoop.
One day, he said, the scoop dug into a crack in the walkway. "The handle came back and struck me in the stomach and drove the back out, and I haven't been back to work since," he said.
That was in January 1989 and Lawlor said he hasn't been able to work since then.
He said the WHSCC approved physiotherapy sessions for him, but he didn't feel it was doing him any good.
In order to deal with his pain, his doctor prescribed numerous medications, including narcotics like OxyContin.
After his third back surgery in 2008, Lawlor said he told his family doctor he wanted to get off this medication.
He said he didn't like the idea of taking OxyContin and was always worried that the drug would increase the risk of his home being broken into by drug addicts.
His doctor began weaning him off the medication. Lawlor said when he got to the end of the process, the withdrawal was almost unbearable. He spent six nights unable to sleep and was extremely restless during the day.
"I was down in the shed with the fire going all night long, sitting in front of the fire, smoking. I couldn't sit down to watch the TV, I couldn't sit down to read, I couldn't sleep," he said.
When he asked the commission whether there was any help available, he said he was told he could go to a hospital emergency department and be admitted to a psychiatric ward.
"I said, 'No, I'm sorry, I'm not going in off the street and be treated like a common drug addict,'" Lawlor said.
Once he was successfully off the narcotic, his doctor suggested he try massage therapy.
Lawlor said the first therapist he went to did nothing for his pain, but his chiropractor referred him to one in Kelligrews who specializes in deep tissue massage.
He began feeling so good that he was able to do some gardening in preparation for his daughter's wedding.
Then in June 2010, when he had to get re-approved for his massage sessions, he found out about the new regulations that limited the number of sessions to six.
His family physician and chiropractor wrote supporting letters about how well he was doing with massage therapy and how he could go without any pain medication.
Lawlor said the commission finally approved 15 sessions a year, and said it would reassess his situation at the end of the sessions.
Lawlor said when he learned the coverage would be capped at $25 for a half-hour session, his biggest beef was "why should I have to pay for treatments? They're already taking back all my Canada Pension, 100 per cent of that goes back to them. I'm losing dollar for dollar on that, and they expect me to turn around and pay part payment for my treatment."
At a recent review hearing, however, Lawlor said he was told that although there's a gap between the coverage and the actual fees charged by therapists, he's not permitted to pay the difference even if he wanted to.
"So, they gave me special circumstances - I can have it but I can't have it," he said.
The WHSCC gave him a list of massage therapists to contact, including some outside Newfoundland. He said the commission argues that some clients are receiving therapy under the new regulations.
But he doesn't understand how. Lawlor said he had no luck finding anyone who would accept $25 for a half-hour session and in Nova Scotia, two therapists he contacted are charging more than $50 a session.
Through all this, he said his back pain has gotten worse without the massage therapy and he's had to resort to taking pain medication again, but he's adamant he'll never again take OxyContin because of the serious withdrawal he experienced when he stopped taking the drug.
"I get up here in the mornings and I can't stand to the counter to make a slice of toast," he said.
Lawlor said if he had been allowed to see a chiropractor 21 years ago, he probably wouldn't be in this situation now.
"But at that time," he said, "the WHSCC was treating chiropractors like voodoo doctors until the chiropractors proved they could do something other than surgery. Now they're doing the same with the massage therapists."
The WHSCC says it has no scientific evidence that massage therapy has a positive influence on injured workers' return to work and their functional capacity, but it would welcome any peer-reviewed research the massage therapists' association can provide.