The Indiana Court of Appeals reversed the dismissal of a medical group’s application for adjustment of claim for provider fee, finding the Indiana Worker’s Compensation Board erred by ruling the application was filed outside the statute of limitations.
The appellate court addressed this issue in three separate rulings today, including Indiana Spine Group PC v. Pilot Travel Centers LLC, No. 93A02-1003-EX-315. Indiana Spine Group had provided medical treatment in July and October 2004 to an employee of Pilot Travel Centers for work-related injury. Pilot paid only a portion of the balance of this treatment, with the last payment coming in June 2008.
In June 2009, ISG filed an application for the balance owed; Pilot sought a dismissal because it believed the application was filed outside the two-year statute of limitations of the date in which compensation was last paid to the employee specified in Indiana Code Section 22-3-3-27. The full board affirmed the dismissal by the single hearing member for lack of jurisdiction based on the two-year statute of limitations.
The statute in question establishes a two-year limit for the “modification” of an award due to a “change in conditions,” which begins to run on the last day for which compensation was paid to the injured employee. The Pilot employee was last compensated in August 2006.
But this statute of limitation doesn’t apply because there were no changed conditions requiring a modification of the worker’s compensation benefits to the employee, wrote Judge Ezra Friedlander. The Worker’s Compensation Act is silent on the statute of limitations applicable to claims involving the pecuniary liability of employers to medical service providers.
The appellate court declined to apply the statute of limitations in I.C. Section 22-3-3-27 because it could lead to absurd results, such as leaving medical service providers little incentive to treat injured workers under the act once an employee’s permanent partial impairment was established.
“While a medical service provider is able to determine the date of an injured employee’s accident, the provider does not generally have ready access to the dates of compensation to the employee, which vary widely from case to case,” wrote the judge. “Rather, a statute of limitations for claims like that asserted by ISG would seem to be more appropriately related to the date of service. We leave that decision, however, as well as the appropriate length of the limitations period, for the Legislature.”
The Court of Appeals reversed the decision and remanded so that ISG can have a determination on the merits of its application. The appellate court reached the same conclusion in the not-for-publication opinions Indiana Spine Group v. All Seasons Holdings, No. 93A02-1003-EX-316, and Indiana Spine Group v. Scenic Hills Care Center, No. 93A02-1003-EX-313.