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High court adopts COA opinion in billing dispute

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The Indiana Supreme Court granted transfer Wednesday in a dispute over who bears the burden to prove "pecuniary liability" under the Worker's Compensation Act, and adopted the Indiana Court of Appeals' opinion on the matter.

Pursuant to Indiana Appellate Rule 58(A)(1), the high court adopted and incorporated the Court of Appeal's opinion in Washington Township Fire Department v. Beltway Surgery Center, No. 93S02-1002-EX-115, in which the appellate court held an employer, not a medical provider, bears the burden of proving whether the charges for medical services provided to an employee exceed the employee's liability to pay under the act.

Beltway Surgery Center provided medical services to a Washington Township Fire Department employee and then submitted a bill to the township's worker's compensation insurance carrier. After a review to determine Washington Township's pecuniary liability under the act, the insurer decided to only pay part of the bill. Beltway filed an application for adjustment of claim with the Worker's Compensation Board. The board ordered the township to pay the remaining balance and concluded the township has to prove its pecuniary liability to Beltway was less than Beltway's billed charges.

The COA upheld the board's decision and held that where an employer refuses to pay in full a medical provider's billed charges, and the provider files a claim with the Worker's Compensation Board and establishes the charges for services to an employee, it's up to the employer to prove the charges exceed the employer's liability under the act. The board may also require that an employer who doesn't meet this burden must pay the medical provider's full bill.

The Court of Appeals judges concluded that placing the burden of proof on the employer is more consistent with Indiana law generally and with the act itself. They also ruled it would be up to the General Assembly to amend state statute so that medical providers would have to bear the burden of establishing that their bills fall outside certain guidelines.

This is the same issue in five other cases pending before the Supreme Court. In a footnote in the opinion, the justices noted they denied transfer to the other five cases based on its adoption and agreement with the Court of Appeals' opinion in Beltway. Those other cases are Onward Fire Department v. Clarian Health Partners, No. 93A02-0811-EX-1007; Adecco, Inc. v. Clarian Health Partners, No. 93A02-0811-EX-1008; Morgan County Commissioners v. Clarian Health Partners, No. 93A02-0811-EX-1009; City of Michigan City v. Memorial Hospital, No. 93A02-0811-EX-1010; and Wayne Township Fire Department v. Beltway Surgery Center, No. 93A02-0811-EX-1011.

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  1. No second amendment, pro life, pro traditional marriage, reagan or trump tshirts will be sold either. And you cannot draw Mohammed even in your own notebook. And you must wear a helmet at all times while at the fair. And no lawyer jokes can be told except in the designated protest area. And next year no crucifixes, since they are uber offensive to all but Catholics. Have a nice bland day here in the Lego movie. Remember ... Everything is awesome comrades.

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  3. All these sites putting up all the crap they do making Brent Look like A Monster like he's not a good person . First off th fight actually started not because of Brent but because of one of his friends then when the fight popped off his friend ran like a coward which left Brent to fend for himself .It IS NOT a crime to defend yourself 3 of them and 1 of him . just so happened he was a better fighter. I'm Brent s wife so I know him personally and up close . He's a very caring kind loving man . He's not abusive in any way . He is a loving father and really shouldn't be where he is not for self defense . Now because of one of his stupid friends trying to show off and turning out to be nothing but a coward and leaving Brent to be jumped by 3 men not only is Brent suffering but Me his wife , his kids abd step kidshis mom and brother his family is left to live without him abd suffering in more ways then one . that man was and still is my smile ....he's the one real thing I've ever had in my life .....f@#@ You Lafayette court system . Learn to do your jobs right he maybe should have gotten that year for misdemeanor battery but that s it . not one person can stand to me and tell me if u we're in a fight facing 3 men and u just by yourself u wouldn't fight back that you wouldn't do everything u could to walk away to ur family ur kids That's what Brent is guilty of trying to defend himself against 3 men he wanted to go home tohisfamily worse then they did he just happened to be a better fighter and he got the best of th others . what would you do ? Stand there lay there and be stomped and beaten or would u give it everything u got and fight back ? I'd of done the same only I'm so smallid of probably shot or stabbed or picked up something to use as a weapon . if it was me or them I'd do everything I could to make sure I was going to live that I would make it hone to see my kids and husband . I Love You Brent Anthony Forever & Always .....Soul 1 baby

  4. Good points, although this man did have a dog in the legal fight as that it was his mother on trial ... and he a dependent. As for parking spaces, handicap spots for pregnant women sure makes sense to me ... er, I mean pregnant men or women. (Please, I meant to include pregnant men the first time, not Room 101 again, please not Room 101 again. I love BB)

  5. I have no doubt that the ADA and related laws provide that many disabilities must be addressed. The question, however, is "by whom?" Many people get dealt bad cards by life. Some are deaf. Some are blind. Some are crippled. Why is it the business of the state to "collectivize" these problems and to force those who are NOT so afflicted to pay for those who are? The fact that this litigant was a mere spectator and not a party is chilling. What happens when somebody who speaks only East Bazurkistanish wants a translator so that he can "understand" the proceedings in a case in which he has NO interest? Do I and all other taxpayers have to cough up? It would seem so. ADA should be amended to provide a simple rule: "Your handicap, YOUR problem". This would apply particularly to handicapped parking spaces, where it seems that if the "handicap" is an ingrown toenail, the government comes rushing in to assist the poor downtrodden victim. I would grant wounded vets (IED victims come to mind in particular) a pass on this.. but others? Nope.

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