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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