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Judges reverse dismissal of application to adjust claim

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The Indiana Court of Appeals reversed the decision by the full Worker’s Compensation Board that a medical services provider’s application for an adjustment of claim was barred by the two-year statute of limitations found in Indiana Code Section 22-3-3-3. The appellate court relied on a recent decision involving a similar scenario to make its ruling.

An employee of International Entertainment Consultants was injured during the course of his employment in 2005 and Indiana Spine Group PC provided medical services to him. Consultants’ insurer only paid a portion of the bill in 2006. In 2009, Indiana Spine filed an application for adjustment of claim with the Worker’s Compensation Board to be paid for the entire amount charged. Consultants filed a motion to dismiss because it believed the claim was barred by a two-year statute of limitation based on I.C. Section 22-3-3-3.

The full board affirmed the single hearing member’s grant of the motion to dismiss. It reasoned that the medical provider’s fee claim is derivative of the underlying injury claim and declined to apply any of the general statutes of limitation found in I.C. Chapter 34-11-2.

In Indiana Spine Group, P.C. v. International Entertainment Consultants, No. 93A02-1007-EX-764, the Court of Appeals relied on its recent ruling in Indiana Spine Group v. Pilot Travel Centers, 931 N.E.2d 435, 438 (Ind. Ct. App. 2010), to reverse. In that opinion, the judges found that the Worker’s Compensation Act is silent on the statute of limitations applicable to claims involving pecuniary liability of employers to medical service providers, but held that neither of the statute of limitations contained in the act – I.C. Sections 22-3-3-3 and -27 - applied to a medical service provider’s claim for pecuniary liability.

Consultants argued that Pilot was wrongly decided and I.C. Section 22-3-3-3 does apply to a medical service provider’s claim because its plain language makes it applicable to all claims for compensation under the act. It also argued that medical services are included in the term “compensation,” but cited no authority suggesting that “pecuniary liability” is included within the term “compensation,” wrote Judge Terry Crone.

“On the contrary, treating these terms as interchangeable would produce illogical and unjust results. In Pilot, we noted that the Act ‘specifically envisioned’ that ‘an employee could very well receive medical services up to the end of the two-year statutory period,’” he wrote. “Although Pilot was discussing the two-year period in Indiana Code Section 22-3-3-27, the reasoning applies with equal force to Section 22-3-3-3. As in Pilot, we ‘fail to see the wisdom of tying a medical service provider’s ability to seek full payment due under the Act’ to a date that has no significance to the medical service provider’s claim.”

Indiana Spine argued to the full board that either the six-year statute of limitation for actions on accounts or the 10-year statute of limitation for actions that are not limited by any other statute should apply. Since the provider’s claim would be timely under either of those statutes of limitation and no argument has been advanced for the application of any other statute of limitation, the judges held the board erred by dismissing the application. They remanded for further proceedings.

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