The Indiana Supreme Court decided Thursday that the period within the general statute of limitations controls the limitation period when a medical provider may seek payment of outstanding bills for authorized treatment to an employer’s worker. The justices came to that conclusion after finding the Worker’s Compensation Act is silent on what the applicable limitation period is for this matter.
Pilot Travel Center’s employee Anthony Wetnight was injured at work in August 2003 and Pilot authorized Wetnight to receive medical treatment from Indiana Spine Group in July and October 2004. Pilot only made partial payments to the balance of Wetnight’s treatment, with the last payment coming in June 2008. ISG sought payment of the remaining balance in June 2009 by filing an application for adjustment of claim for provider’s fee with the Indiana Worker’s Compensation Board. Pilot argued that ISG filed the claim outside the statute of limitations in Indiana Code 22-3-3-27 listed under the Worker’s Compensation Act, and that it had to file the application within two years after the date Pilot last paid Wetnight compensation.
The full Worker’s Compensation Board affirmed the decision to dismiss ISG’s application. ISG appealed, and the Indiana Court of Appeals reversed, finding neither I.C. 22-3-3-3 or -27 in the Worker’s Compensation Act applied.
In Indiana Spine Group, PC v. Pilot Travel Centers, LLC, 93S02-1102-EX-90, the justices reversed the board’s decision, holding that I.C. 22-3-3-3 and -27 do not apply and therefore don’t bar ISG’s claim. Nothing in the Worker’s Compensation Act indicates that the time limitation on a health care provider’s claim for unpaid bills is connected to the time limitation on an employee’s claim for compensation, wrote Justice Robert Rucker. Section 27’s limitation is for modification of awards due to a “change in conditions,” and the two-year period begins to run on the last day for which compensation is paid to an injured employee. However, in the instant case, there are not changed conditions requiring modification to Wetnight’s award.
“The issue presented in ISG’s Application is the pecuniary liability of ISG and not whether the bills must be paid at all,” wrote Rucker. “Further, we agree with the observations from the Court of Appeals that the application of section 22-3-3-27 in ‘this context could lead to absurd results.’”
The justices found ISG’s claim to be timely under I.C. 34-11-1-2, the general statute of limitation, which says a cause of action that isn’t limited by another statute must be brought within 10 years. They remanded the cause for further proceedings. Based on their decision Thursday, Rucker noted that the justices have denied the pending transfer petitions of five other cases involving similar issues with ISG as a party.