MELANIE M. BENSON, Employee, v. METROPOLITAN COUNCIL/METRO TRANSIT, SELF-INSURED, Employer/Appellant, and HEALTH PARTNERS, THIRD PARTY SOLUTIONS, and PARK NICOLLET HEALTH SERVS., Intervenors.
WORKERS= COMPENSATION COURT OF APPEALS
OCTOBER 16, 2007
MEDICAL TREATMENT & EXPENSE. The compensation judge erred in awarding reimbursement for medical expenses incurred for treatment provided prior to the employee=s date of injury and expenses for treatment of conditions clearly unrelated to the employee=s work-related injury.
Affirmed in part and reversed in part.
Determined by: Johnson, C.J., Rykken, J., and Stofferahn, J.
Compensation Judge: Kathleen Behounek
Attorneys: Raymond R. Peterson, McCoy, Peterson & Jorstad, Minneapolis, MN, for the Respondents. Stacy P. Bouman, Pustorino, Tilton, Parrington & Lindquist, Minneapolis, MN, for the Appellant.
THOMAS L. JOHNSON, Judge
The self-insured employer appeals the compensation judge=s decision ordering the appellant to pay certain medical expenses. We affirm in part and reverse in part.
Melanie M. Benson, the employee, sustained a personal injury on February 21, 2005, while driving a bus for the Metropolitan Council/Metro Transit, then self-insured for workers= compensation liability. The self-insured employer denied liability for the injury.
On February 21, 2005, the employee was seen at the Park Nicollet Clinic by Dr. Mary Arneson complaining of tail bone pain since 2003. The employee gave no history of a specific injury, but Dr. Arneson noted several references to an injury to the employee=s tail bone on an amusement park ride at Valley Fair. The employee stated, however, that driving bus for the employer had contributed to her pain. The doctor took the employee off work that day and prescribed Tylenol. On March 1, Dr. John Dunne diagnosed coccydynia that he opined was work-related. The doctor prescribed anti-inflammatory medication, ordered physical therapy and took the employee off work for a limited period of time.
Dr. Paul T. Wicklund examined the employee in January 2007 at the request of the self-insured employer. The doctor obtained a history from the employee, reviewed medical records and performed a physical examination. Dr. Wicklund stated the records documented a history of coccyx pain for some time prior to February 21, 2005, and opined the employee manifested symptoms of her pre-existing coccydynia on February 21, 2005. Dr. Wicklund further opined the employee reached maximum medical improvement within three months of February 21, 2005, needed no further medical care or treatment, and could continue to drive bus on a full-time basis.
The employee filed a claim petition seeking payment of temporary total and temporary partial disability benefits and medical expenses. Following a hearing, the compensation judge found the employee sustained a personal injury on February 21, 2005, and awarded the requested benefits. The self-insured employer appeal solely from the award of certain medical expenses.
The self-insured employer asserts the compensation judge ordered it to pay certain medical expenses that were incurred prior to February 21, 2005, the date of the employee=s personal injury. Citing Stiner v. Don R. Blakeslee, D.D.S., slip op. (W.C.C.A. Dec. 16, 1994), the appellant contends an employer cannot be liable for medical bills incurred for treatment prior to the employee=s date of injury. We agree.
The compensation judge awarded reimbursement of $207.76 to the employee for a co-pay for an MRI scan taken on February 17, 2005. Since this expense was incurred prior to the date of the employee=s injury, the self-insured employer is not liable for this expense. The compensation judge>s award of this expense is reversed.
HealthPartners, Third Party Solutions, and Park Nicollet Health Services all intervened in this proceeding. The Park Nicollet intervention claim also included a small reimbursement claim by Park Nicollet Health Care Products. The compensation judge found the treatment provided to the employee was reasonable, necessary, and causally related to the February 21, 2005, personal injury, and ordered the self-insured employer to reimburse the intervenors. Included in these intervention claims, the appellant contends, are medical bills for treatment of conditions unrelated to the employee=s personal injury, including a skin disorder, a brain injury, and a fractured finger. The appellant contends substantial evidence does not support an award of these medical benefits and requests the order be reversed.
Attached to the employee=s brief as Exhibit B, is a copy of the documentation provided by Third Party Solutions in support of its intervention claim. This claim was for drugs prescribed by Dr. Dunne as part of his treatment of the employee=s personal injury. These expenses relate to the employee=s personal injury and were properly ordered reimbursed by the compensation judge. Similarly, there appears to be no dispute about the claims of HealthPartners or Park Nicollet Health Care Products. These awards are, therefore, affirmed.
Intervenor Exhibit 1 at the hearing contains documentation in support of the intervention claim of Park Nicollet Health Services. Pages 1 through 3 of that exhibit contain a summary of the claim itemized by case number and invoice number. The summary reflects a total claim of $4,036.10. The balance of the exhibit contains documentation supporting the claim summary itemized by what we assume is a diagnostic code. There was no objection to the admission of Exhibit 1 and no testimony was offered to explain the exhibit. The appellant does not identify the specific invoice numbers which it claims are unrelated to the employee=s personal injury. The decision herein is based upon our review of Intervenor Exhibit 1 and the other evidence in the case.
The majority of the invoices for which reimbursement was claimed are for case number 414315 which references two diagnostic codes: 724.20 lumbago and 724.79 disorder of coccyx. The treatment reflected by these invoices was necessitated by the employee=s personal injury and the judge=s reimbursement order is affirmed. There are five invoices for which reimbursement is claimed referenced under case number 469271. These invoices are 29059849, 29108445, 29139708, 29156363, and 29310061, each in the amount of $10.00. The diagnostic codes for these invoices are 729.50 pain in a limb, 709.90 skin disorder, 816.01 fractured finger, and 726.71 Achilles tendinitis. There is no evidence that treatment for these conditions was necessitated by the employee=s personal injury. The compensation judge=s award ordering reimbursement to Park Nicollet Health Services is, accordingly, reduced by $50.00.
 The claim of Health Care Products, Intervenor Ex. 2, was for a cushion for the employee to sit on and is related to the employee=s personal injury.