DONNA K. LAMME, Employee/Appellant, v. WAL-MART, SELF-INSURED/CLAIMS MGM'T, INC., Employer, and ESSENTIA HEALTH SMDC, Intervenor.
WORKERS’ COMPENSATION COURT OF APPEALS
AUGUST 29, 2012
PRACTICE & PROCEDURE - REMAND. Where the compensation judge inadvertently failed to address medical bills in dispute at the hearing, the matter is remanded for determination of the issues raised by the employee's medical request.
Determined by: Stofferahn, J., Johnson, J., and Wilson, J.
Compensation Judge: Jerome G. Arnold
Attorneys: David R. Vail, Soderberg & Vail, Minneapolis, MN, for the Appellant. Cory A. Genelin, Gislason & Hunter, Mankato, MN, for the Respondent.
DAVID A. STOFFERAHN, Judge
The employee appeals the compensation judge’s failure to determine the employee's medical request. We remand for determination of the employee’s claims.
The employee, Donna K. Lamme, sustained a work injury on December 24, 2005, while she was in the employ of Wal-Mart. Liability for the work injury was accepted by the employer and workers’ compensation benefits were paid.
On June 13, 2011, the self-insured employer filed a notice of intention to discontinue temporary total disability compensation asserting that the employee had failed to cooperate with rehabilitation and the employer had work available within the employee’s restrictions. Discontinuance was denied at an administrative hearing and the self-insured employer filed a petition to discontinue benefits.
On August 4, 2011, the employee filed a medical request seeking payment for two medical bills for which payment had been denied by the self-insured employer. The bills were for physical therapy on June 22, 2011, and for occupational therapy on June 16, 2011 and totaled $402.00. The employee’s medical request was denied after an administrative conference and the employee filed a request for formal hearing.
An order to consolidate the self-insured employer’s petition to discontinue and the employee’s request for formal hearing on the medical request was issued and a hearing on the consolidated issues took place on December 29, 2011.
The compensation judge, in his findings and order served and filed on March 23, 2012, granted discontinuance of temporary total disability compensation effective June 13, 2011. On the disputed therapy expenses, he wrote in his preamble to the findings and order that
At hearing it appeared from statements of counsel that issues related to employee's Medical Request filed August 4, 2011 and the Request for Formal Hearing filed September 29, 2011 had been resolved and are therefore not addressed herein.
In Order 2, the compensation judge ordered that
Any issues which remain unresolved relating to the compensability of medical treatment claimed in employee's Medical Request filed August 4, 2011 and the Request for Formal Hearing filed September 29, 2011 are preserved for future determination.
The employee did not appeal the discontinuance of benefits but has appealed the compensation judge’s failure to address the claim for payment of medical bills. The employee argues on appeal that the medical expenses at issue were not resolved prior to or during the hearing, are still claimed by the employee, and should have been determined in the findings and order.
The self-insured employer argues that the compensation judge's findings and order should be read as constituting a final determination of all issues in the medical request and as a denial of the employee’s claim. They point out that they argued at hearing that the employee's failure to cooperate with rehabilitation should result not only in the cessation of temporary total disability compensation, but also in the forfeiture of all workers' compensation benefits, including medical expenses. While the transcript of the hearing demonstrates that the compensation judge did not agree with the employer’s position, the self-insured employer argues that the compensation judge might have changed his view after the hearing and that the absence of an order to pay the disputed medical expenses should be seen by this court as an implicit determination of the issue.
Based on these arguments, the self-insured employer contends that this court should simply vacate Order 2, which leaves open any unresolved issues raised in the employee's medical request, since that Order is inconsistent with language in Order 3 dismissing both the petition to discontinue and the employee's request for formal hearing.
We find no merit to the employer’s argument. We note in this regard that the compensation judge’s decision consisted of sixty-four findings of fact detailing the issues, the evidence, and the conclusions he reached in this matter. It is readily apparent from a review of the pleadings, the exhibits and the transcript that the compensation judge’s failure to address the issue of medical bills claimed by the employee was a matter of inadvertence and not a determination on the merits.
We remand this matter to the compensation judge to make specific findings and to issue an order regarding the compensability of the disputed medical expenses.