Text Box: A PUBLICATION BY THE LAW FIRM OF Clifton, Mueller & Bovarnick, P.C. ATTORNEYS AT LAW

Text Box: 2005

Text Box: NOVEMBER

Text Box: CURRENT EVENTS, ARTICLES, AND SUMMARIES OF RECENT CASES AND LEGISLATION IN THE AREAS OF WORKERS’ COMPENSATION, LIABILITY, INSURANCE, AND EMPLOYMENT LAW Text Box: Practice Pointer

Text Box: Penalties? Why worry? By Eric W. Truhe    

Text Box: VISIT US ON THE WEB:  WWW.CMB-PC.COM Text Box: SM Text Box: Associated Business Products v. ICAO 04CA2370 (Ct. App., Nov. 3, 2005)      The Court of Appeals (CA) affirmed an order of the Industrial Claim Appeals Office (ICAO) upholding the imposition of a $24,900 penalty for Respondents’ failure to pay $107.79 in phone bills incurred by Claimant.    Claimant sustained an industrial injury in  1995 that included a traumatic brain injury and paralysis.  Due to Claimant’s confinement to a wheelchair, cellular phone service was medically necessary and therefore provided by Respondents.    The ALJ found Claimant submitted re-quests for payment of phone bills to Re-spondents totaling $107.79, and Re-

Text Box: spondents did not pay the bills until approximately 2 and 1/2 months later.      The ALJ found that even though pre-vious penalties had been imposed against Respondents, Respondents’ conduct con-tinued to demonstrate a pattern of delay.  Therefore, pursuant to C.R.S. 8-43-304(1), the ALJ imposed penalties of $300 per day for 83 days for a total of $24,900.    Respondents argued that imposing approximately $25,000 in penalties for delayed payment of bills totaling $107.79 was constitutionally excessive.  The CA rejected Respondents’ argument.  The CA found that the ALJ did not abuse his discretion in imposing the penalties.     The CA found the $300/day penalty was “well below” the $500/day amount that

Text Box: was permitted under the statute, and was therefore reasonable.    Moreover, the CA found Respondents did not present any evidence in mitigation, specifically, Respondents did not offer any explanation for their conduct.  What this means to you:         Regardless of how small the bill, Respondents will be exposed to penalties for failure to timely pay.  Unless you file a written notice contesting payment of medical bills, you must pay medical bills submitted for reasonably necessary treatment from an authorized provider.    If you have any questions regarding the payment of bills, and/or rules for contesting bills, please contact any of the attorneys at CMB, for assistance.

Text Box: Court of Appeals Upholds $24,900 Penalty Against Respondents for Failure to Timely Pay Claimant’s Phone Bill

Text Box:    Based on the Court of Appeals’ recent decision discussed above, Respondents need to be aware now more than ever of the exposure for penalties for failure to timely pay for authorized medical treatment.    To impose penalties, an administrative law judge (ALJ) must first determine whether the disputed conduct constitutes a violation of the Workers’ Compensation Act (Act).  If so, the ALJ must then determine if Respondents’ actions were “objectively reasonable,” ie., based on a rational argument based in law or fact.     If the ALJ finds a violation of the Act was not objectively reasonable, the ALJ will most likely impose penalties.

Text Box:    Pursuant to Rule XVI(K)(2)(b), in all cases where a billed service is contested by Respondents, Respondents shall, within 30 days of receipt of the bill, submit to the billing party a written notification of contest.     Pursuant to Rule XVI(J)(1), if Respon-dents contest a request for prior authoriza-tion for non-medical reasons, the Respon-dents shall notify the provider and parties, in writing, of the basis for the contest, within 7 business days.  The written con-test must include a certificate of mailing.    Respondents must be aware that Claimant’s attorneys will not hesitate to request penalties if there has not been strict compliance with the above rules.    

Text Box: CMB Welcomes New Attorney Holly Barrett

Text Box:    Holly Barrett has relocated to her home state of Colorado and has brought a wealth of workers’ compensation experience to CMB.    For the past 4 years, Holly Barrett has represented the Wyoming Workers’ Safety and Compensation Division as well as Claimants in workers’ compensation matters.     Holly received her undergraduate degree in Business Administration from the University of Colorado, Boulder, and graduated cum laude from Creighton University School of Law in May, 2000.  Holly is licensed to practice law in both Colorado and Wyoming.