Alaska State Commission for Human Rights v. United Physical Therapy, United Physical Therapy v. Alaska State Commission for Human Rights

484 P.3d 599
CourtAlaska Supreme Court
DecidedApril 16, 2021
DocketS17634, S17650
StatusPublished
Cited by6 cases

This text of 484 P.3d 599 (Alaska State Commission for Human Rights v. United Physical Therapy, United Physical Therapy v. Alaska State Commission for Human Rights) is published on Counsel Stack Legal Research, covering Alaska Supreme Court primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Alaska State Commission for Human Rights v. United Physical Therapy, United Physical Therapy v. Alaska State Commission for Human Rights, 484 P.3d 599 (Ala. 2021).

Opinion

Notice: This opinion is subject to correction before publication in the PACIFIC REPORTER. Readers are requested to bring errors to the attention of the Clerk of the Appellate Courts, 303 K Street, Anchorage, Alaska 99501, phone (907) 264-0608, fax (907) 264-0878, email corrections@akcourts.us.

THE SUPREME COURT OF THE STATE OF ALASKA

ALASKA STATE COMMISSION ) FOR HUMAN RIGHTS, ) Supreme Court Nos. S-17634/17650 ) Appellant and Cross-Appellee, ) Alaska Workers’ Compensation ) Appeals Commission No. 18-024 v. ) ) OPINION UNITED PHYSICAL THERAPY, ) ) No. 7516 – April 16, 2021 Appellee and Cross-Appellant. ) )

Appeal from the Alaska Workers’ Compensation Appeals Commission.

Appearances: Adam R. Franklin, Assistant Attorney General, Anchorage, and Kevin G. Clarkson, Attorney General, Juneau, for Appellant and Cross-Appellee. James C. Croft, The Croft Law Office, Anchorage, for Appellee and Cross-Appellant.

Before: Bolger, Chief Justice, Winfree, Maassen, and Carney, Justices. [Borghesan, Justice, not participating]

BOLGER, Chief Justice.

I. INTRODUCTION After an employer filed a retroactive controversion of medical treatment, the employee’s healthcare provider filed a workers’ compensation claim seeking payment for services it provided before the controversion was filed. The employer disputed its liability for payment, and after several prehearing conferences, the Alaska Workers’ Compensation Board set a hearing on the merits of the provider’s claim. The Board ordered the employer to pay the provider approximately $510.00 for the services. The employer appealed, disputing several procedural aspects of the decision, and the Alaska Workers’ Compensation Appeals Commission affirmed the Board’s decision. We affirm the Commission’s decision. II. FACTS AND PROCEEDINGS An Alaska State Commission for Human Rights1 (State) employee with preexisting medical conditions was involved in a work-related motor vehicle accident in January 2017. The employee consulted with Dr. Teresa Bormann two days after the accident, complaining of “neck, back and hip pain after [a motor vehicle accident].” X- rays taken at the time showed no fractures and mild degenerative changes “without evidence of an acute injury.” Dr. Bormann referred the employee to chiropractic treatment. After several months of treatment the employee returned to Dr. Bormann, who diagnosed “a prolonged whiplash type injury of the lateral neck muscles.” In December 2017 Dr. Bormann referred the employee to physical therapy at United Physical Therapy (UPT) for chronic neck pain and headache. After an evaluation UPT recommended eight weeks of twice weekly physical therapy. Dr. Bormann endorsed the treatment plan, and the employee’s symptoms improved enough that she reduced her

1 The parties’ briefs and the Commission’s decision identify the State, Department of Health & Social Services as the State agency involved in this litigation. The January 2017 report of injury, the employer’s answer, and other documents in the record identify the agency for which the employee worked as the Alaska State Commission for Human Rights. There is no indication that the employee worked for the Department of Health & Social Services; that agency is not named in the record until the Department of Law entered an appearance about three weeks after it answered the health care provider’s written claim.

-2- 7516 physical therapy visits to once a week beginning in mid-January. She saw UPT three times in February 2018. Payment for these February visits became the main dispute before the Board. The State arranged an employer’s medical evaluation (EME) on February 28, 2018, with Dr. M. Sean Green, a neurologist, and Dr. R. David Bauer, an orthopedist. The State provided few medical records to the doctors: the EME report’s chart review section summarized one chart note from 2005 and one from 2010, followed by Dr. Bormann’s notes. Dr. Green expressed concern with the dearth of records related to the employee’s preexisting conditions. The doctors thought they had adequate information to comment on causation, but included a disclaimer indicating that the medical records the State provided were “insufficient to fully understand [the employee’s] current complaints and medical conditions.” The EME doctors diagnosed the employee with a cervical strain caused by the accident as well as several conditions they considered preexisting or unrelated to the work injury. The doctors stated that cervical strain is “an inherently self-limited and benign condition,” which typically resolves “in a matter of days to weeks.” They said that “[t]here is, in biological terms, no such thing as a chronic muscle strain.” They identified the employee’s preexisting conditions as the cause of her continuing pain. They did not think the accident had aggravated any of her preexisting conditions, did not think any treatment after Dr. Bormann’s initial examination was related to the accident, and concluded no further treatment was needed. The EME doctors thought the work- related condition was medically stable and, in response to questions about whether the employee had a permanent impairment under the criteria in the American Medical

-3- 7516 Association Guides to the Evaluation of Permanent Impairment2 (the Guides), they stated that the employee did not have a permanent partial impairment. Based on the EME report the State filed a notice of controversion on March 13, retroactively controverting all care after January 2017; the State had received UPT’s invoices for the employee’s February treatments the day before.3 UPT filed a workers’ compensation claim and request for a prehearing conference shortly after the State’s controversion notice. It took the position that the State owed a penalty as well as interest on the disputed balance because the State had “never submitted payment or denial” for the specific claims, making UPT’s total claim $1,033.27. The State answered the claim, and wrote to UPT expressing “confus[ion] regarding the scope of [its] Workers’ Compensation Claim”; it asked for clarification about whether UPT was “contesting the controversion itself, i.e. the medical basis for the controversion . . . or only the non-payment of those treatment dates.” The State then requested a prehearing conference “in order to determine [UPT’s] position on the controversion.” According to a summary of the July prehearing conference, UPT “was not seeking to challenge the controversion itself, but argued that the medical bills should be paid even with the controversion in place.” The prehearing conference summary does not show an explicit agreement to limit the issues for hearing. UPT filed an affidavit of

2 AM.MED.ASS’N,GUIDES TO THE EVALUATION OF PERMANENT IMPAIRMENT (6th ed. 2008) [hereinafter GUIDES]. AS 23.30.190(b) requires use of the Guides when assessing permanent partial impairment. 3 The State initially refused to pay for two December 2017 visits as well as the February visits, claiming that UPT had not billed them in a timely manner. At the hearing the parties informed the Board that the State had agreed to pay for the December visits, and the Board subsequently denied UPT’s claim for penalties and interest on the December bill.

-4- 7516 readiness for hearing on “the issues set forth in the Workers’ Compensation Claim,” and the parties met for a second prehearing conference. The August prehearing summary identified the issue for hearing as the “Merits of [UPT’s] 3/23/2018 Workers’ Compensation Claim.” Neither party sought to amend or clarify this summary before the hearing.

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Bluebook (online)
484 P.3d 599, Counsel Stack Legal Research, https://law.counselstack.com/opinion/alaska-state-commission-for-human-rights-v-united-physical-therapy-united-alaska-2021.