Drew v. Industrial Commission

301 P.3d 202, 232 Ariz. 36, 657 Ariz. Adv. Rep. 15, 2013 WL 1209618, 2013 Ariz. App. LEXIS 42
CourtCourt of Appeals of Arizona
DecidedMarch 26, 2013
DocketNo. 1 CA-IC 12-0044
StatusPublished
Cited by2 cases

This text of 301 P.3d 202 (Drew v. Industrial Commission) is published on Counsel Stack Legal Research, covering Court of Appeals of Arizona primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Drew v. Industrial Commission, 301 P.3d 202, 232 Ariz. 36, 657 Ariz. Adv. Rep. 15, 2013 WL 1209618, 2013 Ariz. App. LEXIS 42 (Ark. Ct. App. 2013).

Opinion

OPINION

JOHNSEN, Judge.

¶ 1 This is a special action review of an award by the Industrial Commission of Arizona denying a claimant’s request for reimbursement of expenses he incurred traveling to receive out-of-town medical treatment to which he was entitled under Arizona’s workers’ compensation law. We affirm the Commission’s rejection of the claim as untimely for failure to comply with the 24-month deadline in Arizona Revised Statutes (“A.R.S.”) section 23-1062.01(0) (West 2013).1

FACTS AND PROCEDURAL BACKGROUND

¶ 2 Drew, who lives in Prescott, was injured at work in June 1995 and was diagnosed with carpal tunnel syndrome and tendinitis in his left hand. He settled his workers’ compensation claim in 1998, with the State Compensation Fund, now called SCF Arizona (“SCF”), agreeing to pay for his continued treatment at a specified clinic in Phoenix. According to the record, in addition to paying the clinic’s bills, SCF reimbursed Drew when he timely submitted claims for expenses incurred in traveling to his monthly medical appointments. In August 2008, the Commission approved Drew’s request to change doctors because, as his lawyer put it, “he is having difficulty getting to his appointments because of the distance.” Three years later, Drew submitted reimbursement requests for expenses he incurred between May 2005 and October 2006 in traveling from Prescott to Phoenix for his medical appointments. SCF denied the requests, citing the 24-month deadline for submission of medical expense claims in AR.S. § 23-1062.01(0.

¶ 3 After Drew sought review, see A.R.S. § 23 — 1061(J) (West 2013), the parties submitted the matter to an Administrative Law Judge (“ALJ”) on stipulated facts. The ALJ denied Drew’s claim, and her award was affirmed on administrative review. We have jurisdiction of Drew’s timely request for special action review under AR.S. §§ 12-120.21(A)(2) (West 2013) and 23-951(A) (West 2013).

DISCUSSION

A. An Injured Worker’s Entitlement to Travel Expenses.

¶ 4 Under our workers’ compensation statutes, an employee who sustains a compensa-ble industrial injury “shall be entitled to receive and shall be paid such compensation for loss sustained on account of the injury ..., [and] such medical, nurse and hospital services and medicines ... as are provided by [the Arizona Workers’ Compensation Act].” A.R.S. § 23-1021 (West 2013).2 Another statute explains in more detail the medical benefits to which an injured employee is entitled:

Promptly, on notice to the employer, every injured employee shall receive medical, [38]*38surgical and hospital benefits or other treatment, nursing, medicine, surgical supplies, crutches and other apparatus, including artificial members, reasonably required at the time of the injury, and during the period of disability. Such benefits shall be termed “medical, surgical and hospital benefits.”

A.R.S. § 23-1062(A) (West 2013).

¶ 5 Neither § 23-1021 nor § 23-1062(A) mentions travel expenses.3 Indeed, in Martinez v. Industrial Commission of Arizona, 175 Ariz. 319, 856 P.2d 1197 (App.1993), this court rejected a claim by an injured worker for expenses incurred in traveling from his home in Peoria to receive medical treatment in Phoenix. In Martinez, we called the two statutes “unambiguous” in holding that they “do not provide for the payment of travel expenses incurred while obtaining industrially related medical treatment.” Id. at 322, 856 P.2d at 1200.

¶ 6 In Carr v. Industrial Commission of Arizona, 197 Ariz. 164, 167, ¶ 12, 3 P.3d 1084, 1087 (App.1999), however, we held a worker may be entitled to reimbursement for travel expenses incurred in obtaining medical treatment “outside the area in which he or she resides.” In that case, the closest place the claimant could obtain physical therapy for his industrial injury was a 230-mile round trip from his home, and the ALJ found he could not afford to travel that distance. Id. at 165-66, ¶¶ 4-5, 3 P.2d at 1085-86. Carr reasoned that, under the circumstances, denying the claimant’s request for reimbursement of travel expenses “effectively denied him the medical treatment to which he had a right under our workers’ compensation law.” Id. at 166-67, ¶¶ 7, 12, 3 P.2d at 1086-87. We concluded that although § 23-1062(A) does not expressly define “medical benefits” to include travel expenses, “an injured worker who must travel outside the area in which he or she resides to receive treatment is entitled to reimbursement for travel expenses.” Id. at 166-67, ¶¶ 10,12, 3 P.2d at 1086-87.

¶ 7 In this case, SCF stipulated before the ALJ that pursuant to Carr, the travel expenses Drew incurred to obtain medical treatment in Phoenix would be reimbursable if timely requested. The ALJ accepted SCF’s contention, however, that the requests Drew made in 2011 for expenses incurred in 2005-2006 were time-barred pursuant to A.R.S. § 23-1062.01(C).

B. Requests for Reimbursement of Travel Expenses Are Subject to A.R.S. § 23-1062.01(0.

¶ 8 Section 23-1062.01 is titled “Timely payment of medical, surgical and hospital benefit billing; content of bills; contracts between providers and earners; exceptions; definitions.” The statute spells out specific billing and payment requirements and deadlines applicable to workers’ compensation medical benefits. In denying Drew’s claim, SCF cited subpart (C) of the statute, which provides,

An insurance carrier, self-insured employer or claims processing representative is not responsible for payment of any billings for medical, surgical or hospital benefits provided under this chapter unless the billings are received by the insurance carrier, self-insured employer or claims processing representative within twenty-four months from the date on which the medical service was rendered or from the date on which the health care provider knew or should have known that service was rendered on an industrial claim, whichever occurs later.

SCF rejected Drew’s request for reimbursement of his travel expenses because he did not submit the request within 24 months pursuant to this provision.

¶ 9 Drew argues the 24-month deadline in § 23-1062.01(C) “cannot possibly apply to an injured worker’s request for reimbursement for travel expenses” because travel expenses are not “medical ... benefits” to which that statute applies. He argues travel reimburse[39]

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Bluebook (online)
301 P.3d 202, 232 Ariz. 36, 657 Ariz. Adv. Rep. 15, 2013 WL 1209618, 2013 Ariz. App. LEXIS 42, Counsel Stack Legal Research, https://law.counselstack.com/opinion/drew-v-industrial-commission-arizctapp-2013.