ITT Specialty Risk Services, Inc. v. Barr

842 So. 2d 638, 2002 Ala. LEXIS 158, 2002 WL 1042484
CourtSupreme Court of Alabama
DecidedMay 24, 2002
Docket1000618
StatusPublished
Cited by7 cases

This text of 842 So. 2d 638 (ITT Specialty Risk Services, Inc. v. Barr) is published on Counsel Stack Legal Research, covering Supreme Court of Alabama primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
ITT Specialty Risk Services, Inc. v. Barr, 842 So. 2d 638, 2002 Ala. LEXIS 158, 2002 WL 1042484 (Ala. 2002).

Opinion

[EDITORS' NOTE: THIS PAGE CONTAINS HEADNOTES. HEADNOTES ARE NOT AN OFFICIAL PRODUCT OF THE COURT, THEREFORE THEY ARE NOT DISPLAYED.] *Page 640

ITT Specialty Risk Services, Inc. (hereinafter referred to as "ITT"), appeals from the St. Clair Circuit Court's denial of ITT's motion for a summary judgment. The Court granted ITT's petition for a permissive appeal pursuant to Rule 5, Ala.R.App.P. We affirm in part, reverse in part, and remand.

In May 1994, Rhonda Barr filed a workers' compensation claim against Bruno's Inc., for an injury that occurred in 1992 in the line and scope of her employment with Bruno's. On June 24, 1996, ITT became the third-party administrator for Bruno's workers' compensation program and in that capacity began handling Barr's claim. Barr's workers' compensation claim against Bruno's was settled in November 1996, but the final order issued by the court provided that "[f]uture medical benefits [remained] open, and Barr [retained] the right to proceed in a future action for any denial of said medical benefits." Barr returned to work at Bruno's and worked there until January 1998.

In January 1998, Barr telephoned ITT, complaining of further medical problems related to her 1992 injury, and she requested medical treatment. ITT authorized treatment from Dr. Sharon Colgin, the physician who had treated Barr's injury before the final order based on the settlement was issued in 1996. On January 26, 1998, ITT received a telephone call from Dr. Colgin's office; during that call ITT was informed that Dr. Colgin had not treated Barr since 1995, and Dr. Colgin requested authorization from ITT to treat Barr.

Although Barr's appointment with Dr. Colgin was rescheduled several times by both Dr. Colgin and by Barr, Barr eventually saw Dr. Colgin on June 16, 1998. On June 23, 1998, Dr. Colgin's office telephoned ITT, at ITT's request, to update ITT on Barr's June 16 appointment. Dr. Colgin informed ITT that she *Page 641 recommended a nerve-conduction study to further evaluate Barr's complaints; ITT authorized the study. ITT authorized a second appointment for Barr with Dr. Colgin on July 28, 1998. At that time, Dr. Colgin made the following note in Barr's file:

"I would recommend that [Barr] consider seeing a pain specialist, for I think that she will have problems from here on out. I would recommend that she be sent to see Dr. Toutec at HealthSouth or Dr. Claudia McDonald, a neurosurgeon and pain specialist here at Brookwood Medical Center. I think that treat[ment] by a pain specialist would allow Ms. Barr to become more functional."

At the bottom of the note is the caption "cc: W/C Nicole Davis, Claims, ITT Specialty Risk Services, Inc., Post Office Box 305104, Nashville, TN 37230-5104." At the bottom of this note is a check mark. Dr. Colgin testified that the check mark was used in her office to indicate that the note had been copied and sent to the appropriate address.

On August 4, 1998, ITT received a telephone call from Barr, stating that Dr. Colgin had referred her to Dr. Toutec at HealthSouth. ITT advised Barr that it could not authorize treatment by Dr. Toutec until ITT had received a referral from Dr. Colgin and her notes from the nerve-conduction study. On September 9, 1998, ITT made the following statements in its activity log for Barr's case:

"Dr. office is waiting for call regarding treatment. . . . Please contact Dr. Colgin's office and obtain [her] notes — find out about the Dr. at HealthSouth. Is this a Dr. we want clmt treating w/? Insured wants to make sure we continue to keep control of this claim and the treating Dr. as they question if clmt is trying to get treatment w/ another physician."

On September 10, 1998, an ITT employee telephoned Barr. Barr explained to the ITT employee that she had been referred to Dr. Toutec by Dr. Colgin for pain management. Also on September 10, 1998, ITT's activity log indicates a conference telephone call between ITT employees and Bruno's employees who monitor workers' compensation claims. The notation in ITT's activity log after the conference call reads: "Another major issue on this case is that if we are going to keep it on this claim, clt should not involve a new phys."

On September 11, 1998, Valerie Boston, an ITT employee, took a recorded statement from Barr concerning Barr's injury and her treatment for that injury. In this statement, Barr informed Boston that she had been referred to Dr. Toutec by Dr. Colgin for pain management. Also on September 11, 1998, ITT telephoned Dr. Colgin's office and an ITT employee spoke with Verda Lloyd, Dr. Colgin's secretary. ITT maintains that this telephone call indicated that neither Dr. Colgin nor Barr had provided ITT with Barr's medical records. However, the entry made in ITT's activity log on September 11, 1998, states:

"Call to Dr. Colgin's office . . . S/W Verda. She states that the medicals have been sent faxed to us 4 times she refused to do it again. She stated she would mail a copy of the records to clmt then the clmt can be responsible for getting it to us."

On September 14, 1998, ITT placed another call to Dr. Colgin's office. The activity log states that Verda Lloyd indicated that Dr. Colgin had not referred Barr to another physician. However, Verda Lloyd submitted an affidavit in which she avers that she never made such a statement and that, because she does not practice medicine, she was authorized only to answer *Page 642 ITT's questions by reading to ITT the contents of Barr's medical records. ITT does not point to any of Barr's medical records that contain the statement made in the activity log.

Barr had a third appointment with Dr. Colgin on September 23, 1998. On that day, Dr. Colgin made the following notes in answer to a questionnaire submitted to her by ITT:

"At the time of our last visit, I did feel that she would benefit for her to see a pain specialist and she has been told by her W/C company that I would have to make that referral. Given that, I will make referral to Dr. Claudia McDonald, a Neurosurgeon at Brookwood. I feel that she will always have an element of chronic pain, and hopefully a pain specialist would be able to help her in some way. I do feel that she will be able to return to some type of gainful employment, but for the time being . . . I would recommend that she not be returned to work until she sees the pain specialist.

". . . .

"Personally, I have no surgical treatment options remaining, and I am making a referral to Dr. Claudia McDonald, a Neurosurgeon and pain specialist."

At the bottom of the note, the line showing the distribution of copies indicated that a copy had been sent to ITT at its Nashville, Tennessee, address. Next to the address was a check mark, indicating that the note had been copied and placed in the mail.

On October 7, 1998, Barr telephoned ITT and stated that Dr. Colgin had referred her to Dr. Claudia McDonald for pain management. ITT told Barr that, at that time, it had not been informed that a referral had been made. On October 20, 1998, ITT telephoned Dr. Colgin's office concerning the referral. ITT's activity log indicated that one of Dr. Colgin's employees stated that Dr. Colgin had "recommended" that Barr see a pain-management specialist, but that she did not "refer" Barr to a pain-management specialist. Verda Lloyd and Debbie Weichman, Dr. Colgin's office manager, submitted affidavits stating that they only read Barr's medical records aloud to ITT in response to ITT's telephone calls about Barr's treatment.

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Cite This Page — Counsel Stack

Bluebook (online)
842 So. 2d 638, 2002 Ala. LEXIS 158, 2002 WL 1042484, Counsel Stack Legal Research, https://law.counselstack.com/opinion/itt-specialty-risk-services-inc-v-barr-ala-2002.