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The Indiana Court of Appeals has clarified a 22 year old decision
that significantly limits the statute of limitations for reopening a
worker’s compensation claim for additional medical benefits in
situations where a permanent partial impairment (PPI) settlement has
been made.
In Halteman Swim Club v.
Duguid, No. 93A2-0106-EX-381 (Ind. Ct. App. 2001), the Court of
Appeals reversed a decision of the Full Worker’s Compensation Board by
holding that claims for post-PPI medical treatments must be filed within
one year from the last date for which compensation is paid.
The Court cited to its decision in Gregg
v. Sun Oil Co., 180 Ind. App. 379, 388 N.E.2d 588 (Ind. Ct. App.
1979) that “[a]pplications for the modification of an award of medical
expenses must be filed within the latter one year statute of
limitations, for that is the period of review incorporated by reference
into the provisions of I.C. §22-3-3-4.” Gregg at 590.
The Court in Duguid reiterated that the Board has continuing jurisdiction to
award medical expenses beyond the statutory periods set out in I.C. §22-3-3-27,
“so long as an application for such benefits ‘is filed within one
year from the last day on which compensation was paid, whether under the
original award or a previous modification.’”
Halteman Swim Club quoting
Gregg at 590.
Plaintiff Duguid injured her left knee on June 29, 1996.
Temporary total disability (TTD) benefits were last paid for the
period ending January 1, 1998. Duguid
settled her claim on April 23, 1998 on the basis of a 17% PPI of the leg
in an amount totaling $3,825.00. On
October 18, 1999 she filed an Application
for Adjustment of Claim alleging the need for additional medical
treatment related to her June 1996 leg injury.
Under the two-year statute of limitations, her deadline for
filing the Application would
have been January 1, 2000.
The decision does not state how the one-year statute of
limitations was determined. Not included in the decision is that the PPI award divided by
Duguid’s TTD rate calculates to just under 35 weeks. If the 35 weeks were counted from the date of injury, the
last date for which compensation was paid under the PPI settlement was
March 2, 1997. However, TTD
benefits were paid beyond that date.
If the 35 weeks were added to the last date of TTD payments
(January 1, 1998), the last date for which compensation was paid under
the PPI settlement would be September 3, 1998.
Apparently, one of these two methods was used to determine the
one-year statute of limitations because counting the 35 weeks from the
actual date of the PPI settlement would make the last date of
compensation December 24, 1998. Calculating
a one-year statute of imitations from the date of settlement would have
made Plaintiff’s filing timely, but would have been contrary to the
accepted method of calculating the period for which compensation is paid
under a PPI award from the end of the TTD period or from the date of
injury. Accordingly,
Duguid’s last date to file her Application
under the one-year statute of limitations was September 3, 1999.
The Worker’s Compensation Board has long allowed claims for
additional medical services to be filed under the two-year statute of
limitations applying to claims for any additional disability benefits.
The general perception is that a need for additional medical
services implies an associated disability and vice versa.
However, the Court rejected Plaintiff Duguid’s argument that
her Application was not for PPI,
but for medical expenses.
The Court held that “[t]his is a distinction without a
difference, . . . as Gregg
specifically applied its holding to medical expenses as well as to PPI.”
The decision also notes the Court’s reaffirmation of Gregg
in Berry v. Anaconda Corp., 534
N.E.2d 250 (Ind. Ct. App. 1989).
Interestingly, the Court reinforced its opinion by references to
the doctrines of stare decisis and legislative acquiescence.
The Court cited Lincoln
Utilities, Inc. v. Office of Utility Consumer Counselor, 661 N.E.2d
562 (Ind. Ct. App. 1996) for the proposition that previous decisions of
the Court must be followed when construing a statute unless it is
provided with a strong reason justifying departure.
The Court found no such reason to deviate from the Gregg
interpretation.
Under the concept of legislative acquiescence, the Court noted
that the General Assembly has modified I.C. §22-3-3-4 and 27 on several
occasions since Gregg was
decided and has not taken action to correct the Court’s
interpretation. The
decision refers to the Court’s holding in Department
of Revenue v. U.S. Steel Corp., 425 N.E.2d 659 (Ind. Ct. App. 1981)
that “[w]hen the court interprets a statute and the legislature fails
to take action to change that interpretation, the legislature is
presumed to have acquiesced in the court’s interpretation.”
The Court’s citation to these two doctrines of jurisprudence
may be understood as a statement by the Court that, simply put, “we
assume this interpretation is correct unless you tell us otherwise.”
This action deflects any criticism of the holding to the General
Assembly and properly asks that body to make any desired change to the
law.
There has long been discussion of enacting a uniform statute of
limitations applicable to all claims.
This decision is likely to renew such debate because many claims
for additional medical services will now be foreclosed under the
one-year statute of limitations. In
the short term, this will be beneficial to employers.
However, the backlash is likely to be an increased practice of
filing Applications for Adjustment
of Claim before the ink is dry on PPI settlements.
Claimants will do so to beat the statute of limitations and thus
greatly add to the Board’s docket.
As the Court of Appeals apparently recognized, this will
eventually become a legislative question.
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