This case confirms that a QRC is entitled to payment of his/her bills up until the filing of a request for termination of rehabilitation services, even if the injury was judicially determined to be fully resolved well before such a request for termination is filed.
The QRC in this case was providing medical management related to a December 2015 work injury, which was partially admitted by the employer and insurer (one body part admitted, others denied). The employer and insurer got an IME which found the employee to have been fully recovered from the work injury by April 20, 2016. The employer and insurer thus filed a Rehab Request to terminate the rehab plan on April 6, 2017.
At hearing, Judge Marshall found the employee’s injury had fully resolved on April 20, 2016 and ordered payment of claims, including the QRC’s bills, through that date only and dismissed all the rest. On appeal, the WCCA reversed holding that the finding of a fully resolved injury doesn’t automatically cut off rehab services or the right for the QRC to get paid. The statute requires notice be given to the parties and a showing of good cause be made before rehab services can be terminated and in this case, the WCCA found that the notice requirement wasn’t satisfied until the April 6, 2017 Rehabilitation Request so the QRC’s bills must be paid through that date rather than only through the date of the full resolution of the injury.