The Employee sustained an injury to his right hip on July 19, 2018 while assisting with delivery of a keg and developed a Staph infection ultimately leading to a hip replacement and permanent physical restrictions. The Employer accommodated the Employee’s restrictions. The Employee returned to work after the hip replacement and resigned the same day. The Employee began working at another brewery at a lower rate of pay but believed it would have better pay and benefits long term; the new employer went out of business. The Employee then began working at a new employer for similar wages to the date of injury employer. The new positions were within his restrictions.
The Employer initially denied primary liability for the injury and after filing a claim petition, the Employee underwent an IME. Based on the IME opinions, the Employer withdrew their primary liability denial and the claim petition was withdrawn and dismissed. The Employer then filed a notice of benefit reinstatement, the Employee’s attorney notified the medical providers the claim was accepting and requested confirming of the outstanding balances. Payments were then initiated.
The Employee filed a claim petition seeking TPD and penalties. The compensation judge found for the Employer and found the reduction in earnings was not causally related to the work injury. The compensation judge did award penalties against the Employer for delayed payments of medical expenses and claims of the intervenors.
The Employee appealed the denial of his claim for TPD and from the award of only a portion of the penalties sought against the employer. The WCCA found the compensation judge weighed the evidence and testimony in determining the wage loss was not due to the work injury and he was not entitled to wage loss benefits. Substantial evidence supported the compensation judge’s determination and therefore it is affirmed.
In relation to the issue of unpaid medical expenses and additional penalties, the WCCA found there was no reason to distinguish between late payments an undisputed non-payments. The evidence showed that by the time of hearing nearly all of the medical expenses remained unpaid. The WCCA vacated the compensation judge’s award of penalties and remanded for a determination of an appropriate penalty under Minn. Stat. 176.225 subd. 1 and 5 that considers both late, and undisputed and unpaid medical expenses.
Takeaway: Penalties can be assessed for both late and undisputed and unpaid medical expenses. If primary liability is accepted, timely payment should be made to avoid a claim for penalties at hearing.