CASE SUMMARY
In this workers’ compensation case the Minnesota Supreme Court was tasked with determining two main issues: (1) Whether the compensation judge’s findings regarding the employee’s October 2018 injury were supported by the evidence; and (2) Whether the employee could assert a direct claim for unpaid medical bills from non-intervening medical providers when the medical provider’s potential interest has been extinguished by order of the compensation judge.
Facts
The employee, Daniel Johnson, sustained a low back injury in March 2005 while working for Furniture & Things, Inc. The employer accepted primary liability and the Employee continued to work for the company until 2011. Despite continuing pain, he managed his symptoms with self-care.
In 2016, the employee worked for Concrete Treatments, Inc. He tried to avoid heavy lifting to prevent an aggravation of his prior 2005 injury. He injured his back again in October 2018, while bending down to move a door hinge. Despite ongoing pain, he initially sought limited medical treatment. In December 2018, he was in a car accident while driving a company owned car and then sought chiropractic treatment at Power Within Chiropractic (PWO) for car accident-related neck pain and his ongoing back and leg pain. He had no other medical treatment in 2019 and 2020 but returned in 2021 due to increased back and leg pain. He then received more extensive treatment, including surgery at Twin Cities Orthopedics (TCO), which improved his condition.
In 2021, the employee filed a workers’ compensation claim seeking benefits and unpaid medical expenses for treatments from TCO and Power Within Chiropractic (PWC). Despite the two potential intervenors being notifying of their right to intervene, neither provider formally intervened.
Procedural History
At the hearing, counsel for both employers argued that because TCO and PWC’s interests were extinguished by court order, the employee’s direct claim for reimbursement was eliminated. All parties submitted expert medical reports addressing causation and apportionment. The compensation judge found that both the 2005 and 2018 injuries substantially contributed to the employee’s need for medical care and surgery. The judge apportioned liability between the injuries, 2005 (40%) and 2018 (60%), and also concluded the employee could assert a direct claim for unpaid medical expenses because the providers did not intervene.
On appeal at the Workers’ Compensation Court of Appeals (WCCA), the court upheld the compensation judge’s findings on the October 2018 injury but was somewhat divided on the employee’s ability to bring a direct claim for unpaid medical expenses. The majority found that once the claims were extinguished that employee’s attorney had to establish dual representation to bring forward the direct claims and because he had not done so, the employee could not make a direct claim. The dissenting judge reasoned that dual representation only applies when the intervenors have intervened and the employee is asserting a claim for the same bills and costs. Since TCO and PWC did not intervene the dissenting judge concluded the employee could bring direct claims. The WCCA reversed the employee’s entitlement to claim unpaid medical expenses, requiring dual representation by the employee’s attorney for both him and the providers, which was not established.
On appeal at the Minnesota Supreme Court, the court concluded the employee was entitled to assert a direct claim for unpaid medical expenses. The court threw out the dual representation argument, determining it did not apply because the potential intervenors had not intervened and because when this requirement was created, intervenors were required to appear at hearings; if they did not then their claims could not proceed unless the employee’s attorney asserted dual representation and such requirement for appearance was no longer required. The court affirmed the WCCA on the October 2018 injury and remanded the case to the WCCA to address further factual findings on the employee’s direct claim for medical expenses.
Recently, on June 13, 2024, on remand from the Minnesota Supreme Court, the WCCA vacated part of the initial compensation judge’s order and remanded the case for additional factual findings. Specifically, the WCCA instructed the compensation judge to evaluate whether the employers were unduly prejudiced by the employee’s direct medical expense claim and to calculate any reimbursements owed to the employee based on the apportionment of responsibility.
Takeaway
The main takeaway from the Johnson case is that injured employees may have the right to directly claim unpaid medical expenses in workers’ compensation cases, even if intervenors’ interests have been extinguished. Minn. Stat. § 176.361 does not limit an employee’s right to seek direct payment for medical expenses, even if providers do not intervene. The statute focuses on the providers’ procedural rights, not the employee’s substantive rights.
The more recent decision on remand emphasizes the importance of assessing whether employers suffer undue prejudice from such claims and highlights the procedural necessity of establishing a clear factual record to resolve disputes effectively. Additionally, the dual representation requirement, as interpreted in previous cases, applies when providers have intervened but did not attend hearings. Here, the providers did not intervene at all, rendering the dual representation requirement inapplicable.
