12-0035. WADE E. WARINER, Employee, Applicant, v. CHUGACH SUPPORT SERVICES, INC., Employer, and ZURICH AMERICAN INSURANCE COMPANY And NOVAPRO RISK SOLUTIONS (f/k/a WARD NORTH AMERICA), Insurer/Adjuster, Defendants.
Court | Alaska |
Alaska Workers Compensation Decisions
2012.
Workers' Compensation Board
12-0035.
WADE E. WARINER, Employee, Applicant, v. CHUGACH SUPPORT SERVICES, INC., Employer, and ZURICH AMERICAN INSURANCE COMPANY And NOVAPRO RISK SOLUTIONS (f/k/a WARD NORTH AMERICA), Insurer/Adjuster, Defendants
WADE E. WARINER, Employee, Applicant, v. CHUGACH SUPPORT
SERVICES, INC., Employer, and ZURICH AMERICAN INSURANCE COMPANY And NOVAPRO
RISK SOLUTIONS (f/k/a WARD NORTH AMERICA), Insurer/Adjuster,
Defendants.AWCB
Decision No. 12-0035Filed with AWCB
Anchorage, Alaskaon February 28, 2012AWCB Case No. 200522520INTERLOCUTORY DECISION AND ORDERChugach Support Services' (Employer) April 10, 2009 petition to
dismiss Wade Wariner's (Employee) June 12, 2006 workers' compensation claim was
heard on August 31, 2011, in Anchorage, Alaska. Employee's wife Jacqueline
Wariner appeared and was Employee's non-attorney representative. Employee
appeared and testified. Attorney Robert Bredesen appeared and represented
Employer and its workers' compensation insurance carrier. The record closed on
September 15, 2011, when time expired for Employee to obtain, file and serve a
copy of an Affidavit of Readiness for Hearing he contended he previously filed
in 2008.
SUMMARY OF
DECISIONS
A brief review of prior decisions in this matter will help put
the instant hearing in context: Wariner v. Chugach Support Services,
Inc., AWCB Decision No. 09-0158 (October 13, 2009), (Wariner
I) addressed Chugach Support Services, Inc.'s (Employer) March 13,
2009 petition to compel discovery or, in the alternative, to dismiss Wade
Wariner's (Employee) claim under AS 23.30.108(c), and addressed Employer's
March 13, 2009 petition requesting a continuance of the July 14, 2009 hearing.
Wariner I ordered Employee to attend a deposition on August
21, 2009, granted Employee's request for a protective order on mental health
records, ordered Employee to sign and deliver appropriately modified releases
and denied Employer's petition to dismiss under AS 23.30.108(c).
Wariner v. Chugach Support Services, Inc.,
AWCB Decision No. 09-0169 (November 10, 2009) (Wariner II)
granted reconsideration of Wariner I on Employer's motion for
limited reconsideration of mental health and employment records release issues
and directed a prehearing conference be set for oral argument on Employer's
petition. Employer contended Employee placed his mental health at issue;
Employee contended any mental health releases should be limited in time.
Wariner v. Chugach Support Services, Inc.,
AWCB Decision No. 10-075 (April 29, 2010) (Wariner III)
addressed these mental health and employment records release issues and ordered
Employee to sign the proposed mental health releases with a limitation of 1969
to present; ordered Employee to sign an employment records release for records
from 1995 to present; and ordered a prehearing conference to address Employee's
continuing request for a second independent medical evaluation (SIME).
ISSUE
Employer contends it controverted Employee's June 12, 2006
workers' compensation claim, he did not file and serve an Affidavit of
Readiness for Hearing within two years of the controversion date, and
consequently his claim should be dismissed under AS 23.30.110(c).
Employee contends he is certain he filed a timely Affidavit of
Readiness for Hearing on the advice of former Board staff member Janet Bailey
just a few days before the deadline, as it was explained to him, was to run
out. Employee contends he filed his Affidavit of Readiness perhaps in early
July 2008, but alternately contends he certainly filed it several days before
the deadline. He seeks an order denying Employer's petition to dismiss.
Shall Employee's June 12, 2006 claim be dismissed under AS
23.30.110(c)?
FINDINGS OF FACT
A review of the entire administrative record establishes the
following facts and factual conclusions by a preponderance of the
evidence:
1) On July 15, 2005, Employee was injured while at work for
employer when he fell onto a piece of pipe and twisted his back while working
in King Salmon (Report of Injury, July 19, 2005).
2) On October 14, 2005, James Eule, M.D., of Orthopedic
Physicians of Anchorage (OPA) evaluated Employee and noted he was asymptomatic
prior to his work injury, and had been off work for three weeks without
significant improvement. Dr. Eule also recorded Employee's idiopathic scoliosis
but was unable to pinpoint a cause for his right leg symptoms. Dr. Eule also
noted Employee was totally disabled and scheduled for reevaluation on December
15, 2005. He prescribed physical therapy (chart note, J. Eule, October 14,
2005).
3) On October 31, 2005, Amber Lawton, claims adjuster for Ward
Strategic Claims Solutions, sent a letter to Dr. Eule inquiring: (1) whether
the work injury was a substantial factor; (2) whether Employee had a
preexisting condition; (3) if so, was it aggravated, accelerated, or
exacerbated by the work injury; (4) if so was it temporary or permanent; (5)
whether Employee had reached pre-injury status; (6) if not, when would he reach
pre-injury status; and (7) seeking recommendations for treatment (letter from
A. Lawton to J. Eule, October 31, 2005).
4) On November 8, 2005, Dr. Eule replied stating: (1) the work
injury was a substantial factor; (2) the employee had a preexisting condition;
(3) it was aggravated, accelerated or exacerbated by the work injury; (4) but
whether it was temporary or permanent was to be determined; (5) Employee had
not reached pre-injury status; (6) but was expected to in six to twelve weeks;
and (7) prescribed physical therapy as treatment (handwritten responses added
by Dr. Eule, November 8, 2005).
5) On June 12, 2006, Employee filed a workers' compensation
claim seeking temporary total disability (TTD) from September 24, 2005, to
"current," transportation costs of $1,650.37, and a compensation rate
adjustment to $1,309.16 per week (claim, June 12, 2006).
6) On June 21, 2006, Marilyn Yodlowski, M.D., evaluated
Employee for an employer's medical evaluation (EME). Dr. Yodlowski noted
Employee stated he "threw his back out from heavy lifting" in 1971. Dr.
Yodlowski opined Employee had a significant preexisting thoracolumbar
scoliosis, and diffuse degenerative changes throughout the thoracic and
lumbosacral spine. She further stated there was no indication Employee's chest
wall contusion from his fall at work in any way accelerated, exacerbated or
aggravated preexisting scoliosis or degenerative spine disease. Dr. Yodlowski
stated the work injury was not a substantial factor in his current treatment,
and his chest wall contusion would have completely resolved in three months
from the date of injury. She also maintained the fall at work had no effect on
progression of Employee's preexisting scoliosis and degenerative disc disease,
any treatment past three months after the injury date was related to
preexisting conditions and not the work injury, and Employee was medically
stable, with no ratable impairment from the work injury (EME report, Dr.
Yodlowski, June 21, 2006).
7) As of June 21, 2006, there were significant medical disputes
between attending physician Dr. Eule and EME Dr. Yodlowski
(observations).
8) On or about June 30, 2006, Employer filed an answer
admitting medical cost reimbursement of $63.20 and transportation costs in the
amount of $805.26, and denying TTD, medical costs for Alaska Club membership,
and any compensation rate adjustment (Answer, June 30, 2006).
9) On July 26, 2006, Employer filed and served by mail both
sides of a completed controversion on a form prescribed by the board, which
stated in relevant part:
15. Specific Benefits Controverted (Denied)
All benefits after 06/21/2006
16. Reason -- Specific Benefits Controverted (Denied)
Per IME report by Dr. Yodlowski on 06/21/2006, 'work injury is
no longer a substantial factor in his current treatment or recommendation for
additional treatment.'
TIME LIMITS
. . .
2. When must you request a hearing (Affidavit of Readiness for
Hearing form)?
IF the insurer/employer filed this controversion notice after
you filed a claim, you must request a hearing before the AWCB within two years
after the date the insurer/employer filed this controversion notice. You will
lose your right to the benefits denied on the front of this form if you do not
request a hearing within the two years.
IF YOU ARE UNSURE WHETHER IT IS TOO LATE
TO FILE A CLAIM OR REQUEST A HEARING, CONTACT THE NEAREST AWCB OFFICE. . .
.
Controversion Notice, July 24, 2006.
10) On July 26, 2006, the parties appeared at a prehearing
conference at which Employee's claim was set forth by specific issues. The
parties agreed the transportation issue was resolved and there "is no issue"
regarding transportation costs. The parties discussed Employee's rate
adjustment claim and agreed to "cooperate and communicate" to resolve this
issue; if it could not be resolved, the parties were to appear in 14 days for a
follow up prehearing conference to discuss the matter further. The adjuster
requested a new copy of an Alaska Club invoice, which Employee had already
paid, as the copy she had was illegible. The parties and Board designee
discussed Employer's controversion based upon Dr. Yodlowski's EME report and
Employee was to seek an opinion from Dr. Eule his attending physician about the
EME report. The designee "explained the SIME process to Mr. Wariner." Lastly,
the summary from this prehearing conference states:
Mr. Wariner is reminded that, if a...
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