LETICIA M. SALINAS, Claimant,
v.
BRIDGE VIEW ESTATES, Employer,
and
OLD REPUBLIC INSURANCE COMPANY, Surety, Defendants.
No. IC 2011-014120
Idaho Workers Compensation
Before the Industrial Commission of the State of Idaho
April 28, 2016
ORDER DENYING DEFENDANTS' MOTION FOR
RECONSIDERATION
R.D.
Maynard, Chairman
Pursuant
to Idaho Code § 72-718, Defendants timely filed a motion
for reconsideration of the Commission's March 4, 2016
decision in the above-captioned case. Defendants argue,
first, that the Commission erred in awarding Idaho Code
§ 72-804 attorney fees; second, that the decision lacked
substantial and competent evidence to support the findings
relating to attorney fees; third, that the decision
impermissibly penalized Defendants; fourth, that the decision
unfairly shifted the burden of showing reasonableness to
Defendants; and fifth, that the decision prejudiced
Defendants by depriving them of a bifurcated hearing on
attorney fees. Claimant did not file a response.
DISCUSSION
Under
Idaho Code § 72-718, a decision of the Commission, in
the absence of fraud, shall be final and conclusive as to all
matters adjudicated; provided, that within twenty (20) days
from the date of filing the decision any party may move for
reconsideration or rehearing of the decision. The Commission
is not compelled to make findings on the facts of the case
during a reconsideration. Davison v. H.H. Keim Co.,
Ltd., 110 Idaho 758, 718 P.2d 1196. The Commission may
reverse its decision upon a motion for reconsideration, or
rehearing of the decision in question, based on the arguments
presented, or upon its own motion, provided that it acts
within the time frame established in Idaho Code §
72-718. See, Dennis v. School District No.
91, 135 Idaho 94, 15 P.3d 329 (2000) (citing Kindred
v. Amalgamated Sugar Co., 114 Idaho 284, 756 P.2d 410
(1988)).
Claimant
alleged she injured her back while lifting a patient on or
about May 5, 2011. While she was receiving medical treatment,
Claimant asserted that Surety "temporarily denied"
her claim and refused to communicate with her. Defendants
countered that Claimant canceled/no-showed to her
appointments, and that such appointments were unnecessary.
Around May 2015, Defendants' expert, Dr. Michael Hajjar
opined that Claimant's industrial injury was a lumbar
strain/sprain, and had resolved within six (6) months of the
injury. While ultimately accepting Dr. Hajjar's medical
opinion, the Referee was critical of Defendants' handling
of the claim, including (1) denying Claimant's medical
care before a physician declared Claimant at MMI; (2)
unreasonably delaying its decision on continuing coverage on
an accepted claim; and (3) refusing to communicate with
Claimant on her coverage status despite her repeated attempts
to speak with the adjuster. The Commission adopted the
Referee's proposed findings in its March 4, 2016 Order
including (1) Claimant has failed to prove her current low
back condition was caused in whole or in part by the
industrial accident of May 5, 2011; (2) Claimant has failed
to prove her right to reimbursement for medical care for her
low back after she reached MMI in November 2011; (3) Claimant
has failed to prove she is entitled to permanent partial
impairment (PPI) benefits from her...
