Indiana Spine Group, P.C. v. International Entertainment Consultants
2011 Ind. App. LEXIS 19
Ind. Ct. App.2011Background
- Webb sustained a work-related injury with Consultants on June 27, 2005; Indiana Spine provided medical services charging $16,132.00.
- Consultants' insurer paid $10,029.86 to Indiana Spine on August 17, 2006.
- On April 8, 2009, Indiana Spine filed an application for adjustment of claim with the Worker's Compensation Board for full payment of the charges.
- Consultants moved to dismiss arguing Indiana Spine's claim was barred by the two-year statute of limitations in IC 22-3-3-3.
- A single hearing member granted dismissal; the Board affirmed, holding the medical provider's fee claim is derivative of the underlying injury claim and not governed by IC ch. 34-11-2 statutes.
- Indiana Spine appealed; the Indiana Court of Appeals held IC 22-3-3-3 does not apply and remanded for further proceedings.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether IC 22-3-3-3 bars the provider fee claim | Spine: IC 22-3-3-3 applies to pecuniary liability for medical services. | Consultants: statute applies to the Act's compensation claims, including medical services. | No; IC 22-3-3-3 does not apply to a medical service provider's pecuniary liability claim. |
| Appropriate limitations framework for pecuniary liability | Board should apply general limitations or statute for accounts; discord with 22-3-3-3. | 2-year limit under 22-3-3-3 governs medical-pecuniary claims as part of compensation. | General civil limitations may apply; neither 22-3-3-3 nor 22-3-3-27 controls in this context. |
| Is Pilot Travel Centers controlling | Pilot supports treating medical service provider claims separately from compensation. | Pilot should apply to support 22-3-3-3 applicability. | Pilot supports that provider claims are not governed by 22-3-3-3. |
Key Cases Cited
- Pilot Travel Centers v. Indiana Spine Group, 931 N.E.2d 435 (Ind.Ct.App. 2010) (medical provider pecuniary liability not governed by 22-3-3-3; two-year period for act does not fit service provider claims)
- Swift v. State Farm Ins. Co., 819 N.E.2d 389 (Ind.Ct.App. 2004) (lien/reimbursement context; not a claim for compensation)
- Colburn v. Kessler's Team Sports, 850 N.E.2d 1001 (Ind.Ct.App. 2006) (23-3-3-3 applies to medical services as compensation)
- Danielson v. Pratt Indus., Inc., 846 N.E.2d 244 (Ind.Ct.App. 2006) (Board not authorized to extend two-year limit beyond statute)
- Berry v. Anaconda Corp., 534 N.E.2d 250 (Ind.Ct.App. 1989) (medical services within compensation scope; timing matters)