Tuesday, June 30, 2015

Medical fee dispute not subject to 60 day service

A doctor selected by the comp carrier disputed partial payment of a medical bill, resulting in an award of the entire bill when the employer offered no evidence disputing the reasonableness of the charges.  Phillips v Allied Systems, 2015 Mo WCLR Lexis 72 (June 25, 2015).

AIG re-priced the bill and reduced the charges by $1,090.  The ALJ found no factual or legal basis to dispute the charges.   The Commission affirmed the award.  The employer objected to the admission of the affidavit by the ALJ pursuant to 287.210 when it was served less than 60 days before the hearing.   The Commission  made a distinction between a doctor-written report that was an expert medical opinion subject to the 60 day rule  and an expert "professional" opinion addressing the narrower issue whether the doctor regarded his own fees were reasonable.  It concluded the admission of fee-dispute reports were governed by 287.140 and not 287.210.7. The only objection was whether the report violated the "rules of evidence in civil proceedings."

ALJ Rebman
Atty Schroer, Moen