Delta, CO (WorkersCompensation.com) – A Colorado hospital was wrong when it sent bills for treatment of a workers’ compensation injury to the worker, a Colorado Court of Appeals panel has found.
Now, Delta County Memorial Hospital faces fines for sending those bills to the employee and a collection agency, the court said, because it violated the state’s Workers’ Compensation Act.
According to Delta County Memorial Hospital v. Industrial Claim Appeals Office, No. 20CA1523 (Colo. Ct. App. 06/17/21), Edith Keating was working for Bob Adams Trucking & Towing when she was injured while loading a pickup truck onto a tow truck in 2017. Keating applied for workers’ compensation benefits and was awarded medical and disability benefits.
However, her employer lacked proper workers’ compensation insurance. In that case, the judge ordered the company to deposit $130,000 with the Colorado Division of Workers’ Compensation to cover Keating’s compensation and benefits, as well as to file a bond with the division in the same amount.
Keating was provided with a copy of the order and gave it to Delta County Memorial Hospital where she was treated, court documents said. The hospital, however, had not received any payments for its services, so it billed Keating. Her attorney notified the hospital that billing their action was illegal because Colorado state law says once a claim is found compensable, a medical provider cannot bill the injured worker for treating the work injury.
Despite receiving notification from Keating’s attorney in April 2019, court documents said, the hospital continued to try and collect for the services through billing statements in June and September 2019.
“Despite being advised of the law and the order, on June 13, 2019, counsel for the hospital responded to claimant’s counsel, writing that because Mr. Adams never paid into the division’s fund ‘as ordered by the Court,’ the hospital had no other available avenue to recoup its expenses and its ‘only recourse in recovering its costs/fees is through continued collection efforts against [claimant],’” court documents said.
An administrative law judge found that by sending the bills to Keating despite being told her injuries were compensable the hospital did violate the state’s Workers’ Compensation Act, and fined the hospital $750 per day for the period between the first bill in June 2019 through October 2019 totaling $89,250.
A review by the Industrial Claims Appeals Office panel found that the hospital did violate the law, but that it could not be fined for all the days between June 2019 and October 2019. The panel found that the hospital only billed Keating eight times, changing the penalty to $6,000.
The hospital appealed, and Keating cross-appealed, with Keating arguing that the penalty should have been larger.
The appellate court found the panel was correct in limiting the number of days for a penalty, and affirmed that the penalties could only be placed on the days the hospital billed Keating. The court, documents said, did however, add two days onto the penalty for days the hospital sent bills to a collection agency.
The case was remanded to the administrative law judge who was instructed to add two days at $750 to the penalties, or $7,500.