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Gist v. Atlas Staffing, Inc.

Supreme Court of Minnesota

April 4, 2018

Anthony Gist, Respondent,
v.
Atlas Staffing, Inc. and Meadowbrook Claims Service, Appellants/Cross-Respondents, and Fresenius Medical Care, Respondent/Cross-Appellant.

          Workers’ Compensation Court of Appeals Office of Appellate Courts

          Benjamin J. Heimerl, Heimerl & Lammers, Minneapolis, Minnesota, for respondent.

          Brent Kleffman, Beth A. Butler, Peterson, Logren, & Kilbury, P.A., Saint Paul, Minnesota, for appellants/cross-respondents.

          Mark A. Frederickson, Katie H. Storms, João C.J.G. de Medeiros, Lind, Jensen, Sullivan & Peterson, P.A., Minneapolis, Minnesota, for respondent/cross-appellant.

          Lillehaug, J. Took no part, Chutich, J.

         SYLLABUS

         1. The compensation judge did not abuse her discretion in concluding that respondent's work-related silica exposure was a substantial contributing factor to his kidney failure.

         2. Under 42 C.F.R. § 447.15 (2016), a provider cannot recover payment from third parties for any services billed to Medicaid after the provider has accepted payment from Medicaid for those services.

         3. Respondent/appellant's 30-day period for filing a notice of appeal to the Workers' Compensation Court of Appeals had not expired at the time of filing the appeal because the findings and order of the compensation judge were not served directly on respondent/appellant.

         4. The Workers' Compensation Court of Appeals did not err by reviewing and modifying the compensation judge's order instructing appellants to make workers' compensation payments "in accordance with all other state and federal laws."

         5. The question of whether Minnesota's workers' compensation fee schedules apply to medical bills for treatment incurred prior to a finding of primary liability is remanded to the Workers' Compensation Court of Appeals.

          OPINION

          LILLEHAUG, JUSTICE.

         Shortly after leaving his job at Atlas Staffing, Inc. ("Atlas"), respondent Anthony Gist was diagnosed with end stage renal disease ("ESRD")-kidney failure. His job with Atlas exposed him to silica, a known cause of ESRD. Gist sought workers' compensation benefits from Atlas and its insurer, Meadowbrook Claims Services (collectively, "appellants"). Appellants denied coverage, and Gist began receiving treatment from respondent/cross-appellant Fresenius Medical Care ("Fresenius"). Fresenius billed Medicaid, Medicare, and private insurer Medica for the costs of Gist's treatment, and accepted payments from each.

         After a hearing, the compensation judge found that Gist's silica exposure was a substantial contributing factor to his kidney disease, and ordered that appellants pay workers' compensation benefits. After dismissing Fresenius's cross-appeal as untimely, the Workers' Compensation Court of Appeals ("WCCA") largely upheld the compensation judge's decision. In the consolidated appeals brought by appellants and Fresenius, we affirm in part, reverse in part, and remand to the WCCA.

         FACTS

         Gist worked for Atlas, a temporary staffing agency, from September 2011 through June 2013. Atlas assigned him to Waltek Casting Company, which creates casting molds for boats, planes, and farming equipment engines. Gist's job at Waltek involved placing wax figures on a rack and then a conveyor, after which a robot would drop the figures into a silica-sand tank. He was also required to fill and clean the silica-sand tanks. Filling occurred 8 to 10 times per 8-hour shift, and the tanks were cleaned at least once per day.

         Because exposure to silica sand is hazardous, Gist wore ear plugs, safety glasses, gloves, and a paper mask. Gist described the 2-hour cleaning process as hot, wet, and muddy. Silica sand got inside his pants and stuck to his skin.

         Gist left the job on June 28, 2013, at age 50. About a month later, he was seen at Mercy Hospital "for evaluation of kidney concerns after being informed by his clinic that his blood work had evidence for kidney failure." Thereafter, Gist saw a number of doctors. In November 2014, he filed a claim petition seeking workers' compensation benefits from appellants.

         The compensation judge held a hearing in August 2016, at which the sole issue relevant to this appeal was whether silica exposure was a "substantial contributing factor to [Gist's] kidney failure."[1] The parties stipulated that "[a]ll medical treatment to date has been reasonable and necessary" and that Gist was "permanently and total[ly] disabled." At the time of the hearing, approximately $1.5 million in medical bills and indemnity benefits were at issue.

         A great deal of evidence regarding Gist's medical history was presented at the hearing. We summarize that history as follows:

• In February 2008, Gist was diagnosed "as having a left foot wound with cellulitis and elevated blood sugar, most likely diabetic."
• In June 2011, Gist was "diagnosed with hypertension, left-sided chest pain, mild anemia, and resolving diverticulitis."
• In July 2013, Gist was evaluated by Dr. James Lee and then hospitalized for acute renal failure. Gist told Dr. Lee that he believed that his kidney failure was due to silica exposure.
• An August 2013 biopsy showed that Gist had a condition "globally interpreted as irreversible, non-salvageable kidney failure."
• A week after his biopsy, Gist saw Dr. James Rusin, a family physician. Dr. Rusin "did not feel silica had anything to do with [Gist's] kidney problem."
• On August 27, 2013, Gist saw Stephanie Gordon, a nurse practitioner. Gordon told Gist that "the kidney biopsy results were not consistent with findings of some type of exposure."
• On November 4, 2013, Gist was evaluated by Dr. Arthur Ney, a surgeon. Dr. Ney noted that Gist had "a history of ESRD . . . possibly hypertension" and deemed him a "reasonable candidate for transplant." Gist ...

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