of Appeals Office of Appellate Courts
Matthew J. Barber, James S. Ballentine, Cole J. Dixon,
Schwebel Goetz & Sieben, P.A., Minneapolis, Minnesota,
Angell, David M. Werwie & Associates, Saint Paul,
Minnesota, for appellant.
O. Thornsjo, Christopher E. Celichowski, Lance D. Meyer,
O'Meara, Leer, Wagner, & Kohl, P.A., Minneapolis,
Minnesota, for amici curiae The Insurance Federation of
Minnesota, The Property Casualty Insurers Association of
America, and The National Association of Mutual Insurance
reimbursement prohibition set forth in Minn. Stat. §
176.83, subd. 5(c) (2018), applies only to "the
provider" determined by a workers' compensation
payer to have provided excessive, unnecessary, or
inappropriate procedures or services. Because the provider of
the treatment for which the injured employee sought
reimbursement from her no-fault insurer had not been
determined by a workers' compensation payer to have
provided excessive, unnecessary, or inappropriate services,
the no-fault insurer's denial of coverage was improper.
case requires us to determine whether respondent Jennifer
Rodriguez, a bus driver who was injured in a motor vehicle
accident while working, may seek reimbursement for
chiropractic services related to her injury from appellant
State Farm Mutual Automobile Insurance Co. (State Farm), her
personal automobile no-fault insurer.
the accident, Rodriguez sought and received chiropractic care
at ChiroFirst and reported the accident to her employer. Her
employer's workers' compensation carrier, Old
Republic Insurance, agreed to pay workers' compensation
benefits. But in accordance with the treatment parameters
adopted for purposes of the Workers' Compensation Act,
Old Republic refused to pay for more than 12 weeks of
chiropractic care. Those parameters state that (subject to
certain exceptions) more than 12 weeks of chiropractic care
is excessive, unnecessary, or inappropriate. See
Minn. R. 5221.6200, subps. 3(C), 9 (2017); Minn. R.
5221.6205, subps. 3(C), 9 (2017); see also Minn. R.
5221.6050, subp. 1 (2017). In accordance with Old
Republic's decision, Rodriguez's initial
chiropractor, ChiroFirst, stopped treatment after providing
12 weeks of care, so Rodriquez sought and received additional
care from a different chiropractor, Core Health Chiropractic
(Core Health). It is for that care that Rodriguez sought
reimbursement from State Farm. State Farm denied coverage.
Farm concedes that Rodriguez's injuries, and the
chiropractic care she received for those injuries, are
covered under its no-fault policy, but argues that Rodriguez
is nonetheless barred from no-fault recovery because of Old
Republic's determination that more than 12 weeks of care
was excessive, unnecessary, or inappropriate. State Farm
asserts that, under those circumstances, a provision in the
Minnesota Workers' Compensation Act, Minn. Stat. §
176.83, subd. 5(c) (2018), prohibits any further
reimbursement to any chiropractor from "any source"
including "another insurer."
State Farm denied coverage, Rodriguez filed a petition for
no-fault arbitration, seeking an award of her expenses for
chiropractic treatment beyond the 12 weeks already covered by
Old Republic. The arbitrator ruled in favor of Rodriguez and
awarded her $16, 883, which was the full amount that she had
sought plus interest and costs. State Farm moved in the
district court to vacate the arbitrator's award on the
ground that the arbitrator exceeded her authority. The
district court granted the motion. The court of appeals
reversed the district court and reinstated ...