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Ewing v. Print Craft, Inc.

Supreme Court of Minnesota

January 2, 2020

Damon A. Ewing, Employee,
v.
Print Craft, Inc., Self-Insured Employer/Relator, and Gallagher Bassett Services, Inc., Third Party Administrator/Relator, and Optimal Recovery, Inc./Ann Brown, QRC, Intervenor/Respondent, and Blue Cross Blue Shield of Minnesota/Blue Plus, et al., Intervenors.

          Workers' Compensation Court of Appeals Office of Appellate Courts

          Gina M. Uhrbom, Brown & Carlson, P.A., Minneapolis, Minnesota, for relators.

          Joshua E. Borken, Law Office of Joshua Borken, Saint Paul, Minnesota, for respondent.

         SYLLABUS

         The compensation judge correctly held that the employer was not liable for rehabilitation services provided after the date by which the employee's work-related injury had resolved, thus making those services neither reasonable nor necessary.

          OPINION

          HUDSON, JUSTICE

         This appeal from the Workers' Compensation Court of Appeals (WCCA) requires that we determine whether an employer can be held liable for rehabilitation services provided after an employee's work-related injury has resolved. The compensation judge denied the qualified rehabilitation consultant's reimbursement claim for rehabilitation services provided during the period in which the employee was no longer suffering from a work-related injury. The WCCA reversed, concluding that the employer must pay for rehabilitation services until the employer files a rehabilitation request for assistance. Because we conclude that the WCCA erred by imposing liability on the employer for rehabilitation services provided after the date that the employee's injury had resolved, we reverse.

         FACTS

         Relator Print Craft, Inc. (Print Craft) is a commercial printer located in New Brighton. Respondent Ann Brown (Brown) is a qualified rehabilitation consultant (QRC) who provided rehabilitation services to one of Print Craft's employees, Damon Ewing (Ewing). Brown billed for her services through her business, Optimal Recovery, Inc.

         Ewing sprained his left ankle when he slipped on ice and fell while leaving work in December 2015. He first sought treatment at a local hospital, and over the months that followed, saw specialists at different clinics in the Twin Cities, in addition to several doctors at the Mayo Clinic. Ewing underwent assessments in the spring of 2016 to determine if he had developed complex regional pain syndrome (CRPS) as a result of his injury. Doctors at the Mayo Clinic concluded that Ewing did not have CRPS and that his work-related injury had resolved by no later than April 20, 2016. His primary care provider and his podiatrist, however, diagnosed him with CRPS related to the ankle injury.

         Ewing first met with Brown on April 20, 2016. Brown prepared a rehabilitation consultation report after their meeting. She indicated in her report that Ewing was a "qualified employee" under Minn. R. 5220.0100, subp. 22 (2019), making him eligible for rehabilitation services. From April 20, 2016 onward, Brown attended medical appointments with Ewing and corresponded with his medical providers as well as Print Craft's insurance adjuster. Brown prepared a rehabilitation plan and submitted it to the Minnesota Department of Labor and Industry (Department) in July 2016. The plan identified the anticipated QRC services as medical management and the coordination of Ewing's return to work, with a projected completion date of August 31, 2016.

         Over the summer of 2016, Ewing received further treatment for his left-ankle sprain, including physical therapy. At the beginning of August 2016, Ewing's self-reported symptoms included pain and twitching in his left arm, short-term memory loss, cognitive difficulties, headaches, and tinnitus. Brown's progress reports show that she continued to provide medical management services for Ewing by arranging a neurology consultation to address Ewing's reported symptoms. When the insurance adjuster requested a reason for the neurology testing, Brown reported that it was necessary to "rule out concussion secondary to his fall."

         In September 2016, Print Craft's insurance adjuster e-mailed Brown to inform her that the adjuster would not approve any further treatment for Ewing until the adjuster received the results of an independent medical examination of Ewing. Print Craft paid Brown's invoices up to September 8, 2016, but refused to pay for any of the services Brown provided after that point. Brown continued to provide rehabilitation services to Ewing and filed a plan amendment with the Department on October 14, 2016, extending the projected completion date to December 30, 2016. Print Craft did not submit a rehabilitation request for assistance to the Commissioner of the Department.[1]

         Ewing appeared for an independent medical examination with Dr. Joel Gedan on November 7, 2016. Based on his physical examination of Ewing and review of Ewing's medical records, Dr. Gedan concluded that Ewing did not suffer from CRPS or any work-related injury resulting from his December 2015 fall other than a left-ankle sprain. Dr. Gedan identified a functional restoration program (i.e., physical therapy) as the only medical treatment that would likely improve Ewing's ankle condition.

         Ewing filed a claim petition on November 9, 2016, asserting that he had CRPS in his left leg and that it had spread to his left arm and right shoulder. Ewing also alleged that he suffered a concussion when he fell at work, leading to tinnitus and memory and cognitive issues. Print Craft denied liability for Ewing's claimed injuries other than the left-ankle sprain. Neither the claim petition nor Print Craft's answer mentioned rehabilitation services.

         Print Craft filed a Notice of Intention to Discontinue Workers' Compensation Benefits (Notice) on December 7, 2016, stating that it would no longer pay Ewing's temporary total disability benefits. Ewing objected, which led to an administrative conference before a compensation judge. On January 4, 2017, the compensation judge granted Print Craft's request to discontinue Ewing's disability benefits, finding that Ewing no longer required work restrictions related to his ankle sprain. Brown received a copy of the decision by mail. Ewing filed an objection to this order.[2]

         Meanwhile, Brown continued to provide rehabilitation services to Ewing through the end of 2016 and into the beginning of 2017. She filed a second rehabilitation plan amendment in late December 2016 that extended the projected completion date to April 30, 2017. Print Craft did not file a rehabilitation request for assistance at that time.

         Print Craft filed a rehabilitation request with the Commissioner on April 6, 2017. Print Craft requested termination of Ewing's rehabilitation plan, while "maintaining a denial of primary liability regarding any and all claimed body parts, other than a strain/sprain of the left ankle." Print Craft alleged that "the QRC is performing medical management only with respect to solely denied conditions." Ewing then filed a rehabilitation response with the Department and requested a hearing before a compensation judge.

         After several continuances, a formal hearing occurred on April 6, 2018. The hearing consolidated Ewing's November 2016 claim petition, his February 2017 objection to the discontinuance of temporary total disability benefits, and Print Craft's request to terminate Ewing's rehabilitation plan. Brown intervened and testified at this hearing. In the interim, Brown continued to provide rehabilitation ...


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