Commonwealth Court Prevents Workers' Compensation Insurance Carriers From Limiting Injured Worker Recourse
The Commonwealth Court in Ruth Hough v. WCAB (AC&T Companies) handed down an important ruling that prevented workers' compensation insurance carriers from limiting an injured worker's recourse when medical bills are not paid in a timely manner. In Hough, the injured worker filed a Penalty Petition alleging that the insurance carrier had failed to pay for the claimant's prescription medications in the time period prescribed by the Pennsylvania Workers' Compensation Act and its medical cost containment regulations. The workers' compensation judge granted the Penalty Petition and assessed penalties against the carrier. The carrier appealed, arguing that rather than filing a Penalty Petition, the claimant was obligated to first seek to rectify the issue by filing a fee review request under Section 306(f.1)(5) of the Act. This Section calls for an "administrative decision" by the Department of Labor and Industry where the medical provider is alleging that the carrier is not making payment in the proper amount or in a timely manner. The Workers' Compensation Appeal Board (WCAB) agreed with the carrier and reversed the judge's award. The Claimant then appealed to the Commonwealth Court.
