The employer’s making of medical payments over an 18-month period was done under a feeling of compulsion and thereby tolled the statute of limitations.
This case was tried before the Superior Court regarding the employer’s appeal from a Board decision that granted the claimant’s petition to determine additional compensation due by awarding payment of medical expenses as well as a counsel fee. The Board had concluded that the claimant’s petition was not barred by the five-year statute of limitations.
The claimant had sustained a compensable injury to his lungs and respiratory system on August 1, 1999. Thereafter, he received compensation for total disability from February 22, 2000, until March 6, 2001. In addition, the claimant received payments for medical expenses. The last payment made for medical treatment was on April 26, 2002. In 2002, the parties resolved the claim by way of commutation, except for medical treatment, which was left open. However, there was then a seven-year hiatus during which no medical expenses were paid.
Beginning on August 13, 2009, and continuing to February 12, 2011, the employer paid medical expenses without objection, but then denied coverage for a medical bill submitted on October 18, 2011, and refused to pay any further medicals. This lead to the claimant filing the petition seeking payment for the medicals, and the evidence consisted of the testimony of the claimant as well as the claims adjuster. The evidence showed that between August 2009 and February 2011, the employer paid over $12,000 in medical expenses without objection, but that they were now contending this was done by mistake. The claimant’s evidence indicated that, in his discussions with the claims adjuster, there was no mention of any statute of limitations issue or problems with the medical bills.
The Board found in favor of the claimant, reasoning it was difficult to accept the employer’s position that the resumption of medical payments in August 2009, after the seven-year gap, was merely an error given the length of the payment period as well as the amount of medical expenses. The Board concluded that the payments were not made in error but, rather, were made under a feeling of compulsion and, thereby, tolled the statute of limitations.
The Superior Court affirmed the Board, finding that there was substantial evidence to support the Board’s determination that the medical expenses were made under a feeling of compulsion and, thereby, created an implied agreement to make those payments. Therefore, the court concluded that the employer remained liable for the claimant’s medical expenses.
Case Law Alert, 1st Quarter 2014