Appellate court reversed in part and affirmed in part. Court awarded an additional $2,000 penalty for failure to properly authorize physical therapy by the original treating physician, but upheld the WCJ's denial of a second separate penalty for Dr. Gunderson's treatments and denied TTD benefits for the earlier period.
Foy v. Amerisafe Risk Services, Inc. - What Workers Need to Know
This case involved a worker named Foy who had a dispute with their employer's workers' compensation insurance company over medical treatment authorization and temporary disability benefits. Foy argued that the insurance company failed to properly approve necessary medical care and should have paid for time off work due to their injury.
The appellate court reached a mixed decision. The court sided with Foy on one issue, ordering the insurance company to pay an additional $2,000 penalty for failing to properly authorize physical therapy treatments from the original doctor. However, the court upheld the earlier judge's decision to deny a separate penalty for treatments from another doctor (Dr. Gunderson) and refused to award temporary disability benefits for an earlier time period.
Why This Matters for Workers:
This ruling shows that workers' compensation insurance companies can face financial penalties when they improperly deny or delay medical treatment authorizations. Workers have the right to receive approved medical care promptly. However, the case also demonstrates that winning every aspect of a workers' compensation dispute can be challenging. If you're having trouble getting medical treatment approved through workers' comp, document everything and consider seeking help from an attorney who specializes in workers' compensation cases.
This summary was generated to explain the ruling in plain English and is not legal advice.
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