In the recent Kentucky Court of Appeals decision of Max and Erma’s v. Lane, designated to be published, employer Max and Erma’s received somewhat of a chiding by the Court for “misinterpreting” and “confusing” the law.
The facts were relatively straightforward. At the ALJ level below, claimant established her entitlement to benefits based on a functional impairment rating of 2%, and was awarded permanent partial disability benefits for 425 weeks based on that rating. However, with regard to past and future medical expenses, the ALJ found that claimant’s need for medical care was temporary and terminated medical benefits as of the date impairment was assessed. Claimant appealed and the Board reversed the ALJ, holding that future medical benefits are mandated per KRS 342.020(1) when there is a finding of a permanent impairment rating per the AMA Guides.
From that decision, Max and Erma’s appealed to the Court of Appeals, raising as the sole issue whether the Board erred in reversing the ALJ’s ruling regarding Lane’s eligibility for future medical benefits.
The court cited to KRS 342.020(1), FEI Installation, Inc. v. Williams, 214 S.W.3d 313 (Ky. 2007), and National Pizza Co. v. Curry, 802 S.W.2d 949 (Ky. App. 1991) for the proposition that an employer can be found responsible for reasonable and necessary medical treatment even in the absence of permanent impairment or curative effect.
It then noted that because a permanent impairment rating was assessed against Lane’s condition, KRS 342.020(1) “obligated Max & Erma’s to pay for any reasonable and necessary medical treatment for the cure and relief of Lane’s disability.”
The Court specifically noted that while Lane’s impairment was permanent, “so too is Max & Erma’s duty to pay for medical treatment…” As such, the court affirmed the Board’s reversal of the ALJ below.
The Court chided Max & Erma’s for attempting to rely on Mullins v. Mike Catron Construction/Catron Interior Systems, Inc., 237 S.W.3d 561 (Ky. App. 2007) for the proposition that an employer required to pay permanent income benefits should not in all circumstances be obliged for future medical benefits. The Court explained to Max & Erma’s that its reliance on Mullins was incorrect and distinguished Mullins noting that in the case before them a permanent disability award had been rendered making future medical benefits mandatory, not permissive as with Mullins. The court also cited to the Supreme Court case of FEI Installation, Inc. v. Williams, 214 S.W.3d 313 (Ky. 2007) which the Court of Appeals relied on for its holding in Mullins.
The Court took additional issue with Max & Erma’s second argument that Lane was not entitled to future medical benefits because the ALJ made no finding that future treatment would be “reasonably required.” To this argument, the Court noted
Max & Erma’s favors this Court with no authority directly supporting this proposition . . . [and] in so arguing . . . necessarily confuses one distinct type of proceeding with another: a proceeding to grant an award of future medical benefits, versus a proceeding to reopen an existing award of medical benefits on the grounds of a medical fee dispute.
Thus, finding no error in the Board’s reversal of the ALJ, the Court affirmed the Board’s opinion. All judges concurred.
Note: All cases cited above can be found at http://courts.ky.gov/