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Arcticshield V Pye

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Tom Leonard
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79 views

Arcticshield V Pye

Uploaded by

Tom Leonard
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
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FILED MAY 23 2007 NOT FOR OFFICIAL PUBLICATION CoMPENS NaS COURT IN THE COURT OF CIVIL APPEALS OF THE STATE OF OKLAHOMA DIVISION IV FILED COURT OF CIV) ST, IL APPEA, ARTICSHIELD, INC., and HANOVER ) ATE OF OKLAHOMALS INSURANCE COMPANY, ) MAY 2 2 ang7 ) Petitioners, ) MICHAEL S. RICHE ) W.c.c.# 2006-5415K ERK vs. ) Case No. 103,941 ) JAMES DAVID PYE and THE ) WORKERS’ COMPENSATION ) court, ) ) Respondents. ) ORIGINAL PROCEEDING FROM AN ORDER OF THE WORKERS’ COMPENSATION COURT HONORABLE ELLEN C, EDWARDS, TRIAL JUDGE VACATED AND REMANDED WITH DIRECTIONS Tracy Pierce Nester James B. Cassody MCGIVERN, GILLIARD & CURTHOYS Tulsa, Oklahoma For Petitioners Bret A. Unterschuetz ARTHUR H. ADAMS, P.C. Tulsa, Oklahoma For Respondent OPINION BY DOUG GABBARD II, PRESIDING JUDGE: Petitioners, Articshield, Inc., (Employer) and Hanover Insurance Company, seek review of the workers’ compensation court’s order awarding additional benefits to Respondent, James David Pye (Claimant), for what the court termed an “unreasonable delay in providing benefits.” We vacate the order and remand with directions. FACTS Claimant filed a Form 3 on May 10, 2006, asserting he injured his back while lifting boxes and stacking pallets for Employer on May 1, 2006. Claimant sought temporary total disability (TTD) benefits. Employer denied Claimant had sustained 2 compensable injury, and did not provide medical treatment. At trial, conflicting evidence was given about whether the injury occurred. Claimant testified he gave notice of the injury to Employer’s managing director. The managing director testified Claimant did not specifically mention the incident and had complained of a sore back since the start of his employment the previous year. The managing director testified he found a doctor for Claimant “out of friendship” and assumed health insurance would pay for treatment. Employer did not pay for the doctor. Claimant became dissatisfied with treatment and found another doctor. Employer again asserted no injury occurred, but alternatively argued that, if Claimant had been injured, he would be limited to eight weeks of TTD under 85 0.8. Supp. 2006 § 22(3)(d)’s “Soft Tissue Injury” provision. Claimant asserted the limitation did not apply because (1) “this is already beyond a soft-tissue injury,” and (2) Employer had denied the claim from the beginning, and “the delay is no fault of [claimants], he’s entitled to TTD.” The trial court also raised the possibility at trial that Employer might be liable for additional TTD benefits “on the issue of unreasonable delay.” In an order dated September 26, 2006 (later corrected by nunc pro tunc order), the trial court found that Claimant had sustained an accidental personal injury arising out of and in the course of employment. The court awarded TTD benefits as follows: 3 THAT as a result of said injury, claimant was temporarily totally disabled from MAY 9, 2006 to SEPTEMBER 26, 2006 (LESS 3 DAYS) in the total amount of $9,214.54. Compensation shall continue at the rate of $471.15 from the date of this order for not more than 8 weeks (FOR A TOTAL OF $14,134.50 due to claimant). Temporary total disability benefits in excess of 8 weeks is ordered due to respondent's unreasonable delay in providing benefits. The court understands and fully believes that a respondent has the right and duty to deny a claim if the facts so warrant. However, under the latest statutory scheme governing workers’ compensation in Oklahoma, an employer needs to immediately offer medical care once it learns of an injury, admitted, alleged, or otherwise, Failure of a respondent to offer medical treatment sends a claimant with a smart attorney directly to the medical care provider of claimant's choice, to act as the treating physician, who by

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