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Roberts v. University of Iowa Hospitals and Clinics3/18/2003
__ P.3d __
CERTIORARI TO THE COURT OF CIVIL APPEALS, DIVISION III
CERTIORARI PREVIOUSLY GRANTED; OPINION OF COURT OF CIVIL APPEALS VACATED; ORDER OF WORKERS' COMPENSATION COURT VACATED; CAUSE REMANDED TO WORKERS' COMPENSATION COURT FOR PROCEEDINGS CONSISTENT WITH THIS OPINION.
In this matter, the Court of Civil Appeals reviewed a Workers' Compensation Court order directing payment for medical services provided to an injured employee. This Court holds that the medical provider's Form 19 request for medical payment was not barred by the statute of limitations and that on remand the Workers' Compensation Court must provide the basis for its decision concerning the amount of allowed charges.
Cole Jungers (Claimant) sustained a work related injury in 1989 while working for Rusty Roberts (Employer). In June, 1992, the Workers' Compensation Court determined that Claimant was permanently partially disabled as a result of injuries to his head, neck, shoulders, lower back, and right foot. A December, 1993, order found that Claimant had sustained a change of condition for the worse and authorized medical treatment. It expressly reserved the issue of alleged bladder and bowel dysfunction for future hearing. Another change of condition for the worse was adjudicated in July, 1996. That order was silent as to any bladder or bowel dysfunction. In February, 1998, Claimant and Employer entered a Joint Petition settlement, approved by the Workers' Compensation Court, covering claims for injury to Claimant's " ead, left shoulder, neck, back, right foot, body as a whole, including all injuries known and unknown."
The medical provider, University of Iowa Hospital and Clinics (Hospital), filed its Form 19 request for payment of medical charges on December 7, 1998. The request covered $22,348.03 in charges from February 18, 1994, to the date of filing with $1,235.48 having been paid. Employer opposed the request asserting the statute of limitations and also asserting that the Workers' Compensation Court Administrator's Schedule of Medical and Hospital Fees (Fee Schedule) should be applied to reduce the unpaid charges.
The Workers' Compensation Court rejected Employer's statute of limitations defense and ordered payment of "$21,112.55 as full, final and complete payment per the Oklahoma Medical Fee Schedule." A three judge panel affirmed the order. The Court of Civil Appeals vacated and remanded holding that a portion of the requested payment was barred by the statute of limitations. It required the trial tribunal, on remand, to make specific findings concerning its apparent refusal to follow the Fee Schedule. This Court granted certiorari review.
I. STATUTE OF LIMITATIONS
Statute of limitations issues in Workers' Compensation ordinarily are mixed questions of fact and law. Sneed v. McDonnell Douglas, 1999 OK 84, 991 P.2d 1001, 1004; Munsingwesr, Inc. v. Tullis. 557 P.2d 899. (Okla 1976). "Even though the trial court's factual determinations relative to the statutory time bar, if supported by any competent evidence, will not be independently reviewed," if application of the time bar is a mere conclusion of law, it is subject to de novo review by this Court. Sneed, 991 P.2d at 1004 (footnotes omitted). See also Tullis, 557 P.2d at 902.
The three year limitations period provided in Title 12, section 95(2) , of the Oklahoma Statutes applies to a medical provider's Form 19 claim for payment. Fortenbacher v. Guardsmark, Inc., 867 P.2d 487, 489 (Okla. Ct. Civ. App. 1993). The limitations period does not begin to run until all elements are present to pursue a request for payment to a successful conclusion. Chumley
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