September 5, 2014
The injured worker KG was employed by JDB Construction as a trade carpenter, working construction framing houses. On December 6, 2006, he slipped and fell into a ditch and herniated two (2) discs. The workers’ compensation insurance carrier is the State Workers’ Insurance Fund (SWIF), who accepted liability for this work injury. The injured worker KG underwent back surgery in 2007, along with back and hip injections. His treating physicians are Dr. Robert Boyer, a chiropractor in Chambersburg, PA, and Dr. Curtis Goltz, an orthopedic surgeon in Harrisburg, PA The injured worker KG has been treating with Dr. Boyer for many years.
On November 17, 2011, The injured worker KG settled his wage loss benefits for a fair and reasonable lump sum wherein Defendant SWIF remained responsible for payment of ongoing, work-related medical treatment for the rest of KG’s life. On September 11, 2012, a Utilization Review Determination found Dr. Boyer’s chiropractic treatment to be reasonable and necessary. It was not appealed. Workers’ comp still refused to pay the medical bills.
We filed a Penalty Petition for Defendant SWIF’s failure to pay Dr. Boyer’s medical bills since March 2013. The injured worker KG and Dr. Boyer testified, and the Judge found their testimony credible. The injured worker KG testified that Dr. Boyer has been providing chiropractic treatment for several years and that the treatment helps with stiffness and enables him to do things. Dr. Boyer testified that he has been providing chiropractic treatment for several years to maintain back function and that Defendant SWIF had been paying the medical bills.
The judge granted The injured worker’s KG”s Penalty Petition. The Judge found that Defendant SWIF unilaterally stopped paying the injured worker’s medical bills. The Judge ordered Defendant SWIF to pay all of the medical bills plus fifty (50%) percent penalties to the injured worker KG totaling $1,729.00, unreasonable contest attorney fees of $2,801.25, and costs of litigation of $850.10.
