Comp Clues


Permanent Partial Impairment

Date: 01/01/2002

The Indiana Court of Appeals has clarified a 22 year old decision that significantly limits the statute of limitations for reopening a worker’s compensation claim for additional medical benefits in situations where a permanent partial impairment (PPI) settlement has been made.

In Halteman Swim Club v. Duguid, No. 93A2-0106-EX-381 (Ind. Ct. App. 2001), the Court of Appeals reversed a decision of the Full Worker’s Compensation Board by holding that claims for post-PPI medical treatments must be filed within one year from the last date for which compensation is paid.

The Court cited to its decision in Gregg v. Sun Oil Co., 180 Ind. App. 379, 388 N.E.2d 588 (Ind. Ct. App. 1979) that “[a]pplications for the modification of an award of medical expenses must be filed within the latter one year statute of limitations, for that is the period of review incorporated by reference into the provisions of I.C. §22-3-3-4.”  Gregg at 590.  The Court in Duguid reiterated that the Board has continuing jurisdiction to award medical expenses beyond the statutory periods set out in I.C. §22-3-3-27, “so long as an application for such benefits ‘is filed within one year from the last day on which compensation was paid, whether under the original award or a previous modification.’”  Halteman Swim Club quoting Gregg at 590.

Plaintiff Duguid injured her left knee on June 29, 1996.  Temporary total disability (TTD) benefits were last paid for the period ending January 1, 1998.  Duguid settled her claim on April 23, 1998 on the basis of a 17% PPI of the leg in an amount totaling $3,825.00.  On October 18, 1999 she filed an Application for Adjustment of Claim alleging the need for additional medical treatment related to her June 1996 leg injury.  Under the two-year statute of limitations, her deadline for filing the Application would have been January 1, 2000.

The decision does not state how the one-year statute of limitations was determined.  Not included in the decision is that the PPI award divided by Duguid’s TTD rate calculates to just under 35 weeks.  If the 35 weeks were counted from the date of injury, the last date for which compensation was paid under the PPI settlement was March 2, 1997.  However, TTD benefits were paid beyond that date.  If the 35 weeks were added to the last date of TTD payments (January 1, 1998), the last date for which compensation was paid under the PPI settlement would be September 3, 1998.  Apparently, one of these two methods was used to determine the one-year statute of limitations because counting the 35 weeks from the actual date of the PPI settlement would make the last date of compensation December 24, 1998.  Calculating a one-year statute of imitations from the date of settlement would have made Plaintiff’s filing timely, but would have been contrary to the accepted method of calculating the period for which compensation is paid under a PPI award from the end of the TTD period or from the date of injury.  Accordingly, Duguid’s last date to file her Application under the one-year statute of limitations was September 3, 1999.

The Worker’s Compensation Board has long allowed claims for additional medical services to be filed under the two-year statute of limitations applying to claims for any additional disability benefits.  The general perception is that a need for additional medical services implies an associated disability and vice versa.  However, the Court rejected Plaintiff Duguid’s argument that her Application was not for PPI,
but for medical expenses.  The Court held that “[t]his is a distinction without a
difference, . . . as Gregg specifically applied its holding to medical expenses as well as to PPI.”  The decision also notes the Court’s reaffirmation of Gregg in Berry v. Anaconda Corp., 534 N.E.2d 250 (Ind. Ct. App. 1989).

Interestingly, the Court reinforced its opinion by references to the doctrines of stare decisis and legislative acquiescence.  The Court cited Lincoln Utilities, Inc. v. Office of Utility Consumer Counselor, 661 N.E.2d 562 (Ind. Ct. App. 1996) for the proposition that previous decisions of the Court must be followed when construing a statute unless it is provided with a strong reason justifying departure.  The Court found no such reason to deviate from the Gregg interpretation.

Under the concept of legislative acquiescence, the Court noted that the General Assembly has modified I.C. §22-3-3-4 and 27 on several occasions since Gregg was decided and has not taken action to correct the Court’s interpretation.  The decision refers to the Court’s holding in Department of Revenue v. U.S. Steel Corp., 425 N.E.2d 659 (Ind. Ct. App. 1981) that “[w]hen the court interprets a statute and the legislature fails to take action to change that interpretation, the legislature is presumed to have acquiesced in the court’s interpretation.”

The Court’s citation to these two doctrines of jurisprudence may be understood as a statement by the Court that, simply put, “we assume this interpretation is correct unless you tell us otherwise.”  This action deflects any criticism of the holding to the General Assembly and properly asks that body to make any desired change to the law.

There has long been discussion of enacting a uniform statute of limitations applicable to all claims.  This decision is likely to renew such debate because many claims for additional medical services will now be foreclosed under the one-year statute of limitations.  In the short term, this will be beneficial to employers.  However, the backlash is likely to be an increased practice of filing Applications for Adjustment of Claim before the ink is dry on PPI settlements.  Claimants will do so to beat the statute of limitations and thus greatly add to the Board’s docket.  As the Court of Appeals apparently recognized, this will eventually become a legislative question.