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Employer scores 2nd chance to avoid liability for medical bills

Case name:Appeal of SAU # 35 White Mountain School District, No. 2007-657 (N.H. 09/12/08).

What it means: New Hampshire's workers' compensation law requires an employer or its insurance carrier to pay for an injured employee's reasonable medical services for "such a period as the nature of the injury may require." When it is unclear whether the treatment an employee received was reasonable and medically necessary, it is appropriate to return the case to the board so that it may make such a determination.

Summary: While attending a school board meeting, the employer's business administrator engaged in a "prolonged and heated discussion" with a board member. The administrator suffered a mini stroke and was taken to the hospital. He returned to work six months later but continued to receive treatment for his condition. He was awarded temporary total disability benefits for a six-month period, and the insurer was ordered to pay for his medical treatment.

After he returned to work, the administrator forwarded his medical bills to the insurer, but it refused to pay them. A hearing officer determined that the disputed medical bills were compensable and ordered the insurer to pay them. The board upheld the hearing officer's decision without addressing whether the medical treatment was reasonable and required by the nature of the injury. The Supreme Court returned the case to the board to make this determination.

The court noted that although the parties urged it to determine on appeal whether the employee's medical treatment was compensable under New Hampshire law, it declined to do so because "it is not our role at this stage of the proceedings." Instead, it directed the board to determine whether the medical bills at issue were the result of "treatment that was both reasonable and required by the nature of [the employee's] work injury."

November 5, 2008

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