Provision shielding director's decision from appeal is invalid
Jou v. Ching, et al., Nos. 27491 and 27539 (Hawaii Ct. App. 01/26/09).
The Hawaii Intermediate Court of Appeals held that a doctor could appeal a decision by the workers' compensation director on a medical billing dispute.
What it means:
According to Hawaiian law, a provision that states no party can appeal the decision of a workers' compensation director on the issue of medical billing disputes is invalid.
The director of workers' compensation ordered an insurance carrier and an insurance adjuster to reimburse a workers' compensation physiatrist for his the services, but not for the late fees. Although the doctor wished to appeal the ruling on the late fees, a provision of Hawaii's workers' compensation law states that the "decision of the director is final and not appealable." The doctor argued the provision was invalid and unconstitutional because it conflicts with other provisions of the law that specifically give parties the right to appeal an adverse decision by the director.
The Hawaii Intermediate Court of Appeals determined that the "no-appeal" provision directly conflicted with the ordinary meaning of the other statutory provisions granting a party the right to appeal. The court further reasoned that Hawaiian law gives the director the authority to issue his opinion in a medical fee dispute in a "summary manner" but does not give the director the ability to insulate his own decisions from appeal.
The Court of Appeals directed the Circuit Court to enter judgment to declare the no-appeal provision invalid but remanded on the other issues presented in the fee dispute.
March 23, 2009
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