Fort James Holding Company, Inc., d/b/a Georgia Pacific v. Cheryl D. Morgan:

On August 28, 2009, the Alabama Court of Civil Appeals released this opinion wherein it reversed the trial court. After a trial regarding workers’ compensation benefits, the judge entered an Order in favor of the employee for permanent and total benefits. The judgment contained detailed findings of fact and conclusions of law, however, the judge did not specifically address the issue of payment responsibility for past medical treatment from unauthorized physicians.

On review, the Court of Civil Appeals determined that the trial court’s Order did not comply with Alabama Code 1975, § 25-5-88 because it did not contain findings of fact or conclusions of law regarding all issues presented at trial. The Court found that, among other issues, the trial court was presented with the issue of which party should be responsible for medical expenses incurred by the employee for treatment obtained from unauthorized physicians. The Court further determined that the trial court failed to address that issue. As such, the Court reversed and remanded the case back to the trial court with instructions that the judge consider the facts and enter an Order that addresses the unauthorized medical treatment issue.

Joseph Grace v. Standard Furniture Manufacturing Company, Inc.:

On August 28, 2009, the Alabama Court of Civil Appeals released this opinion wherein it reversed the trial court. After a trial on the merits, the trial court ruled in favor of the defendant employer and entered the following judgment:

This matter having come before this Court for trial on September 29, 2008 [,] and the Court having heard the testimony finds, based on the evidence presented, in favor of [employer].

Effective January 12, 2009, the Workers’ Compensation Division of the Alabama Department of Industrial Relations amended Administrative Code § 480-5-5-.36. This section sets time limits associated with an employee filing incurred expense claims. Employers must pay reasonable charges for an employee’s necessary board, lodging, and travel, if vocational rehabilitation requires residence at or near a facility away from the employee’s customary residence. Employers must also pay mileage costs to and from medical and rehabilitation providers. However, the employee’s incurred expense claims are limited in some respects.

All mileage submissions are subject to verification. An employee may not claim mileage to a medical provider or rehabilitation site that is incurred in travel between the claimant’s work location and normal residence. Additionally, mileage to drop off a prescription and return mileage to pickup a prescription shall not both be reimbursable. Only one round trip is reimbursable. Lastly, an employee may not file a claim for reimbursement for over the counter medications (i.e., Advil, Tylenol, etc.) that may also be used by an employee’s family members. The employee has one year from the date of a valid incurred expense to file the claim with the employer/agent.

Of great importance, an employer must notify an injured employee in writing that he is entitled to reimbursement for expenses as outlined in Alabama Code § 25-5-77 (c) and (f). The written notice must be sent within two weeks of acceptance of the claim as a compensable work-related injury. Otherwise, the employer may waive its right to challenge the employee's expense claims.

In order to comply with the notification requirement, you should send all claimants (even med only) a copy of Administrative Code § 480-5-5-.36 immediately upon acceptance of the workers’ compensation claim. You should send it via certified mail, via e-mail with a "read receipt", or have the claimant sign an acknowledgment of receipt. You can access Administrative Code § 480-5-5-.36 at the following link:  http://dir.alabama.gov/docs/law/wc_480-5-5-.36.pdf.