Who “Owns” the Medical Bills?

Group 152

Table of Contents

Minn. Stat. § 176.et seq. governs all workers’ compensation claims in the state of Minnesota. Workers’ compensation claims often involve complex legal issues relating to the language contained in the statute. The statute has undergone multiple revisions over the years in connection with its benefit scheme.


No provision, however, has weathered more revisions and modifications than the statute section applying to “intervenors”. Minn. Stat. § 176.361 governs the process and procedure by which health and disability insurers and medical providers intervene and engage in the workers’ compensation system.


The process and procedure by which treatment providers, who administer care to injured workers in Minnesota, has endured a complicated legal journey. For example, in 2013 the legislature amended Minn. Stat. Sec. 176.361 to require treatment providers who filed Motions to Intervene to attend hearings at which injured workers pursued their claims. Because medical providers would often file formal Motions but then not actually show up for the hearing, attorneys for injured workers often claimed that they also represented the medical provider secondary to the unpaid bills. The trial courts consistently allowed the cases to go forward. The WCCA, however, viewed these assertions of representation with skepticism and issued a decision compelling the lawyers for injured workers to document this dual representation. Fischer v. Indep. Sch. Dist. 625, 76 W.C.D. 889 (WCCA 2016)


While adding this requirement of “dual representation” to counsel for the injured worker the WCCA created the concept of bill “ownership”. The court found the treatment provider, not the injured worker, “owned” the bills. Fisher v. Indep. Sch. Dist. 625, 76 W.C.D. 8889 (W.C.C.A. 2016) Thus, the court determined that only the treatment provider could assert the claim for the unpaid bill and by failing to show up for the hearing, or the employee’s lawyer failing to establish “dual representation”, the provider waived their claim resulting in an automatic denial of the bill.


The legislature then amended the statute in 2017 to no longer require provider “attendance” at hearings unless so ordered by the trial judge. The courts have done their best to keep up with these multiple amendments and properly interpret the legislature’s intent.


The issue of dual representation, however, did not, unfortunately, go away. In Johnson vs. Concrete Treatments and Furniture and Things, Inc., this firm asserted a direct claim for bills from two medical providers who treated the injured employee but did not endeavor to intervene at all. The trial judge allowed the claim to proceed and awarded payment of the unpaid bills. The employers/insurer appealed that ruling.


Unfortunately, the WCCA appeared to have lost their way. In Johnson v. Furniture and Things and Concrete Treatments, Inc. (currently on appeal to the Supreme Court) the WCCA denied an injured employee’s ability to assert a claim for his own unpaid medical bills. The court opined that the providers’ failure to formally and timely intervene “extinguished” the providers’ interests and even the employee could not assert the unpaid bills on his own behalf unless his lawyer established dual representation for both the providers and the injured worker.


In a split decision, the WCCA ignored the plain language of the statute and reversed the trial judge and instead ruled on grounds that no dual representation was established, then the bills could not be addressed. They then extinguished the intervention interest. What made the decision baffling, to put it kindly, was a 2004 (WCCA) decision that seemed to make the issue of who could claim the medical bills simple. In Adams v. DSR Sales, Inc., 64 W.C.D. 396 (W.C.C.A. 2004) the employee made claims for unpaid bills from providers who did not motion to intervene. In Adams, the WCCA analogized the employee’s assertion of a medical bill claim to a claim for indemnity benefits and concluded the employee could assert the claim for their own bills. These same facts occurred in the Johnson matter, so case closed right? Right?


In the words of Lee Corso: “not so fast my friends.”


This office appealed the decision to the Supreme Court. We asserted that the WCCA erroneously decided the case on two grounds. First, Minn. Stat. § 176.361 subd 1 does not compel a treating provider to intervene. It provides them with the option to intervene or not. The specific wording of the statute uses the phrase “may intervene” thereby making intervention status a voluntary process. We argued the Adams case remains good law and to accept the WCCA position required the court to overturn the sound logic and proper legislative interpretation articulated in Adams. Secondly, we asserted the WCCA erroneously arrived at its conclusion because the two providers were not intervenors at all. Accordingly, to the extent the dual representation doctrine remained relevant, it would be inapplicable under the facts of the Johnson case.


The Supreme Court granted certiorari and an oral argument in the matter. That oral argument occurred on January 8, 2024. The court has taken the matter under advisement. We are hopeful that the Supreme Court will issue a clarifying decision to address whether the Adams case remains good law. It should. We are also hopeful the Court will eliminate the “dual representation” requirement for employees’ attorneys where the injured worker is seeking payment of injury-related treatment bills.


As a policy matter, this firm believes that analysis is flawed. Injured workers whose claims are denied, compelling them to seek legal representation and pursue unpaid bills, should unequivocally have the right to pursue payment for their own medical bills. The Adams Court acknowledged Adams, the assertion of an unpaid medical bill is no different than that same injured worker seeking payment of unpaid wage loss or permanent partial disability.


We are hopeful our arguments will compel the Supreme Court to eliminate the uncertainty surrounding this issue and simplify it not only for injured workers but for the lawyers who represent them, the employers who employ them and the insurance companies who insure those employers.