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Jobe v. American Legion #79/18/2001
__ P.3d __
ON CERTIORARI TO THE COURT OF CIVIL APPEALS, DIV. III
Claimant brought this proceeding to review an order by a three-judge panel of the Workers' Compensation Court. That order adopted a trial judge's ruling which denied claimant's postsettlement quest for reimbursement of prescriptions. The Court of Civil Appeals sustained the panel's decision. On certiorari granted upon claimant's petition,
THE COURT OF CIVIL APPEALS' OPINION AND THE THREE-JUDGE PANEL'S ORDER ARE VACATED WITH DIRECTIONS TO THE PANEL THAT THE CLAIM BE REMANDED TO THE TRIAL JUDGE FOR A HEARING AND DISPOSITION THAT WOULD MEET THE MINIMUM STATUTORY STANDARDS FOR JUDICIAL REVIEW.
The dispositive question on certiorari is whether the Court of Civil Appeals erred in accepting as judicially reviewable the three-judge panel's adoption of the trial judge's order that denied prescription drugs' reimbursement without the critical ยง 26 findings of fact and conclusions of law. We answer in the affirmative.
I. THE ANATOMY OF LITIGATION
Jobe I
The claimant, Evelyn Serena Hamilton Jobe [Jobe or claimant], was adjudicated permanently partially disabled in 1987 from a back injury sustained while working for the employer, American Legion #7 [American Legion or employer]. On 10 December 1991, after the trial tribunal's award of temporary total disability benefits in 1988 and 1990, claimant was determined to have suffered a change of condition for the worse, resulting in increased permanent partial disability occasioned by the back injury, depression and psychological overlay.
Several medical providers filed Form 19 claims for services rendered to claimant during the period between 1992 and 1993. These were approved by the Workers' Compensation Court's 7 December 1993 order. Claimant also sought reimbursement for prescriptions she had bought in the amount of $749.93. The trial judge's 17 January 1995 order denied Jobe's reimbursement claim because (1) these medications were purchased after the 1991 PPD determination, (2) the 10 December 1991 order contained no provision for continuing medical maintenance, nor (3) had claimant, after the 1991 order, moved to reopen for a change of condition for the worse. The order was adopted by a three-judge review panel of the Workers' Compensation Court and the panel's decision sustained by the Court of Civil Appeals.
Jobe II
On 6 March 1996 claimant moved to reopen based on a changed condition for the worse. She sought authorization for medical treatment for a period from 28 April 1992 to the present. The employer's response denied that claimant's condition had changed. The report by an independent medical examiner, Dr. H., who was appointed to determine if she had suffered a change of condition for the worse, stated that no change had occurred.
Claimant's reopening motion was pending when the parties settled the case by joint petition dated 29 July 1997. According to the terms of their agreement, the claimant received $10,000, which was to be "in addition to the authorized, reasonable and necessary medical . . . expenses heretofore incurred by claimant by reason of said accidental personal injury ." (emphasis added).
On 5 September 1997 claimant filed a Form 13 (titled Request for Rehearing Conference) for reimbursement of prescription expense ($4,283.06). The claimed prescriptions were purchased during the period between 21 December 1993 and 25 July 1997.
The Trial Judge's First Denial of Claimant's Postsettlement Request
The trial judge summarily denied claimant's request for reimbursement of prescriptions
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