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Boise Cascade Corp. v. Huizar12/20/1994
edging responsibility for Mr. Huizar's treatment if the challenge was unsuccessful.
On March 10, L&I;set aside its December 18th order and reopened Mr. Huizar's claim for authorized treatment and benefits effective January 1, 1986.
On April 29, 1987, the Board granted Boise Cascade's appeal and directed further proceedings. At those proceedings, the parties agreed the spinal fusion was a nonemergent or elective surgery and Dr. Orvald had not obtained authority from either Boise Cascade or L&I;prior to performing it.
An industrial appeals judge (IAJ) subsequently entered a proposed decision and order finding that Mr. Huizar's injury , related to the industrial injury, had become aggravated between April 18, 1984 and March 10, 1987, and concluding he was in need of further treatment. The IAJ concluded L&I;s March 10, 1987 order reopening his claim should be affirmed. Boise Cascade's petition for review was denied. The Board adopted the proposed decision and order. Boise Cascade appealed to Superior Court.
On July 7, 1989, the Superior Court affirmed the Board's March 28, 1988 order. The matter was remanded to L&I;with directions to reopen the claim. Boise Cascade was directed to pay time loss compensation and permanent partial disability adjusted for prior awards. The claim was to be closed without any farther award of benefits.
On August 2, 1989, Boise Cascade received Dr. Orvald's billing for Mr. Huizar's surgery. Boise Cascade refused to pay on the grounds the surgery was unauthorized and it was the first time it received any billing. Dr. Orvald's office responded with a letter stating his office received a letter from Boise Cascade in January 1987, indicating it was appealing L&I;s decision to close Mr. Huizar's claim and if unsuccessful, it would be responsible for medical costs. The letter also stated a billing had been sent to Boise Cascade in January 1987. Boise Cascade denied received any billing in January. However, both agreed a billing was not sent within 90 days of the surgery.
On September 29, 1989, L&I;directed Boise Cascade to deny payment for Mr. Huizar's surgery because of lack of prior authorization, WAC 296-20-03001(2), and because the billing was not received within 90 days of the surgery, WAC 296-20-125(5). Dr. Orvald protested and requested reconsideration. L&I;reconsidered, reversed its decision, and directed Boise Cascade to pay the surgery charges. Boise Cascade appealed to the Board. The Board affirmed the L&I;order.
The Board's decision was appealed to Superior Court by Boise Cascade, and was consolidated for hearing with the appeal of Dewayne L. Wentz.
Dewayne L. Wentz Claim
On July 9, 1987, Mr. Wentz injured his cervical spine during the course of employment with Boise Cascade. Prior to the industrial injury , Mr. Wentz suffered from degenerative disc disease in his cervical spine, although at the time of the injury, the disease was asymptomatic. Mr. Wentz submitted a written accident report to his employer on March 5, 1988, and Boise Cascade authorized treatment only for the injury on March 8, 1988.
On August 3, 1988, Mr. Wentz was seen by neurosurgeon, Leslie Bornfleth. Dr. Bornfleth reported that the apraxia and clumsiness he observed in Mr. Wentz appeared to be something in the spinal cord and not due to a specific nerve root syndrome. He indicated he would review his cervical spine films and order an MRI. He did not recommend surgery.
On August 17, 1988, Mr. Wentz was involved in an automobile collision involving a horse. As a result, he sustained a low back injury .
Mr. W
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