More Fun With Final Admissions – An Admission Deemed “Invalid” Can Be Challenged At Any Time

Claimant does not have to object to a final admission of liability (FAL) lacking required documentation as an invalid FAL does not close a claim.

In Humphrey, claimant sought review of the Administrative Law Judge’s (ALJ) order denying his motion to strike the respondents’ FAL. Claimant submitted the motion to strike due to the FAL’s failure to have an attached medical report stating the claimant was at maximum medical improvement (MMI). The claimant argued that the report was necessary and its absence made the FAL invalid. Respondents opposed the motion to strike the FAL, arguing that claimant had waived any right he had to complain of defects in the FAL because the claimant did not raise them within the 30 day time period set forth by the Act within which to object to the FAL. The ALJ agreed with the Respondents argument and denied the motion to strike.

A Panel of the Industrial Claim Appeals Office set aside the ALJ’s order and remanded the matter for further findings. It found that a valid FAL was a “jurisdictional prerequisite to a claim’s closure,” and that an invalid FAL would prevent a claim from closing. It noted that FAL inadequacies may be raised at any time, and therefore claimant did not waive his right to file the motion to strike the FAL.

Claim Handling Tip: Strictly comply with W.C.R.P. 5-5 and include: 1) a completed physician’s report of workers’ compensation injury form (WC Form 164); 2) a narrative report; and 3) appropriate worksheets.

Humphrey v. Fed Ex Freight Inc., W.C. No. 4-911-782-001 (I.C.A.O. June 3, 2019)

Would you like to know more? Contact Gail Benson at gbenson@pollartmiller.com or 877-259-5693.

 

From the September 2019 Newsletter 

2019-10-02T12:04:48+00:00