Richey v. Perry Arnold, Inc.
Annotate this CaseClaimant injured his shoulder during his employment. Claimant and Employer agreed to settle the matter. Claimant subsequently underwent a surgery, which Employer failed to pre-authorize. Claimant then filed several motions, including a motion to reopen. An ALJ determined (1) the surgery was reasonable and necessary; (2) Employer must pay for the procedure and related expenses; (3) the parties' settlement precluded any claim for TTD benefits relative to the surgery; and (4) Employer's failure to pre-authorize or contest the surgery within thirty days did not warrant the imposition of sanctions. The workers' compensation board reversed with respect to future TTD benefits and affirmed otherwise. The court of appeals reversed with respect to future TTD and reinstated the ALJ's decision. The Supreme Court (1) affirmed the denial of a future TTD award, holding that the terms of the parties' agreement barred a future TTD claim; and (2) reversed with respect to the issue of sanctions, holding that the case must be remanded to the ALJ to reconsider the question of sanctions based on a correct understanding of Employer's obligations and any other considerations relevant to the reasonableness of its action under Ky. Rev. Stat. 342.310(1) and 803 Ky. Admin. Reg. 25:012, 2(1)(a).
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