Neel v. Western Construction, Inc., 147 Idaho 146

Summary

The Idaho Supreme Court considered whether a workers' compensation surety that initially denied a claim could review the claimant's medical bills for reasonableness after the claim was later determined compensable. The court held that bills incurred before compensability was determined had to be paid in full, while bills incurred thereafter could be reviewed under the workers' compensation regulations. The court remanded for findings regarding the timing of the bills, vacated the attorney-fee award, and declined to award appellate fees.

Holdings

1. A surety that initially denies a claim later determined compensable may not review for reasonableness medical bills incurred from the accident through the date the claim is deemed compensable. The surety may review for reasonableness bills incurred on and after the date the claim is deemed compensable, in accordance with the workers' compensation regulatory scheme.
2. The attorney-fee award was improper because the surety's position on the reasonableness review issue was not unreasonable when the issue was one of first impression.

Questions Presented

1. Whether a workers' compensation surety that initially denied a claim later determined compensable may review the claimant's medical bills for reasonableness under the workers' compensation regulations.
2. Whether the Industrial Commission properly awarded attorney fees to the claimant based on the surety's refusal to pay the full invoiced amount.

Disposition

reversed_and_remanded