YC&L Attorneys Benjamin L. Costello & Kelly J. Dollins recently obtained a Decision and Order from a Workers’ Compensation Judge (WCJ) awarding payment of medical bills, penalties and a substantial attorney fee for a Claimant whose physical therapy bills were being unreasonably denied by Selective Insurance Company. The case involved a Claimant who received physical therapy services from The Physical Therapy Institute (PTI) for his work related injury. The workers’ compensation carrier, Selective Insurance Company of America, failed and refused to pay for this medical treatment alleging that PTI was not the provider of the therapy services at issue.
YC&L filed penalty and review petitions on behalf of the Claimant alleging that Selective Insurance had violated the Workers’ Compensation Act in refusing to pay the medical bills for the physical therapy rendered by PTI. After several years of litigation, the WCJ sweepingly concluded that PTI was the provider of the physical therapy services, that PTI had entered into a joint venture with a Part B physical therapy provider, that the arrangement was valid, and that PTI was entitled to be paid for the services rendered. In addition to ordering Selective Insurance to pay the outstanding medical bills with interest (totaling in excess of $9,000), the WCJ also ordered Selective Insurance to pay the Claimant the maximum available penalty of 50% of the unpaid bills for their violation of the Workers’ Compensation Act, and ordered Selective Insurance to pay $83,400.00 in unreasonable contest attorney fees to YC&L for the time expended to represent the Claimant in this case.