STATE OF WISCONSIN
LABOR AND INDUSTRY REVIEW COMMISSION
P O BOX 8126, MADISON, WI 53708-8126 (608/266-9850)
ARNOLD WIESENER, Applicant
C K CONSTRUCTION, Employer
WEST BEND MUTUAL INSURANCE COMPANY, Insurer
WORKER'S COMPENSATION DECISION
Claim No. 94050697
The employer submitted a petition for commission review alleging error in the administrative law judge's order dated February 13, 1997 and the applicant submitted an answer. The commission, pursuant to its authority under Wis. Stat. § 102.18(3), has carefully reviewed the entire record in this matter and after consultation with the administrative law judge concerning the demeanor and credibility of witnesses hereby sets aside the administrative law judge's order and remands the matter to the department for further testimony and evidence on the issue of whether the applicant received the bill from St. Joseph's Hospital in the amount of $4,546.18 prior to June 19, 1996.
Dated and mailed: October 22, 1997
wiesear.wpr : 175 : 3 ND § 10.5
Pamela I. Anderson, Chairman
David B. Falstad, Commissioner
The applicant contended in the proceedings before the administrative law judge that the compromise order dated June 25, 1996 should be set aside. The compromise order provided for payment to the applicant of $5,000 and in addition the insurer agreed to pay the sum of $7,441.51 to Marshfield Clinic and $681.64 to St. Joseph's Hospital. The evidence indicated that there was an additional bill from St. Joseph's Hospital in the amount of $4,546.18. The applicant contended at the hearing that he had never received the bill for $4,546.18 prior to the scheduled hearing on June 19, 1996 although he received several bills from St. Joseph's Hospital in the amount of $681.64. A compromise order provided that the applicant would be responsible to pay other medical expenses other than those enumerated in the agreement.
It appears that the bill from St. Joseph's Hospital in the amount of $4,546.18 was for surgery and related expenses on April 26 and April 27, 1995. It would seem reasonable to expect that the applicant was aware of the medical expenses associated with the surgery 14 months later at the time of the hearing. However the commission is unable to determine from the record presented whether the applicant received such bills or not prior to the date of hearing on June 19, 1996. Therefore the commission is remanding the matter to the department for further testimony and evidence of the bills which the applicant received from St. Joseph's Hospital related to his medical expense for his work-related injury prior to the date of hearing and the compromise agreement.
cc: ATTORNEY TONY WELHOUSE
WELHOUSE LAW OFFICE
ATTORNEY KATHLEEN E GRANT
GRANT & HOENISCH
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