Article ID: d66ddfac4c01b34dac5c5a69476ba19965d8b858daec70bdee0b7b8446858f1b
Source ID: secondary:businessinsurance.com
Published At: -
Extraction Method: bs4_heuristic
URL: https://www.businessinsurance.com/appeals-board-says-comp-fee-schedule-applies-to-unauthorized-care/
Body Text
Appeals board says comp fee schedule applies to unauthorized care - Business Insurance Skip to content Register for free Search Search Log In Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Risk Management Cyber Risks Pricing Trends Mergers & Acquisitions Technology Sponsored Content WSIA RISKWORLD Workers Comp & Safety Workers Comp Cost Control Pain Management Workplace Safety International EMEA Asia-Pacific Latin America People Events BI Intelligence Top 100 Agents & Brokers Best Places to Work 2025 Lists Directories Insurance Pricing BI Stock Index Magazine Current Issue Past Issues Subscribe Women to Watch ALL INsurance Resources Risk Perspectives Sponsored Content Webinars White Papers Appeals board says comp fee schedule applies to unauthorized care by Gavin Souter Workers Comp Coverage Aug 10, 2026 An employer ordered to pay for previously denied medical treatment is not required to pay more than the amounts allowed under the state’s workers compensation medical fee schedule, the Tennessee Workers’ Compensation Appeals Board ruled in a published opinion Friday. In Hands v. Fresenius Medical Care Holdings Inc. , the board affirmed a trial court ruling that required Fresenius to pay under the fee schedule for unauthorized back treatment received by Derrick Hands, who injured his lower back and right knee after falling through rotted wood while making a delivery in 2018. Fresenius accepted the knee injury but denied the recommended back surgery after two doctors concluded that the need for surgery was primarily related to a pre-existing condition. Mr. Hands nevertheless underwent surgery and additional treatment. A workers comp judge later found the accident had permanently worsened Mr. Hands’ pre-existing back condition and awarded permanent partial disability and future medical benefits. Mr. Hands sought payment for unauthorized back-treatment bills that he said totaled $562,783.85. His attorney said at trial that his wife’s health insurance had paid the medical bills. The judge limited Fresenius’ payment to the workers comp fee schedule. Mr. Hands argued on appeal that because Fresenius had denied the treatment, it should be responsible for the full cost, contending that otherwise he could be left responsible for unpaid balances. The appeals board disagreed, noting there was no evidence that any medical provider was seeking or intended to seek payment from Mr. Hands for unpaid bills. It found his concern that he could be held responsible for amounts above the fee schedule was speculative. “We have found no statute or regulation that suggests payment of medical bills differs depending on whether the treatment was authorized or unauthorized,” the board said. Any change to the fee schedule requirement “is for the legislature, not the courts, to address.” Related News MMA acquires Iowa-based broker August 10, 2026 Judge splits coverage ruling in murdered employee’s case August 10, 2026 Federal judge tosses coverage suit over ex-coach’s data breach August 10, 2026 Oakbridge buys Tennessee agency August 10, 2026 Oman says grounded tanker oil spill covers 150 square miles August 10, 2026 Munich Re’s first-half profit jumps 23% August 10, 2026 Hormuz fee plan faces insurance restrictions August 10, 2026 Allianz records net income grows 15% August 10, 2026 Swiss Re to insure multinational companies in India, Mexico August 10, 2026 Facebook-f X-twitter Linkedin-in Business Insurance is a singular, authoritative news and information source for executives focused upon risk management, risk transfer and risk financing. Never miss important news: Become a Business Insurance Online subscriber today Subscribe Now Information About Us Contact Advertise Privacy Policy Terms & Conditions Copyright 2026. BUSINESS INSURANCE HOLDINGS Member, Beacon International Group, Ltd.
Metadata (JSON)
{
"score": 13.033333333333333
}