Opinion
No. 1627 C.D. 2014
05-15-2015
State Workers' Insurance Fund, Petitioner v. Bureau of Workers' Compensation Fee Review Hearing Office (O'Brien, D.O.), Respondent
BEFORE: HONORABLE DAN PELLEGRINI, President Judge HONORABLE ROBERT SIMPSON, Judge HONORABLE ROCHELLE S. FRIEDMAN, Senior Judge
OPINION NOT REPORTED
MEMORANDUM OPINION BY SENIOR JUDGE FRIEDMAN
The State Workers' Insurance Fund (SWIF) petitions for review of that portion of the Bureau of Workers' Compensation Fee Review Hearing Office's (hearing officer) August 14, 2014, decision that ordered SWIF to pay William O'Brien, D.O. for treatment rendered to David Stone (Claimant) on November 12, 2013, November 26, 2013, and December 18, 2013. We vacate and remand.
The hearing officer consolidated three medical fee reviews, which he identified as MF-439041, MF-439500, and MF-440109, and held hearings regarding treatment provided by Dr. O'Brien to Claimant and Charles Riley. (Findings of Fact, No. 1.) The hearing officer's decision as to MF-439041 and MF-439500, regarding treatment provided by Dr. O'Brien to Riley, is not at issue here. SWIF only appeals the hearing officer's decision as to MF-440109.
In its petition for review, SWIF argues that MF-440109 is a medical fee review for services provided to Claimant by Christopher Belletieri, not by Dr. O'Brien. MF-440109, which is not part of the record before this court, states that Belletieri provided treatment to Claimant from April 24, 2013, to May 10, 2013. We note that MF-449096, which is part of the record before this court, is a medical fee review that lists Dr. O'Brien as the healthcare professional and lists the dates of service as November 12, 2013, to December 18, 2013. (R., Item No. 25.)
Our scope of review is limited to determining whether constitutional rights were violated, whether an error of law was committed, or whether the necessary findings of fact were unsupported by substantial evidence. Section 704 of the Administrative Agency Law, 2 Pa. C.S. §704.
Although medical fee review MF-440109 is not part of the original record, SWIF has included it in the reproduced record. (R.R. at 202a.) --------
Because medical fee review MF-440109 was not before the hearing officer, the hearing officer erred in ordering SWIF to reimburse Dr. O'Brien pursuant to MF-440109. We agree with SWIF that the record demonstrates that an administrative error occurred. Accordingly, we vacate the hearing officer's decision regarding MF-440109 and remand for further proceedings.
/s/_________
ROCHELLE S. FRIEDMAN, Senior Judge
ORDER
AND NOW, this 15th day of May, 2015, we hereby vacate that portion of the Bureau of Workers' Compensation Fee Review Hearing Office's August 14, 2014, decision regarding medical fee review number MF-440109 and remand for further proceedings.
Jurisdiction relinquished.
/s/_________
ROCHELLE S. FRIEDMAN, Senior Judge