WORKERS COMPENSATION – Timely filing claim and “fully completed” form 114: Speedway / Super America v. Mazen Elias (6/25/2009)

Speedway / Super America v. Mazen Elias; ALJ; and Workers’ Compensation Board
2008-SC-000873-WC June 25, 2009
Opinion of the Court. All sitting; all concur.

ALJ awarded claimant workers’ compensation benefits for home healthcare services provided by claimant’s spouse. The employer appealed, arguing the ALJ should have dismissed the claim since claimant had not submitted a “fully completed” Form 114 as required by 803 KAR 25:09 § 11(1). Further, the employer argued that the claim for the period before August 2003 should have been dismissed since it was not filed timely under 803 KAR 25:09 § 11(3). The Court affirmed the decisions of the Board and Court of Appeals, holding that while failure to include detailed information or failing to respond to requests for additional information may justify an employer’s refusal to pay a claim, it did not preclude an ALJ from deciding the extent to which the services covered by a disputed form are compensable. The Court noted the permissive nature of the timeliness component of § 11(3), and held that there was no authority requiring dismissal of claim because of an untimely form. The Court further held that sufficient compliance with § 11(1) depends on the facts and circumstances and that the ALJ’s decision was reasonable under the circumstances at hand.