The SD Department recently issued a ruling that the employee bars responsibility for making sure medical bills were sent to the correct entity.
South Dakota has a three year statute of limitations from the last payment of benefits on an accepted claim (subject to an exception for a change in condition). The claimant was treating with a chiropractor who was billing the claimant's health carrier instead of workers' compensation. Claimant sought payment of those bills and the Department held the bills were barred since it had been more than three years since the insurer paid any benefits on the claim.
The Department reasoned that only claimant could have corrected this situation as claimant would have received EOBs and presumably had co-payments or paid on a deductible. Therefore, the employer and insurer were entitled to partial summary judgment on all claims barred by the three year limitation period. This decision is subject to appeal.
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