Opinion
No. 106,359.
2012-05-25
Donna K. THOMPSON, Appellee, v. HASTY AWARDS, INC. and Continental Western Insurance Co., Appellants.
Appeal from Workers Compensation Board. Opinion filed May 25, 2012. Affirmed in part and reversed in part. Nathan Burghart, of Fairchild & Buck, P.A., of Lawrence, for appellants. Mark E. Kolich, of Lenexa, for appellee.
Appeal from Workers Compensation Board. Opinion filed May 25, 2012. Affirmed in part and reversed in part.
Nathan Burghart, of Fairchild & Buck, P.A., of Lawrence, for appellants. Mark E. Kolich, of Lenexa, for appellee.
Before MARQUARDT, P.J., HILL, J., and LARSON, S.J.
MEMORANDUM OPINION
PER CURIAM:
Donna K. Thompson's former employer, Hasty Awards, Inc., and its insurer, Continental Western Insurance Company, appeal the decision of the Workers Compensation Board of Appeals (Board). Hasty Awards/Continental Western claim that the Board erred in finding that Thompson incurred a permanent impairment as a result of her accident on October 17, 2006, and in awarding Thompson reimbursement for two emergency room visits as authorized medical expenses. We affirm in part and reverse in part.
The facts in this case are not substantially disputed. Thompson worked for Hasty Awards for approximately 4 1/2 years as a production assistant. For most of her employment, Thompson's work consisted of attaching neck ribbons to medals. While seated, she would pick up a 10– to 15–pound tub containing medals, set it on her lap, pull out a medal, and fasten the ribbon to the medal with a machine or by hand. Thompson put the finished medals in a bag and would take them to shipping. Thompson estimated that she repeated this process an average of 2,000 to 10,000 times every workday. Occasionally, Thompson would engage in other production activities, but 90 percent of her work involved attaching ribbons to medals, until she was transferred to the trophy department in November 2008.
On October 17, 2006, Thompson lifted a 10– to 15–pound tub of medals, and as she twisted her body to the left, she felt a popping sensation followed by a burning sensation in her right shoulder blade area. Thompson felt no pain in her neck but advised her supervisor of the incident and visited Dr. Willard Ransom at the Ottawa Family Physicians clinic the same day. Believing that Thompson had merely suffered a pulled muscle, Ransom prescribed some anti-inflammatory medication but imposed no limitations on Thompson's activities. When several weeks passed without notable improvement, Thompson again sought permission for medical care. Hasty Awards sent her back to the Ottawa Family Physicians office, this time to consult Dr. Ellen Sinclair, who referred her to Dr. Gregory Lynch, an orthopedic specialist.
At her January 29, 2007, visit with Dr. Lynch, Thompson complained of pain in her right shoulder that radiated into the right side of her neck and down her right arm. Later, Thompson could not recall when her neck pain started. Dr. Lynch took x-rays, ordered MRI scans, and ordered physical therapy. Dr. Lynch restricted Thompson's lifting activities but not her repetitive work. Thompson's work and her other activities involving repetitive motions of the upper extremities increased her pain. However, the pain would diminish with rest.
When her pain would not abate, Thompson scheduled an appointment with Dr. Lynch, who ordered an electromyography (EMG) and a nerve conduction study. The EMG did not help in diagnosing Thompson's neck and shoulder pain but indicated the possibility of carpal tunnel syndrome in Thompson's right arm. Dr. Lynch referred Thompson to a neurosurgeon and a chiropractor; however, their treatments and diagnoses did not alleviate Thompson's pain.
On November 15, 2007, while continuing medical treatment, Thompson filed a workers compensation claim, alleging injury to her neck, right shoulder, and upper back, on October 17, 2006.
Prior to the hearing on her claim for injuries to her neck and shoulder, the parties stipulated that Thompson met with personal injury by accident on October 17, 2006, that the injury arose out of and in the course of employment, that Thompson provided proper notice to her employer, that an employment relationship existed at the time of the injury, that the parties were covered by the Workers Compensation Act (Act), and that a claim under the Act had been made by Thompson. Based on deposition evidence, however, Hasty Awards/Continental Western argued that the neck injury did not arise out of the October 17, 2006, accident but was caused by a series of microtraumas after October 17, 2006. Thompson agreed that the issue before the administrative law judge (ALJ) was whether her neck injury arose out of the October 17, 2006, accident or from repetitive work performed after the accident.
As a result of the position taken by Hasty Awards/Continental Western, Thompson asked that she be allowed to amend her claim to allege a possible repetitive work injury to her neck. After entertaining arguments by the parties, the ALJ denied the request to amend the claim, stating that he would not consider any repetitive injury subsequent to October 17, 2006, and that the hearing would be limited to a work injury occurring on October 17, 2006.
On December 20, 2010, the ALJ determined that Thompson's neck injury was causally related to the October 17, 2006, accident. But, the ALJ concluded that the neck injury did not cause permanent impairment of the neck and denied recovery for a work disability. The ALJ also rejected Thompson's request for reimbursement of the hospital charges related to her emergency room visits as authorized medical expenses. The ALJ concluded that Hasty Awards/Continental Western must compensate Thompson for $111.39 of unpaid unauthorized medical expenses and ordered payment of 27 weeks of permanent partial disability benefits at the rate of $249.01 per week for a 12% impairment rating of the right shoulder, which amounted to $6,723.27 as of the date of the award. Thompson filed a letter requesting an order nunc pro tunc regarding an award for her wage loss, but the ALJ denied the request.
Thompson filed a timely application for review by the Board. On May 27, 2011, the Board issued a 3–2 decision affirming the ALJ in part and reversing in part. The Board:
• Concluded that Thompson's shoulder and neck injuries were the result of the October 17, 2006, accident.
• Disagreed with the ALJ and found that Thompson had suffered a permanent functional impairment rating of 12% to her body as a whole.
• Adopted Dr. Koprivica's opinion regarding Thompson's task loss, awarding a 64.25% work disability.
• Concluded that the ALJ erred in refusing to allow Thompson's hospital charges as authorized medical expenses.
• Awarded 49.80 weeks of permanent partial disability benefits ($12,400.70) for the period from the date of the accident until January 25, 2010, Thompson's termination date; 9.71 weeks of permanent partial disability benefits ($3,032.92) for the period of January 26, 2010, through April 3, 2010; no disability benefits for the period of April 4, 2010, through April 10, 2010; and 207.13 weeks of permanent partial disability benefits ($64,697.06) beginning on April 11, 2010.
The Board left the other decisions of the ALJ undisturbed.
Hasty Awards/Continental Western has filed a timely petition for judicial review with this court. On appeal, Hasty Awards/Continental Western claims the Board: (1) erred in concluding that Thompson's neck injury constituted a permanent impairment; (2) improperly concluded that Thompson's neck injury arose out of the October 17, 2006, accident rather than repeated traumas after the accident; and (3) erred in characterizing Thompson's unpaid hospital expenses as authorized medical expenses.
While attempting to frame some of the arguments as a misapplication of the legal authority, Hasty Awards/Continental Western essentially dispute the facts supporting the Board's decisions.
Appellate review of a Board's decision is governed by the Kansas Judicial Review Act (KJRA), K.S.A. 77–601 et seq.K.S.A.2010 Supp. 44–556(a); K.S.A.2010 Supp. 77–603(a). This court has unlimited review of the Board's legal conclusions. See K.S.A.2010 Supp. 77–621(4); Nistler v. Footlocker Retail, Inc., 40 Kan.App.2d 831, 835, 196 P.3d 395 (2008). In contrast, under K.S.A.2010 Supp. 77–621(c)(7), appellate review of the Board's factual determinations is limited to verifying that the determinations are supported by substantial competent evidence “in light of the record as a whole.” Olds–Carter v. Lakeshore Farms, Inc., 45 Kan.App.2d 390, 394, 250 P.3d 825 (2011). The appellate court's consideration of the record as a whole is defined by statute.
“[T]he adequacy of the evidence in the record before the court to support a particular finding of fact shall be judged in light of all the relevant evidence in the record cited by any party that detracts from such finding as well as all of the relevant evidence in the record, compiled pursuant to K.S.A. 77–620, and amendments thereto, cited by any party that supports such finding, including any determinations of veracity by the presiding officer who personally observed the demeanor of the witness and the agency's explanation of why the relevant evidence in the record supports its material findings of fact. In reviewing the evidence in light of the record as a whole, the court shall not reweigh the evidence or engage in de novo review.” K.S.A.2010 Supp. 77–621(d).
Under this standard of review, an appellate court does not weigh conflicting evidence except to determine whether the evidence supporting the Board's decision has been so undermined by conflicting evidence that the appellate court no longer has confidence in the substantial nature of the evidence. Substantial evidence is evidence that a reasonable person might accept as being sufficient to support a particular conclusion. Herrera–Gallegos v. H & H Delivery Service, Inc., 42 Kan.App.2d 360, 363, 212 P.3d 239 (2009).
Evidence Supporting Permanent Impairment to Claimant's Neck
Hasty Awards/Continental Western contend that the record as a whole fails to establish a permanent impairment to Thompson's neck. Their argument is slightly confusing because, after framing the issue as one of the existence of a permanent neck injury and citing the statutory standard for permanent partial general disability, Hasty Awards/Continental Western devote the majority of their argument on this issue to challenging the Board's finding that the neck injury was causally related to the October 17, 2006, accident, the apparent basis of their second appellate issue.
“Permanent partial general disability exists when the employee is disabled in a manner which is partial in character and permanent in quality and which is not covered by the schedule in K.S.A. 44–510d, and amendments thereto.” K.S.A. 44–510e(a). The disagreement in this case depends on the permanent nature of Thompson's neck injury. Hasty Awards/Continental Western concedes that any injury to Thompson's neck would constitute a nonscheduled injury. Also, the parties have not disputed the partial character of an injury to Thompson's neck.
In finding a permanent partial general disability as a result of the nonscheduled neck injury, the Board relied heavily on Dr. Koprivica's deposition testimony, apparently rejecting Dr. Fevurly's testimony that Thompson suffered no ratable impairment to her shoulder or neck and Dr. Prostic's testimony that Thompson's condition had not yet achieved maximum medical improvement. The Board noted that only Fevurly specifically concluded that Thompson's injury provided no medical basis for a ratable impairment.
Koprivica provided extensive testimony regarding Thompson's impairment. Koprivica described the neck injury as a tear in the soft tissue of the muscle that had formed a scar. The scar tissue remained contracted and caused pain whenever Thompson attempted to extend the muscle. Koprivica admitted that the vast majority of people who suffer a strain or sprain of a muscle eventually experience a full recovery because the scar tissue is not in a location that requires constant expansion of that scar tissue. In those rare cases in which the scar tissue creates an ongoing dysfunction, as in Thompson's case, Koprivica characterized the dysfunction as a permanent impairment.
Fevurly also characterized Thompson's injury as “a soft-tissue injury of the shoulder girdle area” but identified no objective signs of impairment through testing or physical examination. Both Fevurly and Koprivica noted that Thompson had suffered a loss in her range of motion in her right upper extremity. Fevurly found no objective signs of impairment through testing and concluded that any impairment rating would be based solely on Thompson's pain levels, which he did not believe the Fourth Edition to the American Medical Association Guides for the Evaluation of Permanent Impairment (1995) authorized. In contrast, Koprivica believed that objective evidence of impairment existed in Thompson's range of motion deficits and her medical history, in addition to her pain. Specifically, Koprivica characterized his impairment rating as a DRE Category II impairment. Hasty Awards/Continental Western have not presented an argument that Koprivica's application of the DRE Category II impairment rating was incorrect.
We note the conflicting medical opinion testimony; however, the weight of the evidence does not overwhelmingly support the position of Hasty Awards/Continental Western, and therefore, we affirm the Board's factual determination that Thompson suffered a permanent impairment to her neck. See K.S.A.2010 Supp. 77–621(d); Herrera–Gallegos, 42 Kan.App.2d at 363, 212 P.3d 239.
Evidence Supporting the Finding that Claimant's Neck Injury was the Result of the October 17, 2006, Accident
Hasty Awards/Continental Western next challenge the Board's finding that Thompson's neck injury was causally related to the October 17, 2006, accident. They contend that the weight of the evidence presented at trial does not support the Board's finding that Thompson's neck injury occurred on October 17, 2006. Then, assuming that the injury is more properly characterized as a repetitive work injury, Hasty Awards/Continental Western contend that the Board erroneously failed to establish the date of injury according to the provisions of K.S.A.2010 Supp. 44–508(d).
Ironically, the date of Thompson's neck injury was a factual determination upon which both the ALJ and the Board agreed. The ALJ's decision rejected the argument that the neck injury occurred subsequent to October 17, 2006, adopting Koprivica's interpretation of the medical data.
“As Dr. Koprivica explained, the injury involved strain/sprain of the muscles in the trapezius area, which attach both to the shoulder girdle and the cervical spine. Whether the effects of such an injury are in the ‘neck’ or ‘shoulder’ seems to be a matter of semantics. The work accident of October 17, 2006 caused injury in the claimant's neck and shoulder area. The more important question was whether the injury caused permanent impairment of the neck, making the case a non-scheduled injury under K.S.A. 44–510e.”
Hasty Awards/Continental Western did not separately appeal the ALJ's determination regarding the date of injury. Nevertheless, they clearly presented the argument to the Board in Thompson's appeal. Applying slightly different reasoning, the Board reached the same conclusion regarding the date of injury.
“This Board finds claimant injured her neck and shoulder as a result of her work-related accident of October 17, 2006, and not as a result of a series of microtraumas as alleged by respondent. Claimant has consistently maintained she injured her shoulder and neck on October 17, 2006. Dr. Prostic indicated ‘On or about October 17, 2006 and each and every working day thereafter, Donna K. Thompson has sustained injury to her cervical spine and right upper extremity.’ (Emphasis [bold] added.) Dr. Koprivica opined that claimant, as a direct and proximate result of her October 17, 2006, injury, has a cerviothoracic strain/sprain.” (Emphasis [italics] added.)
Hasty Awards/Continental Western claim that the Board's finding with respect to the date of injury is not supported by substantial competent evidence because the evidence is uncontroverted that Thompson did not complain of neck pain until her January 29, 2007, appointment with Dr. Lynch, at the earliest, and the medical opinion testimony unanimously concurs that, if Thompson's neck had been injured on October 17, 2006, the injury would have become symptomatic within days of the injury.
The characterization of the evidence in this case by Hasty Awards/Continental Western is a bit oversimplified. While Koprivica, Prostic, and Fevurly all expected that a direct injury to the neck would cause pain within days of the injury, the evidence is not necessarily contrary to a finding that Thompson felt pain in her neck within that window. While the evidence is undisputed that Thompson reported a lack of neck pain when she initially sought medical care for her shoulder pain, Thompson was not certain when her neck pain developed. Contrary to her estimate, the medical records clearly demonstrate that Thompson was experiencing neck pain on January 29, 2007, when she first visited Dr. Lynch. Hasty Awards/Continental Western contend that the record establishes that the earliest time that Thompson felt any neck pain was January 29, 2007, but the lack of medical reports indicating neck pain does not establish that Thompson was not feeling pain prior to January 29, 2007. Thompson initially sought medical treatment for her shoulder pain on October 17, 2006. Because the treating physician diagnosed a pulled muscle that would eventually heal, Thompson did not immediately seek further treatment. By the time she sought additional treatment, she was suffering neck pain, as evidenced by Dr. Lynch's examination report. Koprivica stated that he did not read the medical records to indicate a lack of neck pain prior to January 29, 2007.
Nonetheless, as Hasty Awards/Continental Western indicate, Thompson had the burden of establishing her entitlement to compensation. See K.S.A.2010 Supp. 44–501(a) and K.S.A.2010 Supp. 44–508(g). The absence of any evidence of neck pain prior to January 29, 2007, weighs against Thompson, who has the initial burden of proof.
Yet, even if the evidence did not support a finding of direct injury to the neck, the medical opinion testimony provided sufficient evidence for the Board to determine that the neck injury was causally related to the October 17, 2006, accident. In arguing against the Board's finding, Hasty Awards/Continental Western draws no distinction between direct and secondary causation. All of the medical testimony in this case indicated that Thompson's injuries were at least secondary to the initial accident on October 17, 2006.
Dr. Fevurly testified that, to a reasonable degree of medical certainty, Thompson suffered “a soft-tissue injury of the shoulder girdle area at the time of the initial injury.” He then gave an opinion that Thompson's neck complaint was compensatory pain caused by shrugging of the shoulders to relieve pain from the shoulder injury, essentially indicating that Thompson's neck pain was a natural and probable consequence of her shoulder injury on October 17, 2006. Dr. Prostic indicated that, in his medical opinion, there was no medical distinction between Thompson's shoulder injury and her neck complaints. In any event, the injury Thompson incurred on October 17, 2006, made further injury likely, and Dr. Prostic opined that any additional injury after the accident would be a natural consequence of the injury. Dr. Prostic stated that he believed the neck injury was causally related to the October 17, 2006, accident, whether it was a direct or a secondary injury. Dr. Koprivica provided similar testimony. He initially discounted the possibility of an aggravating neck condition, distinguishing between aggravation to an injury and intensification of pain associated with an injury. But, admitting the possibility of aggravated injuries due to Thompson's repetitive work, Dr. Koprivica stated his opinion that any aggravated condition was causally related to the accident on October 17, 2006.
“The permanent structural injury that occurred is something that was a necessary component for any change in symptoms that followed with additional activity.
“The permanent injury occurred, I believe, with this lifting of the tote when this shoulder blade popped. It's like if you have a rag and it's torn, that tear in the rag now has predisposed it to have any further problems because the rag is torn and weakened.
“Without that event and that permanent structural change, nothing else would have happened thereafter. That's how I look at this subsequent—if there is aggravation, it's because the structure is weakened and because of the weakening that's why it's getting worse.”
Contrary to Hasty Awards/Continental Western's appeal, none of the medical experts indicated that the neck pain was related to a separate and distinct injury as the result of a series of microtraumas.
“The question of whether an injury results from a new and separate accident depends on the facts in each case. When there is expert medical testimony linking the causation of the second injury to the primary injury, the second injury is considered to be compensable as the natural and probable consequence of the primary injury. [Citations omitted.]” Casco v. Armour Swift–Eckrich, 283 Kan. 508, 516, 154 P.3d 494 (2007) (citing 10 cases applying the rule).
After weighing all the facts, we find there is substantial competent medical evidence causally connecting Thompson's neck injury to the accident on October 17, 2006. Accordingly, we find that the Board did not err in determining the date of the neck injury as October 17, 2006.
Hasty Awards/Continental Western also contend that the Board erred in failing to apply K.S.A.2010 Supp. 44–508(d) when determining the date of Thompson's neck injury. Because we have found that Thompson's neck injury was properly attributed to her accident on October 17, 2006, this secondary argument is moot. See Rodarte v. Kansas Dept. of Transportation, 30 Kan.App.2d 172, 183, 39 P.3d 675,rev. denied 274 Kan. 1113 (2002) (noting that an issue becomes moot when the controversy between the parties has been resolved and any judgment of the court would have no practical effect).
The statutory definition of accident includes the following language:
“In cases where the accident occurs as a result of a series of events, repetitive use, cumulative traumas or microtraumas, the date of accident shall be the date the authorized physician takes the employee off work due to the condition or restricts the employee from performing the work which is the cause of the condition. In the event the worker is not taken off work or restricted as above described, then the date of injury shall be the earliest of the following dates: (1) The date upon which the employee gives written notice to the employer of the injury; or (2) the date the condition is diagnosed as work related, provided such fact is communicated in writing to the injured worker. In cases where none of the above criteria are met, then the date of accident shall be determined by the administrative law judge based on all the evidence and circumstances; and in no event shall the date of the accident be the date of, or the day before the regular hearing. Nothing in this subsection shall be construed to preclude a worker's right to make a claim for aggravation of injuries under the workers compensation act .” (Emphasis added.) K.S.A.2010 Supp. 44–508(d).
This statutory provision was adopted in 2005 in response to caselaw assigning the last day worked as the date of injury in cases where a single injury could not be identified due to the repetitive trauma presented by the facts of the case. See Saylor v. Westar Energy, Inc., 292 Kan. 610, 615, 256 P.3d 828 (2011). There is no indication that the legislature intended to replace a clearly identifiable accident date with the statutory presumption of K.S.A.2010 Supp. 44–508(d) merely because a condition was aggravated by subsequent use after an initial injury. In fact, the last sentence of the quoted portion of the statute indicates a legislative intent to distinguish aggravated injuries from repetitive traumas. Although, at first glance, Saylor appears to support the application of K.S.A.2010 Supp. 44–508(d) under facts similar to the present case, Saylor is distinguishable because no party in Saylor claimed that the injury related to a specific accident. 292 Kan. at 611–13, 256 P.3d 828.
While not applicable to the instant case, the 2011 amendments to the Act, K.S.A. 44–501 et seq. , are instructive in determining the legislative intent behind the repetitive use provision. In the amended definition section, the legislature separated the definition of “accident” from the definition of “repetitive trauma.” K.S.A.2011 Supp. 44–508(d) and (e). The definition of “accident” now provides: “An accident shall be identifiable by time and place of occurrence, produce at the time symptoms of an injury, and occur during a single work shift. The accident must be the prevailing factor in causing the injury.” (Emphasis added.) K.S.A.2011 Supp. 44–508(d). The definition of “repetitive trauma” states that “[t]he repetitive trauma must be the prevailing factor in causing the injury.” K.S.A.2011 Supp. 44–508(e). These amendments demonstrate the legislative intent to distinguish a repetitive use injury from an aggravated injury following an initial accident. Because the medical testimony supports the Board's conclusion that Thompson's neck injury was causally related to the accident on October 17, 2006, and the prevailing factor causing the injury was the accident, the repetitive use injury provision in K.S.A.2010 Supp. 44–508(d) has no application in this case.
Unauthorized Emergency Room Visits
The final issue raised by Hasty Awards/Continental Western in this appeal pertains to the Board's award of $751.18 for an unpaid hospital bill incurred when Thompson twice visited an emergency room in November 2007. Both visits occurred during hours when the doctors' offices were not open. Thompson went to the emergency room with symptoms she believed were related to a heart attack. Thompson felt her shoulder blades cramping and tightening and her lungs closing off. In describing the pain, Thompson testified, “It just feels like somebody's grabbing your spine and pulling your rib cage. You can't breathe and it's just excruciating.” Thompson did not feel that she could wait until the following morning to consult a doctor about the pain.
The ALJ found the hospital expenses were unauthorized medical expenses, noting:
“The claimant submitted a bill for an outstanding balance of $751.18 from Anderson County Hospital. The claimant said she went to the hospital's emergency room in November 2007 because of pain between her shoulder blades. She said she went there in an evening because the pain was so severe she did not think she could wait until the next day to contact the respondent about seeing the authorized physician. There were no medical records or other testimony about this emergency room visit. The claimant's injuries in this case were rather minor ‘strain/sprains.’ Without more evidence to support the need for emergent treatment, the court considers this treatment obtained without authorization or approval, and the respondent's liability for such treatment is limited to a total of $500, K.S.A. 44–510h.”
The Board reversed the ALJ's determination, finding that Thompson's testimony established an emergency warranting prompt medical attention. The Board provided no authority or reasoning for its position. On appeal, Hasty Awards/Continental Western contend that the Board's award of the hospital bill was contrary to K.S.A.2010 Supp. 44–510h. In response, Thompson contends that emergency care is implied by the employer's affirmative obligation to “provide the services of ... such medical, surgical and hospital treatment ... as may be reasonably necessary to cure and relieve the employee from the effects of the injury.” K.S .A.2010 Supp. 44–510h(a).
Although K.S.A.2010 Supp. 44–510h(a) establishes an employer's general duty to provide medical care for an injured employee, there is no provision requiring an employer or an employer's insurance carrier to pay for the medical expenses incurred solely at the employee's discretion. To the contrary, K.S.A.2010 Supp. 44–510h(b)(2) states:
“Without application or approval, an employee may consult a health care provider of the employee's choice for the purpose of examination, diagnosis or treatment, but the employer shall only be liable for the fees and charges of such health care provider up to a total amount of $500.” K.S.A.2010 Supp. 44–510h(b)(2).
In Saylor, the Kansas Supreme Court affirmed the Board's compensation award for unauthorized medical expenses that exceeded the $500 limit because the employer possessed knowledge of the work-related injury but provided no medical care. 292 Kan. at 623, 256 P.3d 828. The result reached by the Saylor court was warranted by K.S.A. 44–510j(h). (“If the employer has knowledge of the injury and refuses or neglects to reasonably provide the services of a health care provider required by this act, the employee may provide the same for such employee, and the employer shall be liable for such expenses subject to the regulations adopted by the director.”) Here, however, Thompson was provided with health care by her employer. Thompson has made no allegations that the health care provided by her employer was inadequate. The Act makes no other provision for emergency treatment other than to charge the first $500 of such treatment to the employer under K.S.A.2010 Supp. 44–510h(b)(2). Consequently, the Board erred, as a matter of law, in authorizing compensation for the unauthorized hospital bill in excess of the $500 limit provided by K.S.A.2010 Supp. 44–510h(b)(2).
The Board's findings related to Thompson's neck injury are affirmed; however, we reverse the award for Thompson's unauthorized emergency room treatment in excess of the $500 allowed by statute.
Affirmed in part and reversed in part.