AI Generated Opinion Summaries

This summary was computer-generated without any editorial revision. It is not official, has not been checked for accuracy, and is NOT citable.

Facts

• A worker filed a claim for compensation for injuries sustained, which led to a dispute over the handling of the claim by the employer and insurer. The contention primarily revolved around the employer and insurer's conduct, particularly concerning their communication with the worker's doctor without the worker's consent, and whether such conduct constituted bad faith.

Procedural History

• Appeal from the Workers’ Compensation Administration, Gregory D. Griego, Workers’ Compensation Judge: The Workers' Compensation Judge awarded compensation to the worker for his injuries and imposed a 25% penalty on the employer and insurer for bad faith conduct.

Parties' Submissions

• Worker-Appellee: Argued that the employer and insurer engaged in bad faith conduct in the handling of the compensation claim, particularly through unauthorized communication with the worker's doctor.
• Employer/Insurer-Appellants: Contended that their communication with the worker's doctor was proper and necessary for the processing of the worker's claim, and that such actions did not constitute bad faith. They also challenged the application of the precedent set by Church’s Fried Chicken, arguing for its reconsideration.

Legal Issues

• Whether the employer and insurer engaged in bad faith conduct by communicating with the worker's doctor without the worker's consent.
• Whether the precedent established by Church’s Fried Chicken regarding unauthorized communications between an insurer and a physician should be reconsidered.

Disposition

• The Court of Appeals affirmed the Workers' Compensation Judge's order awarding compensation to the worker and imposing a 25% penalty on the employer and insurer for bad faith conduct.

Reasons

• The Court, per Judge Michael E. Vigil, with Judges Michael D. Bustamante and Cynthia A. Fry concurring, held that:
  The employer and insurer did not preserve any argument for entitlement to discovery on the issue of their own bad faith conduct, failing to explain why they would need such discovery (para. "MEMORANDUM OPINION").
  The evidence supported the conclusion that the appellants engaged in intentional conduct in the handling of the claim that amounted to willful or reckless disregard of the worker's rights, thus constituting bad faith (para. "MEMORANDUM OPINION").
  The appellants' communication with the worker's doctor without consent was improper, and the regulations cited by the appellants did not expressly permit such communications. The Court reaffirmed the interpretation of Section 52-10-1(A) as allowing an insurer to request the release of certain preexisting records from a worker's physician but not to engage in further discussions without the worker's consent (para. "MEMORANDUM OPINION").
  The Court declined to reconsider the precedent established by Church’s Fried Chicken, finding no compelling reason to overrule it and emphasizing the importance of stare decisis (para. "MEMORANDUM OPINION").
  The Court disagreed with the appellants' assertion that their conduct should not constitute bad faith, emphasizing that the appellants were required to investigate and process the worker's claim in accordance with the law, including adherence to Section 52-10-1(A) as interpreted by the Court (para. "MEMORANDUM OPINION").