Case Title: DIANE BAILEY v. STATE OF WYOMING, ex rel

Citation: 

Docket Number: S-10-0051

State: wyoming

Court: Wyoming Supreme Court

Date: 2010-11-23T00:00:00Z

Document:
DIANE BAILEY v. STATE OF WYOMING, ex rel2010 WY 152Case Number: No. S-10-0051Decided: 11/23/2010NOTICE: This opinion is subject to formal revision before publication in Pacific Reporter Third. Readers are requested to notify the Clerk of the Supreme Court, Supreme Court Building, Cheyenne, Wyoming 82002, of any typographical or other formal errors so correction may be made before final publication in the permanent volume.
OCTOBER 
TERM, A.D. 2010

 
 

DIANE 
BAILEY,Appellant (Petitioner),v.STATE OF WYOMING, ex rel., 
WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION,Appellee 
(Respondent).

 
 

Appeal 
from the District Court of Natrona County

The 
Honorable Scott W. Skavdahl, Judge

 
 
Representing 
Appellant:

Stephenson 
D. Emery of Williams, Porter, Day & Neville, P.C., Casper, 
Wyoming.

 
 
Representing 
Appellee:

Bruce 
A. Salzburg, Wyoming Attorney General; John W. Renneisen, Deputy Attorney 
General; James Michael Causey, Senior Assistant Attorney 
General.

 
 
Before 
KITE, C.J., and GOLDEN, HILL, VOIGT, and BURKE, JJ.

 
 
KITE, 
Chief Justice.            

 
 
[¶1]      Diane Bailey 
appeals from the district court's order affirming the Office of Administrative 
Hearing's (OAH) denial of her claim for temporary total disability (TTD) 
benefits.  We conclude the OAH 
correctly determined that Ms. Bailey failed to file a proper health care 
provider certification when she applied for TTD benefits and, under the relevant 
statutes and agency rule, she is not entitled to benefits.

 
 
[¶2]      We affirm.  

 
 
 
 
ISSUES

 
 
[¶3]      Ms. Bailey 
presents a single issue on appeal:

 
 
            
Did the Office of Administrative Hearings . . . act arbitrarily and 
capriciously, and contrary to law, in denying payment of temporary total 
disability benefits ("TTD") to Appellant, Diane Bailey ("Bailey"), even though 
she was "temporarily and totally incapacitated from performing employment at any 
gainful employment or occupation for which [s]he [was] reasonably suited by 
experience or training?" Wyo. Stat. §27-14-102(a)(xviii).

 
 
State 
of Wyoming ex rel., Wyoming Workers' Safety and  Compensation Division (Division) states 
two issues on appeal:

 
 

I.              
Is 
the hearing officer's determination denying Appellant's requested temporary 
total disability ("TTD") benefits because Appellant failed to properly submit a 
completed TTD certification form, signed by her physician, arbitrary, 
capricious, or otherwise not in accordance with Wyoming 
law?

 
 

II.            
Does 
substantial evidence support the hearing officer's determination that Appellant 
failed to follow the procedural requirements for filing a TTD claim and that, 
therefore, her request for TTD benefits should be denied?

 
 
FACTS

 
 
[¶4]      Ms. Bailey 
injured her right shoulder in November 2007, while working as a welder's helper 
for Gregory & Cook Construction, Inc.  
She was examined by a physician's assistant at Rawlins Urgent Care on 
December 18, 2007.  The physician's 
assistant restricted her from overhead work and lifting more than 5 pounds.  After working for a few more days, she 
returned home to Michigan.  Ms. 
Bailey was examined by family physician, Dr. D. Dotson, on December 26, 
2007.  Dr. Dotson filled out a 
"Return to Work/School Statement" which stated that Ms. Bailey was not to 
perform any work until she was seen by an orthopedic physician.    

 
 
[¶5]      Ms. Bailey faxed 
a report of injury and eighteen page letter to the Division on January 2, 
2008.  She also asserted that she 
submitted an application for TTD benefits at the same time, although the 
application in the record was not stamped as "received" by the Division and the 
Division argued there was no evidence that it received the application.  The application was filled out only by 
Ms. Bailey; her physician did not complete the "Health Care Provider's 
Certification" part of the document or sign it.      

 
 
[¶6]      Ms. Bailey saw 
Rhonda Whelan, D.O. on January 24, 2008.  
Dr. Whelan ordered a right shoulder arthrogram, which was completed on 
February 21, 2008.  The test 
indicated that Ms. Bailey had a partial rotator cuff tear, labral tear, 
impingement syndrome and adhesion capsulitis in her right shoulder, and Dr. 
Whelan determined that surgery was indicated. On February 28, 2008, Dr. Whelan's 
office completed a "Disability Certificate," indicating that Ms. Bailey "is to 
be off work as of today (2-28-08) through 3 months after surgery.  Pt's surgery date is 4-23-08."     

 
 
[¶7]      Ms. Bailey had 
surgery on April 23, 2008, and subsequently began physical therapy.  Dr. Whelan completed another disability 
certificate on August 4, 2008, indicating that Ms. Bailey would continue to be 
off work for another two months.  On 
September 9, 2008, Dr. Whelan filled out a form for Ms. Bailey's private 
disability insurance, which stated that Ms. Bailey still could not work.    

 
 
[¶8]      The Division 
initially denied coverage, but later agreed that Ms. Bailey's injury was 
compensable and paid her medical claims.  
The Division did not, however, award her TTD benefits, asserting that she 
had not filed a proper application for benefits.  The OAH held a contested case hearing on 
November 4, 2008.  The OAH ruled 
there was no evidence that Ms. Bailey filed her application for TTD benefits 
with the Division on January 2, 2008, as she claimed and, in any event, she was 
not entitled to benefits because her application did not contain a health care 
provider's certification.  Ms. 
Bailey filed a petition for judicial review with the district court, and that 
court determined the OAH finding that there was no evidence Ms. Bailey filed her 
application was not supported by substantial evidence because she testified 
repeatedly that she faxed it to the Division on January 2, 2008.  The district court, nevertheless, upheld 
the OAH decision denying benefits because her application did not contain a 
proper certification from her health care provider.   Ms. Bailey appealed to this 
Court.     

        

 
 
STANDARD 
OF REVIEW

 
 
[¶9]      This case 
requires interpretation of worker's compensation law, necessitating application 
of the following standard of review:

 
 
The 
interpretation and correct 
application of the provisions of the Wyoming Workers' Compensation Act is a question of law 
over which our review authority is plenary.  Conclusions of law made by an 
administrative agency are affirmed only if they are in accord with the law. We 
do not afford any deference to the agency's determination, and we will correct 
any error made by the agency in either interpreting or applying the 
law.

 
 

Osenbaugh 
v. State ex rel. Wyoming Workers' Safety & Comp. Div., 10 P.3d 544, 547-48 (Wyo. 2000) (citations omitted).  See also, Boe v. State ex rel. Wyoming Workers' Safety 
& Comp. Div., 2009 WY 115, ¶ 7, 216 P.3d 494, 496 (Wyo. 2009).  Similarly, interpretation of the agency 
rules and regulations implementing statutory directives is a question of law, 
reviewed de novo.  See Powder River Basin Resource Council v. 
Wyoming Dep't of Environmental Quality, 2010 WY 25, ¶ 6, 226 P.3d 809, 813 
(Wyo. 2010).

 
 
 
 
DISCUSSION

 
 
[¶10]   The OAH's decision denying TTD 
benefits did not focus on whether Ms. Bailey met the definition of TTD under 
Wyo. Stat. Ann. § 27-14-102(a)(xviii) (LexisNexis 2009), i.e., whether she was 
"temporarily and totally incapacitated from 
performing employment at any gainful employment or occupation for which [she 
was] reasonably suited by experience or training."  Instead, it ruled that the procedural 
deficiencies in her application for benefits warranted denial of her claim.  Resolution of this issue requires us to 
interpret the relevant statutes and administrative agency rules.  

 
 
[S]tatutory 
interpretation begins with an inquiry into the ordinary and obvious meaning of 
the words employed by the legislature according to the manner in which those 
words are arranged. [Parodi v. Wyoming Department of Transportation, 947 P.2d 1294, 1295 (Wyo.1997)]; Sheridan Commercial Park, Inc. v. Briggs, 
848 P.2d 811, 815 (Wyo.1993). If more than one reasonable interpretation exists, 
we resort to general principles of statutory construction. Moncrief v. 
Wyoming State Bd. of Equalization, 856 P.2d 440, 444 (Wyo.1993) (quoting 
Parker Land and Cattle Co. v. Wyoming Game and Fish Com'n, 845 P.2d 1040, 
1044 (Wyo.1993)). When the legislature has spoken in unambiguous terms, however, 
"we are bound to the results so expressed." State ex rel. Wyoming Workers' 
Compensation Div. v. Bergeron, 948 P.2d 1367, 1369 
(Wyo.1997).

 
 

Osenbaugh, 
10 P.3d  at 548, quoting Platte Development Co. v. State 
Environmental Quality Council, 966 P.2d 972, 974 (Wyo. 1998).  We apply the same strategies in 
interpreting agency rules and regulations.  
See Powder River, ¶ 6, 226 P.3d  at 813.    

 
 
[¶11]   In addition to the definition of 
TTD quoted above, several other statutes are relevant to our inquiry.  Wyo. Stat. Ann. § 27-14-404(a) 
(LexisNexis 2009) states in pertinent part: 

 
 
            
If after a compensable injury is sustained and as a result of the injury 
the employee is subject to temporary total disability as defined under W.S. 
27-14-102(a)(xviii), the injured employee is entitled to receive a temporary 
total disability award for the period of temporary total disability as provided 
by W.S. 27-14-403(c).   

 
 
Wyo. 
Stat. Ann. § 27-14-404(d) (LexisNexis 2009) sets out procedural requirements for 
filing a TTD claim and states in relevant part:  "Benefits under subsection (a) of this 
section shall not be paid if . . . (ii) A 
claim is filed without the signature of the claimant and certification by the 
attending health care provider[.]"  

 
 
[¶12]   Wyo. Stat. Ann. § 27-14-501(b) 
(LexisNexis 2009) requires a "health care provider [to] examine the employee 
before certification and . . . without charge file a written report with the 
division. . . .  The report shall 
specify reasons for temporary total disability or continued temporary total 
disability."  Subsection (e) of § 
27-14-501 states:  

 
 
            
An initial claim for temporary total disability benefits under W.S. 
27-14-404 and any subsequent claim for temporary total disability following the 
initial period of certification shall be filed with the division and the 
division shall transmit a copy of the initial claim to the employer. Failure to 
file a claim for temporary total disability in accordance with W.S. 27-14-404(d) 
shall result in denial of the claim.

 
 
Finally, 
Wyo. Stat. Ann. § 27-14-601(e) (LexisNexis 2009) directs the Division to "by rule and regulation establish necessary procedures for 
the review and settlement of . . . claims filed under this act through 
interviews with employees, employers and health care personnel or through review 
of written reports."  

 
 

[¶13]   To that end, the Division adopted 
and filed rules setting out the procedural requirements for filing TTD 
claims.  Rules, Regulations and Fee 
Schedules of the Wyoming Workers' Safety and Compensation Division, 
Ch. 5, § 4 (August 14, 2006) (Division 
Rule).  Like all administrative 
rules, the Division Rule has the force and effect of law.  Diamond B Services, Inc. v. Rohde, 2005 
WY 130, ¶ 60, 120 P.3d 1031, 1048 (Wyo. 2005).  The relevant 
provisions of the Division Rule state:

 
 

Section 
4.     Claims for 
Benefits. A person seeking an 
award of benefits under the [Wyoming Workers' Compensation] Act must submit a 
written application for benefits to the Division, on a form provided by the 
Division.  

. 
. . . 

 
 
    (b) Claim for Temporary 
Total Disability (TTD) Benefits (Lost Wages).

 
 
            
(i) When Submitted. A claim for TTD must be filed within 60 days 
after the first day of certified temporary total disability. W.S. § 
27-14-404(d).

 
 
(ii) 
Certification. An award of TTD cannot be made without certification from 
a treating health care provider that the worker is temporarily and totally 
disabled (that is, incapacitated from performing any gainful employment for 
which the worker is reasonably suited by experience or training). The 
certification shall specify the reasons for the total disability and the 
expected period of disability.

. 
. . .

(iv) 
Where Submitted. A claim for TTD benefits must be filed with the 
Division.  W.S. § 
27-14-501([e]).

 
 
[¶14]   The hearing examiner articulated 
two independent grounds for denying Ms. Bailey TTD benefits:  1) there was no evidence that she 
submitted her application for TTD benefits to the Division on January 2, 2008; 
and 2) her application did not include a proper certification from her health 
care provider.  The district court 
determined that the record did not contain sufficient evidence to support the 
hearing examiner's ruling on the first basis, but the OAH decision on the second 
matter was correct and dispositive.    

 
 
[¶15]   We agree that resolution of the 
certification issue is dispositive and will focus on that analysis.  We start by recognizing that the 
claimant has the burden of proving the essential elements of her claim by a 
preponderance of the evidence.  Sims v. State ex rel. Wyoming Workers' Comp. 
Div., 872 P.2d 555, 557 (Wyo. 1994).  
The claimant "also must establish [her] compliance with the rules and 
procedures set forth in the Wyoming Worker's Compensation Act."  Alcorn v. Sauer Drilling Co., 2006 WY 15, ¶ 7, 126 P.3d 924, 926 (Wyo. 2006), citing Pittman 
v. State ex rel. Wyoming Workers' Comp. Div., 917 P.2d 614, 617 (Wyo. 
1996).   

 
 
[¶16]   Sections 27-14-404(d) and 501(b) 
and (e) and the Division Rule require certification by the treating health care 
provider that the worker is temporarily and totally disabled.  The Division Rule mandates that the 
application for benefits be submitted on a form provided by the Division and the 
health care provider specify the reasons for the disability and the expected 
period of disability.  Division 
Rule, Ch. 5, § 4.    

 
 
[¶17]   The Division's TTD form contains 
two parts, one for the employee to complete with questions about her personal 
information, injury and work status and a separate section titled "Health Care 
Provider's Certification of Temporary Total Disability."  The health care provider's section 
starts with the following statement:  

 
 
THIS 
CERTIFICATION FULFILLS THE REQUIREMENT UNDER W.S. 27-14-404 AND 27-14-501(B) FOR 
TTD BENEFITS.  THE HEALTH CARE 
PROVIDER SHALL EXAMINE THE INJURED EMPLOYEE AND FILE THIS WRITTEN REPORT WITH 
THE WYOMING WORKERS' SAFETY AND COMPENSATION DIVISION. 

 
 
The 
health care provider is required to supply a significant amount of information, 
including:  the health care 
provider's name, address, phone number and federal tax identification number; 
the employee's diagnosis; whether the injury was work related; the date the 
employee will be able to return to full duty work; whether the employee can 
return to modified duty work and, if so, what restrictions would be imposed; the 
dates of the health care provider's last examination of the employee and the 
employee's next appointment; whether surgery is indicated and the number of 
anticipated follow up visits; who the provider referred the employee to; whether 
the employee's injury resulted in an ascertainable loss, as that term is defined 
in Wyoming law; and whether the provider can provide a permanent impairment 
rating.  The health care provider is 
required to sign and date the form under the following certification:  

 
 
BASED 
ON MY EXAMINATIONS, CONDUCT AND STATEMENTS OF THE EMPLOYEE, I HEREBY CERTIFY 
THAT I HAVE EXAMINED THE ABOVE PATIENT WITHIN THE LAST SIXTY (60) DAYS AND THAT 
THE ABOVE PATIENT IS TEMPORARILY DISABLED FROM RETURNING TO ANY GAINFUL 
EMPLOYMENT EXCEPT AS SET FORTH ABOVE.  

 
 
The 
health care provider must also provide the dates of the expected duration of 
temporary total disability.  

 
 
[¶18]   Ms. Bailey filled out the 
employee's section of her application for TTD benefits and signed and dated it 
January 2, 2008.  The health care 
provider's certification was not completed or signed by her doctor, although Ms. 
Bailey filled in some of that section herself.    

 
 
[¶19]   Ms. Bailey claims that, despite the 
fact the Division's form was not completed by her physician, the legal 
requirements were satisfied by a combination of the employee part of her 
application for TTD benefits and Dr. Dotson's Return to Work/School 
Statement.  Dr. Dotson's form was 
dated December 26, 2007, and indicated that Ms. Bailey's work status was "No 
work."  It included the 
comment:  "patient unable to work 
until seen by orthopedic Dr." and was signed by someone in Dr. Dotson's 
office.    

 
 
[¶20]   Dr. Dotson's Return to Work/School 
document was not the form provided by the Division for TTD certification and, 
consequently, did not meet the requirement to use the Division's form set out in 
Division Rule, Ch. 5, § 4.  The 
Return to Work/School document did not include a certification that Ms. Bailey 
was temporarily totally disabled under Wyoming law or set forth the reasons for 
the disability or expected period of disability as required by the Division Rule 
and §§ 27-14-404(d) and 501(b).  
Moreover, Dr. Dotson's form did not provide detailed information about 
the health care provider or Ms. Bailey's diagnosis, treatment plan, or 
prognosis.  

 
 
[¶21]   Section 27-14-404(d) mandates that 
TTD benefits "shall not be paid if . . . a claim is filed without the signature 
of the claimant and certification by the attending health care provider."  Given that Ms. Bailey did not fulfill 
the statutory or regulatory requirements for health care provider certification, 
we agree with the hearing examiner that she was not entitled to TTD 
benefits.  See generally, Hernandez v. Laramie County School Dist. No. 
1,  8 P.3d 318, 323 (Wyo. 2000); 
Snyder v. State ex rel. Wyoming Workers' 
Comp. Div., 957 P.2d 289, 293 (Wyo. 1998); Higgins v. State ex rel. Wyoming Workers' 
Comp. Div., 739 P.2d 129, 133 (Wyo. 1987).  

 
 
[¶22]   Ms. Bailey claims that we should 
overlook the procedural deficiencies and decide the case on its merits.  In support of her assertion, she directs 
us to part of Wyo. Stat. Ann § 27-14-101(b) (LexisNexis 2009), which provides 
that "benefit claims cases [should] be decided on their merits."  A review of the entire statutory section 
reveals that Ms. Bailey is taking that phrase out of context and misinterpreting 
the legislature's intent in adopting § 27-14-101(b):   

 
 
            
(b) It is the intent of the legislature in creating the Wyoming worker's 
compensation division that the laws administered by it to provide a worker's 
benefit system be interpreted to assure the quick and efficient delivery of 
indemnity and medical benefits to injured and disabled workers at a reasonable 
cost to the employers who are subject to the Worker's Compensation Act. It is 
the specific intent of the legislature that benefit claims cases be decided on 
their merits and that the common law rule of "liberal construction" based on the 
supposed "remedial" basis of workers' benefits legislation shall not apply in 
these cases. The worker's benefit system in Wyoming is based on a mutual 
renunciation of common law rights and defenses by employers and employees alike. 
Accordingly, the legislature declares that the Worker's Compensation Act is not 
remedial in any sense and is not to be given a broad liberal construction in 
favor of any party.

 
 
[¶23]   The language of this section 
indicates a clear intent to abrogate the common law rule that workers' 
compensation laws were interpreted in favor of injured employees.  We explained in Appleby v. State ex rel. Wyoming Workers' 
Safety & Comp. Div., 2002 WY 84, ¶ 27, 47 P.3d 613, 621 (Wyo. 2002) that 
in § 27-14-101(b), the legislature "specifically renounced any rule affording 
liberal construction to workers' compensation statutes, and our statutory 
interpretations must be reached without the assistance of any presumption in 
favor of coverage."  The reference 
to deciding benefit claims cases "on their merits" was in the context of 
nullifying the historical liberal construction in favor of coverage.  Contrary to Ms. Bailey's assertion, 
there is nothing in the section indicating that the legislature intended that 
procedural deficiencies be overlooked simply because the claimant appears to 
meet the definition of TTD.

 
 
[¶24]   Ms. Bailey also claims that the 
Division cannot insist on strict compliance with the procedural requirements of 
the Wyoming Workers' Compensation Act because it did not fulfill its procedural 
responsibilities.  In particular, 
she claims the Division violated  § 
27-14-601(d) by not telling her that she had not filed the proper form for TTD 
benefits and § 27-14-404(k) by failing to advise her that she was entitled to 
receive interim TTD benefits.  
Section 27-14-601(d) states:  

 
 
            
(d) Upon receipt of a claim for impairment, disability or death benefits 
filed under W.S. 27-14-403(g) or 27-14-501(e) and (f) and if the initial injury 
or death resulting from injury is determined compensable and within the 
jurisdiction of this act, the division shall determine if the injured employee 
or his dependents are eligible for benefits and shall approve or deny the claim 
in accordance with this act. If a claim is approved, the division shall 
determine the amount of the award for compensation in accordance with W.S. 
27-14-403 through 27-14-406 and 27-14-408, if applicable. The division shall 
provide notice of any determination under this subsection to the employer, 
employee and the claimant.

 
 
This 
statutory provision does not require the Division to inform the claimant that 
she filed an incorrect form or did not fill it out correctly.  It simply requires the Division to make 
a determination as to whether the claimant is eligible for benefits and provide 
notice of that determination to the interested parties. 

 
 
[¶25]   Section 27-14-404(k) provides for 
interim TTD benefits "[i]f the employer objects to a 
division determination that an injury is compensable and the employee's health 
care provider has certified the employee as temporarily totally disabled . . . 
."   That provision does not 
apply in this case because: 1) the Division originally determined Ms. Bailey's 
injury was not compensable; 2) she does not identify any evidence in the record 
indicating that, once the Division determined her injury was compensable, the 
employer objected; and 3) as we stated earlier, her health care provider did not 
properly certify that she was temporarily totally disabled under Wyoming 
law.  Moreover, Ms. Bailey 
does not direct us to any legal authority stating that the Division is obligated 
to notify her of all potential benefits.1 

 
 
[¶26]   Ms. Bailey also claims that State ex rel. Wyoming Workers' Safety & 
Comp. Div. v. Gerdes, 951 P.2d 1170 (Wyo. 1997) supports allowing her TTD 
claim even though she failed to file an appropriate application for 
benefits.  In that case, Ms. Gerdes 
received TTD benefits until her doctor indicated that she had reached maximum 
medical improvement, at which point the Division terminated her continuing 
benefits.  Id. at 1172.  She objected and, after a hearing, the 
OAH determined that she had not reached maximum medical improvement and awarded 
her TTD benefits for the period prior to the hearing.  The Division appealed, claiming that Ms. 
Gerdes was not entitled to benefits because she did not file claim 
certifications while her contested case was pending.  Id. at 1173.  This Court noted that § 27-14-404(d) 
does not address the procedural requirements for requesting continuing benefits 
after benefits have been terminated and the claimant is awaiting a contested 
case hearing.  We ruled, therefore, 
that the certification requirements set forth in the statute did not apply under 
such circumstances.  Id. at 1174-75.  

 
 
[¶27]   The critical distinction between Gerdes and the present case is the type 
of benefit being requested.  In Gerdes, the employee had already filed 
her initial application and had been receiving TTD benefits for some time.  She was simply requesting continuing 
benefits.  Here, we are concerned 
with an initial claim for TTD benefits.  

 
 
[¶28]   In that regard, Alcorn is more applicable.  Mr. Alcorn did not file his initial 
claim for TTD benefits by the statutory deadline.  Alcorn, ¶ 10, 126 P.3d  at 926.  We distinguished Gerdes when we affirmed the denial of 
TTD benefits to Mr. Alcorn:

 
 

            
The facts regarding Mr. Alcorn's claim for TTD benefits are 
distinguishable from those presented in Gerdes. Mr. Alcorn's claim for 
retroactive TTD benefits is a claim for initial TTD benefits. It is not a claim 
for a continuation of TTD benefits as was present in Gerdes. The 
applicable statutes and rules are not silent regarding the procedural 
requirements which must be met by a claimant for an initial award of TTD 
benefits. The unambiguous language of the pertinent statutes and rules requires 
timely filing of the TTD claim and certification by a healthcare provider. A 
claimant's failure to file a timely claim limits the Division's opportunity to 
effectively monitor and evaluate a claimant's entitlement to TTD benefits. The 
failure to properly file an initial TTD claim also undermines an employer's 
right to offer light duty work to the employee in lieu of TTD 
benefits. 

 
 

Id., 
¶ 
13, 126 P.3d  at 927-28.   

 
 
[¶29]   Although Ms. Bailey committed a 
different procedural error than Mr. Alcorn, the legal principle is the 
same.  Ms. Bailey failed to file a 
proper initial claim for TTD benefits and the statutes and rules provide that, 
under those circumstances, benefits "shall not be paid."  Section 27-14-404(d).  The same policies for denying benefits 
expressed in Alcorn apply here.  Because the health care provider did not 
fill out the Division's form, the Division and employer did not have information 
necessary to effectively evaluate and monitor Ms. Bailey's qualification for 
benefits and the employer was not provided the opportunity to determine whether 
it could offer her alternative work.  

 
 
 
 
CONCLUSION

 
 
[¶30]   Ms. Bailey did not comply with the 
statutory and regulatory requirements for filing an application of TTD 
benefits.  Her failure to file a 
proper health care provider's certification was fatal to her claim.  The OAH correctly denied her claim for 
TTD benefits.  

 
 
[¶31]   Affirmed.  

FOOTNOTES

 
 

1Ms. Bailey acknowledged that she had received a handbook from the 
Division after she filed her report of injury.   She testified she read the 
handbook, but did not remember that it included information about TTD 
benefits.  Ms. Bailey agreed that 
the handbook included various forms and stated that the TTD application she 
filed was from the handbook.