Opinion ID: 2519638
Heading Depth: 2
Heading Rank: 8

Heading: frivolous or unfair controversion

Text: Mr. Bauder argues that the Board erred by failing to conclude that the workers' compensation administrator frivolously and unfairly controverted his right to benefits. Of the three controversions filed in this case, Mr. Bauder focuses on the controversion of his right to a lump sum payment of permanent partial impairment benefits filed on July 1, 1997. [165] The relevant statute, AS 23.30.155( o ), provides as follows: The board shall promptly notify the division of insurance if the board determines that the employer's insurer has frivolously or unfairly controverted compensation due under this chapter. After receiving notice from the board, the division of insurance shall determine if the insurer has committed an unfair claim settlement practice under AS 21.36.125. [166] The Board considered three arguments supporting the administrator's position that the controversions were not frivolous but only two arguments involve the July 1, 1997 controversion. One of those arguments, that Mr. Bauder committed fraud, was sharply rejected by the Board. [167] The Board found very little evidence of fraud and found that the evidence presented about that investigation was hearsay. [168] But the Board did find that at the time of the controversion, Mr. Bauder was being considered for reemployment benefits. According to the Board, during this evaluation and determination phase for reemployment benefits, an employee is not entitled to receive a lump sum impairment award. [169] Furthermore, the July 1, 1997 controversion did not contest the payment of permanent partial impairment benefits; it just contested a lump sum payment. [170] Therefore, the Board's conclusion that the July 1, 1997 controversion was not frivolous or unfair because it did not deny Mr. Bauder any compensation due under AS 23.30.155( o ) is supported by substantial evidence.